Completion treatment following parenteral therapy for severe falciparum malaria
Forms and strengths
Artesunate (AS) tablets and sulfadoxine/pyrimethamine (SP) tablets, in blister packs, for a complete treatment for one individual
There are 4 different blister packs:
Child < 25 kg: blister pack with 3 tab AS 50 mg and 1 tab SP 500/25 mg
Child25 to < 50 kg: blister pack with 6 tab AS 50 mg and 2 tab SP 500/25 mg
Child≥ 50 kg and adult: blister pack with 12 tab AS 50 mg and 3 tab SP 500/25mg or blister pack with 6 tab AS 100 mg and 3 tab SP 500/25mg
Dosage and duration
Artesunate is administered once daily for 3 days. Sulfadoxine/pyrimethamine is administered as a single dose on D1, with the first dose of artesunate.
Weight
Blister pack
D1
D2
D3
5 to < 10 kg
3 tab AS50 + 1 tab SP
½tab AS + ½ tab SP
½ tab AS
½ tab AS
10 to < 25 kg
3 tab AS50 + 1 tab SP
1tab AS + 1 tab SP
1 tab AS
1 tab AS
25 to < 50 kg
6 tab AS50 + 2 tab SP
2tab AS + 2 tab SP
2 tab AS
2 tab AS
≥ 50 kg and adult
12 tab AS50 + 3 tab SP
4tab AS + 3 tab SP
4 tab AS
4 tab AS
6 tab AS100 + 3 tab SP
2tab AS + 3 tab SP
2 tab AS
2 tab AS
Contra-indications, adverse effects, precautions
Do not administer to patients with allergy to sulfonamides. May cause: see artesunate and sulfadoxine/pyrimethamine. Do not use in combination with co-trimoxazole.
Do not give folic acid on the same day SP is administered, or within 2 weeks thereafter. Pregnancy: CONTRA-INDICATED during the first trimester (risk of neural tube defects); no contra-indication during the 2nd and 3rd trimester
Breast-feeding: no contra-indication
Storage
–Below 30 °C
Leave tablets in blisters until use. Once a tablet is removed from its blister, it must be administered immediately.
If half tablets are used, remaining half tablets may be given to another patient if administered within 24 hours.