1 May 2026Drugs for external use and antiseptics
Artesunate rectal
Rectal artesunate guidance for pre-referral treatment of suspected or confirmed severe malaria in young children.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Antimalarial.
Indications
Pre-referral treatment of suspected or confirmed severe malaria in children less than 6 years, before transfer to a facility where parenteral antimalarial treatment can be administered.
Forms and strengths, route of administration
100 mg rectal capsule.
Dose and duration
10 mg/kg as a single dose before transferring the patient.
- Child 2 months to under 3 years, up to 10 kg: 1 rectal capsule single dose (100 mg).
- Child 3 to under 6 years, up to 20 kg: 2 rectal capsules single dose (200 mg).
Contra-indications, adverse effects, precautions
- May cause gastrointestinal disturbances and headache.
- Buttocks should be held together for at least 1 minute to ensure retention.
- If capsules are expelled from the rectum within 30 minutes of insertion, re-administer the treatment.
- Up to 2 capsules can be administered simultaneously.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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