Injection Falcigo dosage
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Falcigo injection artesunate dosage dosing regimen severe malaria
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Here is the complete dosing information for Injection Falcigo (Artesunate for Injection):
Injection Falcigo (Artesunate) - Dosage
Brand: Falcigo
Generic: Artesunate
Available strengths: Powder for Injection - 60 mg and 120 mg vials
Indication
Treatment of severe malaria (including severe Plasmodium falciparum malaria) - first-line parenteral therapy per WHO and national guidelines.
Dosing Regimen
Adults and Children weighing ≥ 20 kg
| Time | Dose | Route |
|---|---|---|
| 0 h (admission) | 2.4 mg/kg | IV or IM |
| 12 h | 2.4 mg/kg | IV or IM |
| 24 h | 2.4 mg/kg | IV or IM |
| Every 24 h thereafter | 2.4 mg/kg | IV or IM |
Continue until the patient can tolerate oral antimalarial therapy (usually 3 days minimum, then switch to oral).
Children weighing < 20 kg
- 3 mg/kg/dose (higher dose to ensure equivalent drug exposure due to pharmacokinetic differences in small children)
- Same schedule: 0 h, 12 h, 24 h, then once daily
Route of Administration
- Intravenous (IV): Preferred route in severe malaria
- Intramuscular (IM): Used when IV access is not available
Reconstitution (60 mg vial)
- Add 1 mL of 5% sodium bicarbonate to the vial - mix until dissolved (artesunate base)
- Then add 5 mL of 5% dextrose (D5W) or normal saline to make a 10 mg/mL solution
- Administer IV over 1-2 minutes (slow IV push) or as a short infusion
Follow-up Oral Therapy (Mandatory)
After parenteral artesunate, a complete course of oral antimalarial must be given:
- ACT (Artemisinin-based Combination Therapy): e.g., Artemether-Lumefantrine (Coartem) x 3 days
- For P. vivax or P. ovale: add an 8-aminoquinoline (e.g., Primaquine) to cover hypnozoite liver stages
Special Populations
| Population | Adjustment |
|---|---|
| Renal impairment | No dose adjustment required |
| Hepatic impairment | No dose adjustment required |
| Pregnancy | Can be used (benefit outweighs risk in severe malaria) |
Key Points
- Artesunate is the first-line treatment for severe malaria, replacing IV quinine (shown to reduce mortality vs. quinine in AQUAMAT and SEAQUAMAT trials)
- Always follow with oral ACT after parenteral course
- Monitor for post-artesunate delayed haemolysis (PADH) - rare but can occur 1-4 weeks after treatment, especially in high-parasitaemia patients
- Check blood smear 4 hours after the 3rd dose to assess parasite clearance
Sources: WHO Guidelines for treatment of malaria; Medscape artesunate dosing; severemalaria.org; Park's Textbook of Preventive and Social Medicine
Clinical note: This information is for healthcare professionals. Always verify current national malaria treatment guidelines for your region, as recommendations may vary.
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