Artesunate (AS)

Artesunate is part of the artemisinin group of drugs that treat malaria. It is a semi-synthetic derivative of artemisinin that is water-soluble and may therefore be given by injection. Artesunate is generally safe and well-tolerated. The best recognised side effect of the artemesinins that they lower reticulocyte counts. This is not usually of clinical relevance. Delayed haemolysis (occurring around two weeks after treatment) has been observed in patients treated with artesunate for severe malaria. Whether or not this haemolysis is due to artesunate, or to the malaria itself is unclear. The safety of artesunate in pregnancy is unclear. There is evidence of embryotoxicity in animal models (defects in long bones and ventricular septal defects in the heart in rates and monkeys). However, observational evidence from 123 human first-trimester pregnancies showed no evidence of damage to the fetus.