Under the National Vector Borne Disease Control Programme (NVBDCP), what is the recommended dosage of artemether for severe malaria in adults?

Explanation

## Artemether Dosing in Severe Malaria (NVBDCP Guidelines) **Key Point:** Under NVBDCP guidelines, artemether is used as a parenteral artemisinin derivative for severe malaria when IV artesunate is unavailable or oral therapy is not feasible. The recommended adult dose is **80 mg intramuscularly once daily for a minimum of 3 days**. ### Dosage Schedule - **Artemether (Adults):** 80 mg IM once daily for a minimum of 3 days - **Artemether (Children):** 3.2 mg/kg on day 1, then 1.6 mg/kg once daily - After parenteral therapy, must be followed by a complete course of oral artemisinin-based combination therapy (ACT) — typically artemether-lumefantrine or artesunate-amodiaquine ### Clinical Context **High-Yield:** Per the NVBDCP Drug Policy and WHO Severe Malaria Treatment Guidelines, the adult IM artemether dose is 80 mg/day (not 120 mg/day). The 120 mg figure is incorrect and does not correspond to any standard guideline. The switch from parenteral to oral ACT is mandatory once the patient can tolerate oral medication. **Clinical Pearl:** While IV artesunate (2.4 mg/kg at 0, 12, 24 hours, then daily) is the WHO/NVBDCP first-line agent for severe malaria, artemether 80 mg IM once daily is the recommended alternative when artesunate is unavailable — as per the NVBDCP Malaria Treatment Guidelines and WHO Guidelines for the Treatment of Malaria (3rd edition, 2015). ### Why 80 mg and Not Other Doses? - 80 mg/day corresponds to approximately 1.6 mg/kg for a 50 kg adult, consistent with the weight-based dosing recommendation - 120 mg, 160 mg, and 200 mg are not supported by any standard NVBDCP or WHO guideline for artemether IM dosing in adults **Reference:** WHO Guidelines for the Treatment of Malaria, 3rd Edition (2015); NVBDCP Drug Policy for Treatment of Malaria in India.