Formulations available | Body weight (kg) | Dose* | |
Artemether-lumefantrineΔ | Available as tablets containing | Dose administered orally twice daily for three days: | |
5 to <15 | 20 + 120 mg | ||
15 to <25 | 40 + 240 mg | ||
25 to <35 | 60 + 360 mg | ||
≥35 | 80 + 480 mg | ||
Dihydroartemisinin-piperaquine◊ | Available as tablets containing 20 + 160 mg or 40 + 320 mg of dihydroartemisinin and piperaquine, respectively. | Dose administered orally once daily for three days: | |
5 to <8 | 20 + 160 mg | ||
8 to <11 | 30 + 240 mg | ||
11 to <17 | 40 + 320 mg | ||
17 to <25 | 60 + 480 mg | ||
25 to <36 | 80 + 640 mg | ||
36 to <60 | 120 + 960 mg | ||
60 to <80 | 160 + 1280 mg | ||
≥80 | 200 + 1600 mg | ||
Artesunate-mefloquine | Available as tablets containing 25 + 55 mg or 100 + 220 mg of artesunate and mefloquine hydrochloride, respectively§. | Dose administered orally once daily for three days: | |
5 to <9 | 25 + 55 mg | ||
9 to <18 | 50 + 110 mg | ||
18 to <30 | 100 + 220 mg | ||
≥30 | 200 + 440 mg | ||
Artesunate-pyronaridine tetraphosphate¥ | Available as tablets containing | Dose administered orally once daily for three days: | |
5 to <8 | 20 + 60 mg (1 sachet)‡ | ||
8 to <15 | 40 + 220 mg (2 sachets)‡ | ||
15 to <24 | 60 + 180 mg (3 sachets or 1 tablet)‡ | ||
24 to <45 | 120 + 360 mg (2 tablets) | ||
45 to <65 | 180 + 540 mg (3 tablets) | ||
≥65 | 240 + 720 mg (4 tablets) | ||
Artesunate-amodiaquine | Available as tablets containing 25 + 67.5 mg, 50 + 135 mg, or 100 + 270 mg of artesunate and amodiaquine, respectively. | Dose administered orally once daily for three days: | |
4.5 to <9 | 25 + 67.5 mg | ||
9 to <18 | 50 + 135 mg | ||
18 to <36 | 100 + 270 mg | ||
≥36 | 200 + 540 mg |
Where available, the dosing regimens listed in this table are consistent with the World Health Organization 2022 guidelines for the treatment of malaria and may differ from dosing recommended in approved product information. Product availability varies by locality.
NOTE: Products listed in this table are not commercially available in the United States except for artemether-lumefantrine (20 + 120 mg) tablets.DP: dihydroartemisinin-piperaquine.
* In general, the course of ACT is administered for three days. In areas of artemisinin resistance, a six-day course of treatment is warranted.
¶ For treatment of infection due to Plasmodium vivax and Plasmodium ovale, presumptive antirelapse therapy to eradicate the hypnozoite liver stages should be administered after normal glucose-6-phosphate dehydrogenase (G6PD) status has been confirmed; options for antirelapse therapy include primaquine or tafenoquine. Refer to UpToDate topics for further discussion.
Δ Take after a full meal or whole milk. If patient vomits within 30 minutes of taking a dose, then they should repeat the dose. Ideally, the first two doses should be taken 8 hours apart.
◊ Piperaquine prolongs the QT interval by approximately the same amount as chloroquine but by less than quinine. DP should not be used in patients with congenital QT prolongation or who are on medications that prolong the QT interval. DP may be taken with food but should not be taken with a high-fat meal.
§ Mefloquine hydrochloride (55 mg) is equivalent to mefloquine base (50 mg); mefloquine hydrochloride (220 mg) is equivalent to mefloquine base (200 mg).
¥ If the patient vomits within 30 minutes of taking a dose, he or she should repeat the dose.
‡ Dosage recommendations are for Pyramax 180 mg/60 mg tablet and granules for oral suspension[1]. Mix the required number of sachets (packets) for oral suspension with 10 mL of water in a small cup until the granules are suspended evenly and administer immediately. Tablets and the oral suspension may be taken with or without food.Data from: World Health Organization. Guidelines for malaria. Geneva 2022.
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