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6. Parasitic diseases
F or patients in sh ock: use artesunate I V or, if not av ailab le, quinine I V . T h e
intram uscular route is not appropriate.
artesunate slow IV (2 -3 m inutes) or slow I M into th e anterior th ig h , if I V route is not
possible): 2 .4 m g / kg on ad m ission th en at 1 2 h ours and 2 4 h ours (H 0 , H 1 2 ,
H 2 4 ) th en
once d aily. A d m inister at least 3 d oses, th en, if th e patient can sw allow , ch ang e to oral
route.
A ccord ing to th e route of ad m inistration used : d issolv e th e pow d er (v ial of 6 0 m g artesunate)
w ith 1 m l of 5 % sod ium bicarbonate th en ad d into th e v ial:
• 5 m l of 0 .9 % N aC l to obtain 6 m l of solution containing 1 0 m g of artesunate/ m l, for I V
injection
or
• 2 m l of 0 .9 % N aC l to obtain 3 m l of solution containing 2 0 m g of artesunate/ m l, for I M
injection
IV injection IM injection
A rtesunate solution 1 0 m g / m l A rtesunate solution 2 0 m g / m l
Weight Dose Weight Dose
< 3 kg 0 .8 m l < 3 kg 0 .4 m l 6
3 -4 kg 1 .2 m l 3 -4 kg 0 .6 m l
5 -7 kg 2m l 5 -7 kg 1m l
8 -1 1 kg 8 -1 1 kg 1 .5 m l
1 2 -1 6 kg 3m l 1 2 -1 6 kg
1 7 -2 3 kg 4m l 1 7 -2 3 kg 2m l
2 4 -3 0 kg 6m l 2 4 -3 0 kg 3m l
3 1 -4 0 kg 8m l 4m l
4 1 -5 0 kg 10 m l 3 1 -4 0 kg 5m l
5 1 -6 0 kg 12 m l 4 1 -5 0 kg 6m l
6 1 -7 0 kg 15 m l 5 1 -6 0 kg 7 .5 m l
> 7 0 kg 18 m l 6 1 -7 0 kg 9m l
21 m l > 7 0 kg 1 0 .5 m l
or artemether I M (anterior th ig h ): 3 .2 m g / kg on ad m ission (D 1 ) th en 1 .6 m g / kg
once
d aily. A s soon as th e patient can sw allow , ch ang e to oral route.
Weight 20 mg ampoule artemether 80 mg ampoule artemether
(20 mg/ml, 1 ml) (80 mg/ml, 1 ml)
L oad ing d ose M aintenance d ose L oad ing d ose M aintenance d ose
(3 .2 m g / kg on D 1 ) (1 .6 m g / kg / d ay) (3 .2 m g / kg on D 1 ) (1 .6
m g / kg / d ay)
< 3 kg 0 .5 m l 0 .3 m l – –
3 -4 kg 0 .8 m l 0 .4 m l – –
5 -6 kg 1 .2 m l 0 .6 m l – –
7 -9 kg 1 .6 m l 0 .8 m l – –
1 0 -1 4 kg 2 .5 m l 1 .2 m l - –
1 5 -1 9 kg 3 .2 m l 1 .6 m l - –
2 0 -2 9 kg – – 1 .2 m l 0 .6 m l
3 0 -3 9 kg – – 1 .6 m l 0 .8 m l
4 0 -4 9 kg – – 2m l 1m l
5 0 -5 9 kg – – 2 .5 m l 1 .2 m l
U se a 1 m l syring e g rad uated in 0 .0 1 m l w h en th e d ose required is less th an 1 m l.
F or patients in sh ock: use artesunate I V or, if not av ailab le, quinine I V . T h e
intram uscular route is not appropriate.
artesunate slow IV (2 -3 m inutes) or slow I M into th e anterior th ig h , if I V route is not
possible): 2 .4 m g / kg on ad m ission th en at 1 2 h ours and 2 4 h ours (H 0 , H 1 2 ,
H 2 4 ) th en
once d aily. A d m inister at least 3 d oses, th en, if th e patient can sw allow , ch ang e to oral
route.
A ccord ing to th e route of ad m inistration used : d issolv e th e pow d er (v ial of 6 0 m g artesunate)
w ith 1 m l of 5 % sod ium bicarbonate th en ad d into th e v ial:
• 5 m l of 0 .9 % N aC l to obtain 6 m l of solution containing 1 0 m g of artesunate/ m l, for I V
injection
or
• 2 m l of 0 .9 % N aC l to obtain 3 m l of solution containing 2 0 m g of artesunate/ m l, for I M
injection
IV injection IM injection
A rtesunate solution 1 0 m g / m l A rtesunate solution 2 0 m g / m l
Weight Dose Weight Dose
< 3 kg 0 .8 m l < 3 kg 0 .4 m l 6
3 -4 kg 1 .2 m l 3 -4 kg 0 .6 m l
5 -7 kg 2m l 5 -7 kg 1m l
8 -1 1 kg 8 -1 1 kg 1 .5 m l
1 2 -1 6 kg 3m l 1 2 -1 6 kg
1 7 -2 3 kg 4m l 1 7 -2 3 kg 2m l
2 4 -3 0 kg 6m l 2 4 -3 0 kg 3m l
3 1 -4 0 kg 8m l 4m l
4 1 -5 0 kg 10 m l 3 1 -4 0 kg 5m l
5 1 -6 0 kg 12 m l 4 1 -5 0 kg 6m l
6 1 -7 0 kg 15 m l 5 1 -6 0 kg 7 .5 m l
> 7 0 kg 18 m l 6 1 -7 0 kg 9m l
21 m l > 7 0 kg 1 0 .5 m l
or artemether I M (anterior th ig h ): 3 .2 m g / kg on ad m ission (D 1 ) th en 1 .6 m g / kg
once
d aily. A s soon as th e patient can sw allow , ch ang e to oral route.
Weight 20 mg ampoule artemether 80 mg ampoule artemether
(20 mg/ml, 1 ml) (80 mg/ml, 1 ml)
L oad ing d ose M aintenance d ose L oad ing d ose M aintenance d ose
(3 .2 m g / kg on D 1 ) (1 .6 m g / kg / d ay) (3 .2 m g / kg on D 1 ) (1 .6
m g / kg / d ay)
< 3 kg 0 .5 m l 0 .3 m l – –
3 -4 kg 0 .8 m l 0 .4 m l – –
5 -6 kg 1 .2 m l 0 .6 m l – –
7 -9 kg 1 .6 m l 0 .8 m l – –
1 0 -1 4 kg 2 .5 m l 1 .2 m l - –
1 5 -1 9 kg 3 .2 m l 1 .6 m l - –
2 0 -2 9 kg – – 1 .2 m l 0 .6 m l
3 0 -3 9 kg – – 1 .6 m l 0 .8 m l
4 0 -4 9 kg – – 2m l 1m l
5 0 -5 9 kg – – 2 .5 m l 1 .2 m l
U se a 1 m l syring e g rad uated in 0 .0 1 m l w h en th e d ose required is less th an 1 m l.
