Bibliographic information
Recommendation
Revised dose recommendation for dihydroartemisinin + piperaquine in young children: Children weighing <25kg treated with dihydroartemisinin + piperaquine should receive a minimum of 2.5 mg/kg bw per day of dihydroartemisinin and 20 mg/ kg bw per day of piperaquine daily for 3 days.
Recommended in favor
Strong
Notes and Remarks
Practical Info Formulations: Currently available as a fixed-dose combination in tablets containing 40 mg dihydroartemisinin and 320 mg piperaquine and paediatric tablets contain 20 mg dihydroartemisinin and 160 mg piperaquine. Target dose and range: A target dose (range) of 4 (2–10) mg/ kg bw per day dihydroartemisinin and 18 (16–27) mg/kg bw per day piperaquine given once a day for 3 days for adults and children weighing ≥ 25 kg. The target doses and ranges for children weighing < 25 kg are 4 (2.5–10) mg/kg bw per day dihydroartemisinin and 24 (20–32) mg/kg bw per day piperaquine once a day for 3 days. Recommended dosage regimen: The dose regimen currently recommended by the manufacturer provides adequate exposure to piperaquine and excellent cure rates (> 95%), except in children < 5 years, who have a threefold increased risk for treatment failure. Children in this age group have significantly lower plasma piperaquine concentrations than older children and adults given the same mg/kg bw dose. Children weighing < 25 kg should receive at least 2.5 mg/kg bw dihydroartemisinin and 20 mg/kg bw piperaquine to achieve the same exposure as children weighing ≥ 25 kg and adults. Dihydroartemisinin + piperaquine should be given daily for 3 days. Body weight (kg) : Dihydroartemisinin + piperaquine dose (mg) given daily for 3 days 5 to < 8 : 20 + 160 8 to < 11 : 30 + 240 11 to < 17 : 40 + 320 17 to < 25 : 60 + 480
Also Featured In
This recommendation also appears in the following guidelines:
Guidelines for the treatment of malaria
WHO guidelines for malaria, 16 February 2021.
WHO guidelines for malaria, 13 July 2021.
WHO guidelines for malaria, 18 February 2022.
WHO guidelines for malaria, 3 June 2022.
WHO guidelines for malaria, 25 November 2022.
WHO Guidelines for malaria, 14 March 2023