# Artesunate in Nigeria

- Source: https://ogbogwu.com/drugs/artesunate/
- Drug class: Antimalarial (Artemisinin) (Antimalarials)
- Also known as: Arinate, Artesunate injection, Malaria injection
- Prescription required: yes
- On the WHO Model List of Essential Medicines
- Last updated: August 2026

## Price in Nigeria

Injectable artesunate mostly moves through hospital pharmacies and wholesale channels rather than the online retail listings we sample, which is why no naira figure appears here. In public facilities, severe-malaria treatment is often covered or subsidised under malaria programmes; in private hospitals the drug is billed with administration. For wholesale quantities, quotes come per vial strength (30mg, 60mg, 120mg) from registered distributors — tell us what you need and we'll connect you with one.

## What is Artesunate?

Artesunate is a powerful antimalarial drug derived from artemisinin, which comes from the sweet wormwood plant (Artemisia annua). It is the drug of choice for treating severe and complicated malaria, a life-threatening condition that kills thousands of Nigerians every year, particularly children under five. Injectable artesunate (given through a vein or into the muscle) has replaced quinine as the first-line treatment for severe malaria because it works faster, is easier to administer, and significantly reduces the risk of death compared to quinine. The World Health Organization and the Nigerian Federal Ministry of Health both recommend injectable artesunate as the gold standard for severe malaria.

In Nigeria, where malaria is the leading cause of death in children and a major cause of illness across all age groups, artesunate injection is a critical life-saving medicine found in hospitals and health centres across the country. When a patient is brought in with high fever, convulsions, severe anaemia, or other signs of complicated malaria, artesunate injection is typically the first drug administered. It works rapidly to reduce the number of malaria parasites in the blood, often showing improvement within hours. After the patient stabilises and can take oral medications, they are usually switched to a full course of an oral ACT like Artemether-Lumefantrine to complete the treatment.

Artesunate is also available as oral tablets and rectal suppositories. The oral tablet form is used as part of combination therapy for uncomplicated malaria, while the rectal suppository is particularly important in rural Nigeria where patients with severe malaria may need pre-referral treatment before they can reach a hospital. If a child in a village develops severe malaria and the nearest hospital is hours away, a single rectal dose of artesunate can be given as an emergency measure while transporting the child to a facility with proper care.

## What is Artesunate used for?

- First-line treatment of severe and complicated Plasmodium falciparum malaria (injection)
- Pre-referral emergency treatment for severe malaria when hospital transfer is needed
- Treatment of malaria in patients who cannot take oral medication due to vomiting or unconsciousness
- Component of oral combination therapy for uncomplicated malaria (tablet form)
- Rectal pre-referral treatment in children under 6 years with severe malaria in remote areas

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: For severe malaria (injection): 2.4 mg/kg body weight given intravenously (IV) or intramuscularly (IM) at 0, 12, and 24 hours, then once daily until the patient can take oral medication. Minimum of 3 parenteral doses should be given before switching to oral ACT. For oral treatment (as part of combination therapy): 4 mg/kg once daily for 3 days combined with a partner drug like amodiaquine or mefloquine.
- Children: For severe malaria (injection): Children weighing 20 kg or less receive 3 mg/kg per dose; children over 20 kg receive 2.4 mg/kg per dose. Same timing as adults (0, 12, 24 hours then daily). Rectal suppository (pre-referral): 10 mg/kg as a single dose, then refer to hospital immediately. The child must still receive full treatment at the hospital.
- Elderly: Same weight-based dosing as adults. Monitor closely for renal function and haemolysis, particularly post-treatment haemolytic anaemia which can occur 1-3 weeks after treatment.

Injectable artesunate must be administered by a trained healthcare worker in a hospital or health facility setting. Do not attempt to give injections at home. After a minimum of 24 hours of parenteral treatment (at least 3 doses) and once the patient can tolerate oral medication, switch to a full 3-day course of an oral ACT such as Artemether-Lumefantrine to complete the treatment. Blood tests should be monitored after treatment for signs of delayed haemolysis.

## Side effects

Common: Delayed haemolytic anaemia (drop in blood level occurring 1-3 weeks after treatment); Dizziness and headache; Nausea and vomiting; Darkened urine; Fatigue and general body weakness; Abdominal pain; Mild diarrhoea; Pain at injection site (for IM injection).

Serious (seek medical help immediately): Post-artesunate delayed haemolysis (PADH) causing significant anaemia requiring blood transfusion; Severe allergic reaction (anaphylaxis); Neutropenia (low white blood cell count); Hepatotoxicity (liver damage with jaundice); Prolonged QT interval and cardiac arrhythmias; Reticulocytopenia (reduced production of new red blood cells).

When to see a doctor: Return to the hospital immediately if you notice dark or coca-cola-coloured urine, excessive tiredness or pale appearance (signs of anaemia), yellowing of the eyes or skin, fever returning within 28 days of treatment, difficulty breathing, or severe weakness after completing treatment. It is especially important to have a blood test done 7 and 14 days after treatment with injectable artesunate to check for delayed anaemia, which is a known complication.

## Warnings

Do not take if: Known hypersensitivity to artesunate or other artemisinin derivatives; First trimester of pregnancy (except in life-threatening severe malaria where no safer alternative exists); Patients with known severe cardiac conduction abnormalities.

Interactions: Mefloquine: increased risk of neuropsychiatric side effects when used together; Ritonavir and nevirapine (antiretroviral drugs): may reduce artesunate effectiveness; Drugs that prolong the QT interval should be used with caution; Avoid combination with other nephrotoxic or hepatotoxic drugs; Rifampicin may reduce blood levels of artesunate.

Pregnancy & breastfeeding: Injectable artesunate should generally be avoided in the first trimester of pregnancy. However, in cases of severe malaria that threaten the mother's life, artesunate can be used at any stage of pregnancy because severe malaria itself carries a very high risk of death for both mother and baby. In the second and third trimesters, artesunate is considered safe and is the recommended treatment for severe malaria in pregnancy. Artesunate is excreted in breast milk in small amounts but is considered compatible with breastfeeding. Always inform the doctor treating you if you are pregnant or breastfeeding.

## Brands in Nigeria

Well-known NAFDAC-registered brands: Arinate (Dafra Pharma); Falcimon (Emcure Pharmaceuticals, made in India).
Full searchable brand list: https://ogbogwu.com/drugs/artesunate/brands/

## How to verify it is genuine

1. Check for the NAFDAC registration number printed clearly on the vial, ampoule, or pack. Verify this number on the NAFDAC website (www.nafdac.gov.ng) or by contacting a NAFDAC office.
2. Use the NAFDAC Mobile Authentication Service (MAS): scratch the panel on the pack and send the code via SMS to the number provided to verify authenticity.
3. Injectable artesunate should only be purchased and administered through hospitals, health centres, or licensed pharmacies. Never buy injectable medicines from open markets or unlicensed vendors.
4. Check that the powder for injection is white or off-white and dissolves clearly when reconstituted. Any discolouration, particles, or unusual appearance should raise suspicion.
5. Verify the manufacturer details, batch number, manufacturing date, and expiry date on the packaging. The WHO-prequalified brand by Guilin Pharmaceutical of China is widely regarded as the gold standard for injectable artesunate.

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### How much is artesunate injection in Nigeria?

There is no single street price worth quoting, and be wary of anyone who gives you one without asking the dose: artesunate injection comes as 60mg and 120mg vials, a severe-malaria course uses at least three doses calculated by body weight, and the medicine is given in a clinic or hospital — so the real bill is vials plus administration and monitoring. Public facilities often supply it free or heavily subsidised under the national malaria programme, which is the first place to ask. What matters more than price: severe malaria is an emergency, injectable artesunate is the treatment that saves lives, and a 'malaria injection' bought informally for home use is both dangerous and a counterfeit magnet. Registered brands and their NAFDAC numbers are listed on this page — verify before anyone pays.

### Is artesunate injection NAFDAC approved in Nigeria?

Yes, several brands of artesunate injection are registered and approved by NAFDAC for use in Nigeria. These include Arinate by Meditab Specialities (NAFDAC Reg. No. 04-5808) and others. Always check for the NAFDAC registration number on the packaging and verify it using the NAFDAC MAS scratch code. Because injectable medicines are a frequent target for counterfeiters, it is critical to only obtain artesunate injection from hospitals and licensed pharmacies.

### Why did artesunate replace quinine for treating severe malaria?

Artesunate replaced quinine as the first-line treatment for severe malaria because large clinical trials (particularly the SEAQUAMAT and AQUAMAT trials) showed that artesunate reduces the risk of death from severe malaria by 22.5% in adults and 22.5% in children compared to quinine. Artesunate also works faster to clear malaria parasites, is easier and safer to administer (quinine requires slow, carefully monitored IV infusion and can cause dangerous drops in blood sugar and heart rhythm problems), and has fewer side effects. Since these findings, the WHO and Nigeria's Federal Ministry of Health have recommended injectable artesunate as the standard of care for severe malaria.

### Can I use artesunate tablets at home to treat malaria?

Artesunate tablets should not be used alone (as monotherapy) to treat malaria, as this can promote drug resistance. If you are using oral artesunate, it must be combined with a partner drug such as amodiaquine as part of an ACT regimen. However, in Nigeria, the more commonly available and recommended oral ACTs are Artemether-Lumefantrine (Coartem/Lonart) and Dihydroartemisinin-Piperaquine (P-Alaxin), which come as fixed-dose combinations and are easier to use correctly. Injectable artesunate is strictly for hospital use and must be given by a trained health worker.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- WHO Model List of Essential Medicines
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)