Artesunate to be diluted in ?
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artesunate IV injection dilution preparation 5% dextrose sodium bicarbonate
Here is the complete, authoritative answer on artesunate dilution:
Artesunate Injection - Reconstitution and Dilution
Step 1: Reconstitution (Activation)
Artesunate powder cannot dissolve in plain water - it must first be reconstituted with:
- 5% Sodium Bicarbonate (1-2 mL, provided as the solvent)
Inject the sodium bicarbonate into the artesunate powder vial and shake until the powder completely dissolves and the solution is clear. Discard if cloudy or a precipitate forms.
Step 2: Dilution (after reconstitution)
The diluent used depends on the route of administration:
| Route | Diluent | Final Concentration |
|---|---|---|
| IV (intravenous) | Add 5 mL of 5% Glucose (Dextrose) OR 0.9% Normal Saline | 10 mg/mL |
| IM (intramuscular) | No further dilution needed (use as reconstituted) | 20 mg/mL |
Key Points
- Water for injection (WFI) alone is NOT an appropriate diluent - artesunate is poorly soluble in plain water and requires the alkaline sodium bicarbonate environment first
- The reconstituted/diluted solution should be used immediately and discarded if not used within 1 hour
- A newer arginine/sodium bicarbonate 1-step formulation (e.g., Argesun) requires only the provided solvent - no further dilution with saline or dextrose is needed
Summary: Artesunate is first reconstituted in 5% Sodium Bicarbonate, then diluted (for IV use) in either 5% Dextrose or 0.9% Normal Saline to give a 10 mg/mL solution for slow IV bolus injection.
(Sources: WHO Prequalified Product monograph; MMV Injectable Artesunate Guidelines; MSF Medical Guidelines)
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