First choice: Combination product artemether/lumefantrine (Riamet®, Coartem®) oral: tablets 20 mg artemether and 120 mg lumefantrine orally.
≥ 35 kg: 4 tablets at T = 0, 8, 24, 36, 48 and 60 hours. Take with fatty food or milk.
Follow-up treatment with primaquine 30 mg/day for 14 days to prevent relapse from the hepatic (liver) stage. Before starting primaquine, promptly exclude G6PD deficiency; do not give in pregnancy or breastfeeding.
Alternative: Chloroquine orally 10 mg/kg once daily for 2 days, followed by chloroquine orally 5 mg/kg as a single dose.
Follow-up treatment with primaquine 30 mg/day for 14 days to prevent relapse from the hepatic (liver) stage. Before starting primaquine, promptly exclude G6PD deficiency; do not give in pregnancy or breastfeeding.
NB1 If in doubt or coming from an area with chloroquine resistance (particularly Southeast Asia): artemether/lumefantrine
NB2 Follow-up treatment of P. vivax and P. ovale with primaquine in SE Asia: 21 days
In severe P. vivax malaria (rare):
Artesunate IV (see dosing for P. falciparum malaria)
P. malariae infection
First choice: Combination product artemether/lumefantrine (Riamet®, Coartem®) oral: tablets of 20 mg artemether and 120 mg lumefantrine orally.
≥ 35 kg: 4 tablets at T = 0, 8, 24, 36, 48 and 60 hours. Take with fatty food or milk.
Alternative: Chloroquine orally 10 mg/kg once daily for 2 days, followed by chloroquine orally 5 mg/kg as a single dose.
P. knowlesi infection
Uncomplicated:
First choice: Combination product artemether/lumefantrine (Riamet®, Coartem®) oral: tablets of 20 mg artemether and 120 mg lumefantrine orally.
≥ 35 kg: 4 tablets at T = 0, 8, 24, 36, 48 and 60 hours. Take with fatty food or milk.
Complicated:
First choice: Artesunate IV, see complicated P. falciparum infection
If species is in doubt, treat as P. falciparum malaria with artemether/lumefantrine or artesunate IV
P. vivax or P. ovale infection
First choice: Combination product artemether/lumefantrine (Riamet®, Coartem®) oral: tablets 20 mg artemether and 120 mg lumefantrine orally.
≥ 35 kg: 4 tablets at T = 0, 8, 24, 36, 48 and 60 hours. Take with fatty food or milk.
Follow-up treatment with primaquine 30 mg/day for 14 days to prevent relapse from the hepatic (liver) stage. Before starting primaquine, promptly exclude G6PD deficiency; do not give in pregnancy or breastfeeding.
Alternative: Chloroquine orally 10 mg/kg once daily for 2 days, followed by chloroquine orally 5 mg/kg as a single dose.
Follow-up treatment with primaquine 30 mg/day for 14 days to prevent relapse from the hepatic (liver) stage. Before starting primaquine, promptly exclude G6PD deficiency; do not give in pregnancy or breastfeeding.
NB1 If in doubt or coming from an area with chloroquine resistance (particularly Southeast Asia): artemether/lumefantrine
NB2 Follow-up treatment of P. vivax and P. ovale with primaquine in SE Asia: 21 days
In severe P. vivax malaria (rare):
Artesunate IV (see dosing for P. falciparum malaria)
P. malariae infection
First choice: Combination product artemether/lumefantrine (Riamet®, Coartem®) oral: tablets of 20 mg artemether and 120 mg lumefantrine orally.
≥ 35 kg: 4 tablets at T = 0, 8, 24, 36, 48 and 60 hours. Take with fatty food or milk.
Alternative: Chloroquine orally 10 mg/kg once daily for 2 days, followed by chloroquine orally 5 mg/kg as a single dose.
P. knowlesi infection
Uncomplicated:
First choice: Combination product artemether/lumefantrine (Riamet®, Coartem®) oral: tablets of 20 mg artemether and 120 mg lumefantrine orally.
≥ 35 kg: 4 tablets at T = 0, 8, 24, 36, 48 and 60 hours. Take with fatty food or milk.
Complicated:
First choice: Artesunate IV, see complicated P. falciparum infection
If species is in doubt, treat as P. falciparum malaria with artemether/lumefantrine or artesunate IV