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Primaquine

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Primaquine

  • See Also
  1. Tafenoquine
  2. Malaria
  • Indications
  1. Malaria Prophylaxis in regions with Plasmodium Vivax transmission
    1. Postexposure prevention for "relapsing" Malaria
    2. Eradication of Malaria liver involvement
  • Contraindications
  1. G6PD Deficiency
    1. Results in acute Hemolysis
  • Mechanism
  1. Synthetic, 8-aminoquinoline derivative
  2. Activate against tissue Malarial infection including late liver stages (hypnozoites, schizonts)
  3. Binds Protozoal DNA, and cross-links glutathione
  • Medications
  1. Primaquine Phosphate Tablets 15 mg base (26.3 mg salt)
    1. Base 0.57 mg = Salt 1 mg
  2. General
    1. May take with or without food
    2. Take with food to reduce gastric irritation
  1. Start 1-2 days before travel and continue until 7 days after return (14 days after an extended stay)
  2. Adult: 30 mg base (52.6 mg salt) daily
  3. Child: 0.5 mg/kg up to 30 mg base (0.8 mg/kg up to 52.6 mg salt)
  1. Follows primary treatment to reduce risk of relapsing infection
  2. Adult: 30 mg base (52.6 mg salt) orally daily for 14 days after initial course
  3. Child: 0.5 mg/kg base up to 30 mg/day (0.8 mg/kg salt) orally daily for 14 days after initial course
  • Adverse Effects
  1. Gastrointestinal (esp. on an empty Stomach, take with food)
    1. Abdominal Pain
    2. Nausea
    3. Vomiting
  2. Other
    1. QTc Prolongation
  • Safety
  1. Considered safe in Lactation
  2. Pregnancy Category X
    1. Avoid in all trimesters of pregnancy
    2. Use Contraception while taking Primaquine
  3. Safe in children age >1 month old (not with G6PD Deficiency)
    1. Not recommended in Malaria Prophylaxis in treatment
  • Resources
  1. Primaquine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1bfbf4ae-81b8-4160-a00d-6322aadd4b59
  • References
  1. (2019) Drugs for Malaria Prophylaxis, Med Lett Drugs Ther, p. e104-5
  2. (2023) Presc Lett, Malaria Prophylaxis, Resource #350806
  3. Sanford (2016) Am Fam Physician 94(8): 620-7 [PubMed]