DHA/PPQ Oral: Malaria Dosing and Precautions
Dihydroartemisinin and piperaquine guidance for uncomplicated malaria and post-parenteral completion therapy, with weight-based 3-day dosing.
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Guide category
Oral drugs
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Prescription medicine information for clinician-guided use.
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Therapeutic action
Antimalarial.
Indications
- Treatment of uncomplicated falciparum malaria.
- Treatment of uncomplicated malaria due to other Plasmodium species when chloroquine cannot be used.
- Completion treatment following parenteral therapy for severe malaria.
Forms and strengths
Co-formulated tablets of dihydroartemisinin and piperaquine in blister packs for a complete treatment for one individual.
There are 5 different blister packs.
- 20 mg DHA/160 mg PPQ tablets, blister pack of 3 tablets.
- 40 mg DHA/320 mg PPQ tablets, blister pack of 3 tablets.
- 40 mg DHA/320 mg PPQ tablets, blister pack of 6 tablets.
- 40 mg DHA/320 mg PPQ tablets, blister pack of 9 tablets.
- 40 mg DHA/320 mg PPQ tablets, blister pack of 12 tablets.
Dose and duration
Child 5 to < 25 kg: 2.5 to 10 mg/kg daily of DHA and 20 to 32 mg/kg daily of PPQ.
Child 25 kg and over and adult: 2 to 10 mg/kg daily of DHA and 16 to 27 mg/kg daily of PPQ.
Tablets are to be taken once daily for 3 days.
Weight-based dosing
- 5 to < 8 kg: 1 tablet of 20 mg/160 mg.
- 8 to < 11 kg: 1 1/2 tablets of 20 mg/160 mg.
- 11 to < 17 kg: 1 tablet of 40 mg/320 mg.
- 17 to < 25 kg: 1 1/2 tablets of 40 mg/320 mg.
- 25 to < 36 kg: 2 tablets of 40 mg/320 mg.
- 36 to < 60 kg: 3 tablets of 40 mg/320 mg.
- 60 to < 80 kg: 4 tablets of 40 mg/320 mg.
- >= 80 kg: 5 tablets of 40 mg/320 mg.
Contra-indications, adverse effects, precautions
- Do not administer in the event of cardiac disorders such as bradycardia, heart rhythm disorders, or congestive heart failure.
- Do not combine with drugs that prolong the QT interval such as amiodarone, other antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, and ondansetron.
- Administer with caution to patients over 60 years or with renal or hepatic impairment.
- May cause cardiac disorders including QT prolongation and tachycardia; rarely gastrointestinal disturbances, pruritus, hepatic disorders, and joint and muscle pain.
- Monitor combination with antiretrovirals and enzyme inducers such as rifampicin, carbamazepine, phenytoin, and phenobarbital.
- If the patient vomits within 30 minutes after administration, re-administer the full dose.
- If the patient vomits between 30 minutes and 1 hour after administration, re-administer half of the dose.
- Pregnancy: no contra-indication.
- Breast-feeding: no contra-indication.
Dosage and duration
| Weight | 20 mg/160 mg tablet | 40 mg/320 mg tablet |
|---|---|---|
| 5 to < 8 kg | 1 tab | - |
| 8 to < 11 kg | 1½ tab | - |
| 11 to < 17 kg | - | 1 tab |
| 17 to < 25 kg | - | 1½ tab |
| 25 to < 36 kg | - | 2 tab |
| 36 to < 60 kg | - | 3 tab |
| 60 to < 80 kg | - | 4 tab |
| ≥ 80 kg | - | 5 tab |
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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