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Key Facts
- Drug Class
- Antimalarial (Artemisinin)
- Prescription
- Required
- NAFDAC Status
- NAFDAC Registered
- Forms
- Injection, Tablet, Rectal suppository
- Price Range
- ₦500 - ₦8,000
- WHO Essential
- Yes
What is Artesunate?
Artesunate is a powerful antimalarial drug derived from artemisinin, which comes from the sweet wormwood plant (Artemisia annua). It is the drug of choice for treating severe and complicated malaria, a life-threatening condition that kills thousands of Nigerians every year, particularly children under five. Injectable artesunate (given through a vein or into the muscle) has replaced quinine as the first-line treatment for severe malaria because it works faster, is easier to administer, and significantly reduces the risk of death compared to quinine. The World Health Organization and the Nigerian Federal Ministry of Health both recommend injectable artesunate as the gold standard for severe malaria.
In Nigeria, where malaria is the leading cause of death in children and a major cause of illness across all age groups, artesunate injection is a critical life-saving medicine found in hospitals and health centres across the country. When a patient is brought in with high fever, convulsions, severe anaemia, or other signs of complicated malaria, artesunate injection is typically the first drug administered. It works rapidly to reduce the number of malaria parasites in the blood, often showing improvement within hours. After the patient stabilises and can take oral medications, they are usually switched to a full course of an oral ACT like Artemether-Lumefantrine to complete the treatment.
Artesunate is also available as oral tablets and rectal suppositories. The oral tablet form is used as part of combination therapy for uncomplicated malaria, while the rectal suppository is particularly important in rural Nigeria where patients with severe malaria may need pre-referral treatment before they can reach a hospital. If a child in a village develops severe malaria and the nearest hospital is hours away, a single rectal dose of artesunate can be given as an emergency measure while transporting the child to a facility with proper care.
What is Artesunate used for?
In Nigeria, Artesunate is commonly used for:
- First-line treatment of severe and complicated Plasmodium falciparum malaria (injection)
- Pre-referral emergency treatment for severe malaria when hospital transfer is needed
- Treatment of malaria in patients who cannot take oral medication due to vomiting or unconsciousness
- Component of oral combination therapy for uncomplicated malaria (tablet form)
- Rectal pre-referral treatment in children under 6 years with severe malaria in remote areas
Dosage
IMPORTANT
Always follow your doctor's or pharmacist's instructions. The information below is for general reference only.
Adults
For severe malaria (injection): 2.4 mg/kg body weight given intravenously (IV) or intramuscularly (IM) at 0, 12, and 24 hours, then once daily until the patient can take oral medication. Minimum of 3 parenteral doses should be given before switching to oral ACT. For oral treatment (as part of combination therapy): 4 mg/kg once daily for 3 days combined with a partner drug like amodiaquine or mefloquine.
Children
For severe malaria (injection): Children weighing 20 kg or less receive 3 mg/kg per dose; children over 20 kg receive 2.4 mg/kg per dose. Same timing as adults (0, 12, 24 hours then daily). Rectal suppository (pre-referral): 10 mg/kg as a single dose, then refer to hospital immediately. The child must still receive full treatment at the hospital.
Elderly
Same weight-based dosing as adults. Monitor closely for renal function and haemolysis, particularly post-treatment haemolytic anaemia which can occur 1-3 weeks after treatment.
Injectable artesunate must be administered by a trained healthcare worker in a hospital or health facility setting. Do not attempt to give injections at home. After a minimum of 24 hours of parenteral treatment (at least 3 doses) and once the patient can tolerate oral medication, switch to a full 3-day course of an oral ACT such as Artemether-Lumefantrine to complete the treatment. Blood tests should be monitored after treatment for signs of delayed haemolysis.
Side Effects
Common side effects
- •Delayed haemolytic anaemia (drop in blood level occurring 1-3 weeks after treatment)
- •Dizziness and headache
- •Nausea and vomiting
- •Darkened urine
- •Fatigue and general body weakness
- •Abdominal pain
- •Mild diarrhoea
- •Pain at injection site (for IM injection)
Serious side effects — seek medical help immediately
- Post-artesunate delayed haemolysis (PADH) causing significant anaemia requiring blood transfusion
- Severe allergic reaction (anaphylaxis)
- Neutropenia (low white blood cell count)
- Hepatotoxicity (liver damage with jaundice)
- Prolonged QT interval and cardiac arrhythmias
- Reticulocytopenia (reduced production of new red blood cells)
When to see a doctor
Return to the hospital immediately if you notice dark or coca-cola-coloured urine, excessive tiredness or pale appearance (signs of anaemia), yellowing of the eyes or skin, fever returning within 28 days of treatment, difficulty breathing, or severe weakness after completing treatment. It is especially important to have a blood test done 7 and 14 days after treatment with injectable artesunate to check for delayed anaemia, which is a known complication.
Warnings & Precautions
Do not take Artesunate if you have:
- Known hypersensitivity to artesunate or other artemisinin derivatives
- First trimester of pregnancy (except in life-threatening severe malaria where no safer alternative exists)
- Patients with known severe cardiac conduction abnormalities
Drug interactions
- •Mefloquine: increased risk of neuropsychiatric side effects when used together
- •Ritonavir and nevirapine (antiretroviral drugs): may reduce artesunate effectiveness
- •Drugs that prolong the QT interval should be used with caution
- •Avoid combination with other nephrotoxic or hepatotoxic drugs
- •Rifampicin may reduce blood levels of artesunate
Pregnancy & Breastfeeding
Injectable artesunate should generally be avoided in the first trimester of pregnancy. However, in cases of severe malaria that threaten the mother's life, artesunate can be used at any stage of pregnancy because severe malaria itself carries a very high risk of death for both mother and baby. In the second and third trimesters, artesunate is considered safe and is the recommended treatment for severe malaria in pregnancy. Artesunate is excreted in breast milk in small amounts but is considered compatible with breastfeeding. Always inform the doctor treating you if you are pregnant or breastfeeding.
NAFDAC-Registered Brands of Artesunate in Nigeria
3 brands registered with NAFDAC as of 2026-02-01.
| Brand Name | Manufacturer | Strength | Form | NAFDAC Reg. No. |
|---|---|---|---|---|
| Artesunate | Guilin Pharmaceutical | 60mg injection | Injection | A4-3421 |
| Arinate | Swiss Pharma Nigeria | 60mg injection, 50mg tablet, 100mg tablet | Injection | A4-6721 |
| Falcimon | Emcure Pharmaceuticals | 60mg injection, 100mg tablet | Injection | B4-1234 |
How to Verify Your Artesunate is Genuine
- 1Check for the NAFDAC registration number printed clearly on the vial, ampoule, or pack. Verify this number on the NAFDAC website (www.nafdac.gov.ng) or by contacting a NAFDAC office.
- 2Use the NAFDAC Mobile Authentication Service (MAS): scratch the panel on the pack and send the code via SMS to the number provided to verify authenticity.
- 3Injectable artesunate should only be purchased and administered through hospitals, health centres, or licensed pharmacies. Never buy injectable medicines from open markets or unlicensed vendors.
- 4Check that the powder for injection is white or off-white and dissolves clearly when reconstituted. Any discolouration, particles, or unusual appearance should raise suspicion.
- 5Verify the manufacturer details, batch number, manufacturing date, and expiry date on the packaging. The WHO-prequalified brand by Guilin Pharmaceutical of China is widely regarded as the gold standard for injectable artesunate.
Artesunate Price in Nigeria
Artesunate prices in Nigeria typically range from ₦500 to ₦8,000 per vial or pack, depending on the brand, strength, and where you buy it.
₦500 – ₦8,000
per vial or pack
Prices vary by location and vendor. Last updated: 2026-02-01
Where to Buy
Purchase Artesunate only from licensed pharmacies and verified distributors. Avoid buying medicines from unverified sources, roadside vendors, or unregistered market stalls.
Frequently Asked Questions
Sources
- •NAFDAC Greenbook — National Agency for Food and Drug Administration and Control registered products database
- •WHO Model List of Essential Medicines (23rd List, 2023)
- •British National Formulary (BNF)
- •Nigerian Standard Treatment Guidelines