Table 1.
Recommended regimens for the treatment of uncomplicated P. falciparum malaria (various sources) §
| Table 1A: First line regimens | ||||||
|---|---|---|---|---|---|---|
| Compound (not exhaustive) | Manufacturers (not exhaustive) | Formulations | Dosage (adult) | Dosage (child) | Notes | Pregnancy |
| Arthemether-lumefantrine (Riamet ® - Coartem ®) | Novartis/Chinese Academy of Medical Military Sciences/MMV | Tablet (adult) and Dispersible (child): 20mg/120 mg | 4 tablets for 6 doses (0-8-24-36-48-60h) | 5–14 kg: 1 for 6 doses 15–24kg: 2 for 6 doses 25–34kg: 3 for 6 doses (0-8-24-36-48-60h) |
With food Reduced efficacy in Cambodia and border regions of Thailand | II and III trim (I trim only if no alternative regimens) |
| Dihydroartemisi nin–piperaquine (Eurartesim ®) | Sigma-Tau/MMV/Pfizer | Tablet (adult): 320/40 mg Crushed and Dispersible (child): 160/20 mg |
36–74kg: 3 tablets 74–100kg: 4 tablets once daily for 3 days |
5–7 kg: ½ tablets 7–13kg: 1 tablets 24–36kg: 2 tablets once daily for 3 days |
Fasting | II and III trim (I trim only if no alternative regimens) |
| Artesunate–amodiaquine (Coarsucam ®) | Sanofi-Aventis/DNDi/MMV) | Dispersible tablet: 25/67.5 mg 50/135 mg 100/270 mg |
>36 kg 200/540mg once daily for 3 days (4/10mg/kg) |
4.5–9 kg: 25/67.5 mg 9–18 kg: 50/135 mg 18–36kg: 100/270 mg once daily for 3 days |
Not with high fatty food | only if no alternative regimens |
| Artesunate–mefloquine (Artequin ®, Mefliam-plus®) | Mepha, ASMQ; Farmanguinhos/ DNDi/Cipla | Crushed tablet: 25/55(=50) mg 100/220 (=200) mg |
200/440mg once daily for 3 days |
5–8 kg: 25/55mg 9–17kg: 50/110mg 18–29kg: 100/220mg >29kg: 200/440mg once daily for 3 days |
With food | II and III trim (I trim only if no alternative regimens) |
| Artesunate–sulfadoxine–pyrimethamine (Altinate ®, Larinate ®, Artescope ®) | Allenge, Intima, Guilin | Tablets, various co-formulations | Artesunate 4 mg/kg/day for 3 days Sulfadoxine/pyrimetamine 25/1.25 mg/kg on day 1 |
II and III trim | ||
| Atovaquone-proguanil (Malarone ®) | GlaxoSmithKline | Tablet (adult): 250/100 mg Tablet (child): 62.5/25 mg |
4 tablets once daily for 3 days |
5–8kg: 1 tablet 62.5/25 9–10Kg: 2 tablets “ “ 11–20Kg: 1 tablet 250/100 21–30kg: 2 tablets “ “ 31–40kg: 3 tablets “ “ >40 kg: 4 tablets “ “ |
With fatty meal. Use for travellers | Only if no alternative regimens available |
| Table 1B: First line regimens (various sources) | ||||||
| Compound (not exhaustive) | Manufacturers (not exhaustive) | Formulations | Dosage (adult) | Dosage (child) | Notes | Pregnancy |
| Quinine^ + Clindamycin | 10mg/kg thrice daily + 10mg/kg thrice daily for 7 days |
10mg/kg thrice daily + 10mg/kg thrice daily for 7 days |
Off-label use | OK | ||
| Quinine^ + Doxycycline | 10mg/kg thrice daily + 200 mg daily for 7 days |
Contraindicated if <8 years | Off-label use | Controindicated | ||
| Mefloquine (Lariam ®, Mephaquin ® or Mefliam ®) | Roche, Mepha, Cipla | Tablet: 250mg | 45–60kg: 5 tablets (3+2) >60kg: 6 tablets (3+2+1) 6–8 hours apart |
20–25mg/kg divided in 1–3 doses 6 hours apart: 5–10 kg: ½–1 tablet 10–20kg: 1–2 tablets 20–30kg: 2–3 tablets 30–45kg: 3–4 tablets |
With food Not suitable for SE-Asia | II and III trim; I trim only if no alternative regimens |
§
: please refer to drug package instruction before use
^
Dosages are for Quinine dihydrocloride. Equivalent doses for available quinine salts are as follow: quinine base 100 mg= quinine bisulfate 169 mg= quinine dihydrochloride 122 mg= quinine hydrochloride 111 mg=quinine sulfate 121 mg=quinine gluconate 160 mg.