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Table 3 Recommended oral treatment for severe falciparum malaria after initial parenteral therapy for at least 24 hours when clinical improvement is evident and the patient can tolerate oral medication

From: Clinical review: Severe malaria





80 mg arthemeter/480 mg lumefantrin once daily for 3 days

Well tolerated, faster parasite clearance, but longer fever resolution time


1000 mg atovaquone/400 mg proguanil at 0, 8, 24, 36, 48 and 60 hours

Well tolerated, more effective than mefloquine in treatment of multidrug-resistant falciparum malaria


15 mg/kg (750 mg) base at 0 hours, followed by10 mg/kg (500 mg) base at 6–8 hours, and (if >60 kg) followed by 5 mg/kg (250 mg) at 16 hours

Contraindicated in persons with seizure or psychiatric disorders, or with cardiac conduction abnormalities

Quinine (sulfate salt)

10 mg salt/kg (600–650 mg) every 8 hours to complete7 days of treatment (total duration)

Side effects include cinchonism and pruritus