Drawback of aesunate is:
Because aemisinins are sho acting drugs, monotherapy needs to be extended beyond the disappearance of the parasites to prevent recrudescence. After 5 days treatment recrudescence rate is -10%, while with a 3 day course it is -50%. Recrudescence can be totally prevented by combining 3 day aesunate/aemether with a long acting drug ESSENTIALS OF MEDICAL PHARMACOLOGY page no. 830
Poor bioavailability
Rapid recrudescence of malaria
Hypoglycemia
Hemolysis
Chemotherapy