1 May 2026Potentially dangerous, obsolete, or ineffective

Artesunate + sulfadoxine/pyrimethamine = AS + SP oral

Artesunate plus sulfadoxine-pyrimethamine guidance for falciparum malaria, with blister-pack dosing by weight.

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

Treatment of uncomplicated falciparum malaria.
Completion treatment following parenteral therapy for severe falciparum malaria.

Forms and strengths

Artesunate tablets and sulfadoxine/pyrimethamine tablets in blister packs for a complete treatment for one individual.

Child under 25 kg: blister pack with 3 tablets AS 50 mg and 1 tablet SP 500/25 mg.

Child 25 to under 50 kg: blister pack with 6 tablets AS 50 mg and 2 tablets SP 500/25 mg.

Child 50 kg and over and adult: blister pack with 12 tablets AS 50 mg and 3 tablets SP 500/25 mg, or blister pack with 6 tablets AS 100 mg and 3 tablets SP 500/25 mg.

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.

5 to under 10 kg: D1 = half tablet AS 50 mg plus half tablet SP; D2 = half tablet AS 50 mg; D3 = half tablet AS 50 mg.
10 to under 25 kg: D1 = 1 tablet AS 50 mg plus 1 tablet SP; D2 = 1 tablet AS 50 mg; D3 = 1 tablet AS 50 mg.
25 to under 50 kg: D1 = 2 tablets AS 50 mg plus 2 tablets SP; D2 = 2 tablets AS 50 mg; D3 = 2 tablets AS 50 mg.
50 kg and over and adult with 12-tablet AS 50 mg pack: D1 = 4 tablets AS 50 mg plus 3 tablets SP; D2 = 4 tablets AS 50 mg; D3 = 4 tablets AS 50 mg.
50 kg and over and adult with 6-tablet AS 100 mg pack: D1 = 2 tablets AS 100 mg plus 3 tablets SP; D2 = 2 tablets AS 100 mg; D3 = 2 tablets AS 100 mg.

Artesunate plus sulfadoxine/pyrimethamine dosing by weight

Weight	Blister pack	D1	D2	D3
5 to < 10 kg	3 tab AS50 + 1 tab SP	½ tab AS + ½ tab SP	½ tab AS	½ tab AS
10 to < 25 kg	3 tab AS50 + 1 tab SP	1 tab AS + 1 tab SP	1 tab AS	1 tab AS
25 to < 50 kg	6 tab AS50 + 2 tab SP	2 tab AS + 2 tab SP	2 tab AS	2 tab AS
≥ 50 kg and adult	12 tab AS50 + 3 tab SP	4 tab AS + 3 tab SP	4 tab AS	4 tab AS
	6 tab AS100 + 3 tab SP	2 tab 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 the adverse effects described for 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: contraindicated during the first trimester; no contra-indication during the second and third trimester.
Breast-feeding: no contra-indication.

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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