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Tafenoquine

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Tafenoquine, Arakoda, Krintafel

  • See Also
  1. Primaquine
  2. Malaria
  • Indications
  1. Malaria Prophylaxis
  2. Plasmodium Vivax Prevention of Relapse
  • Contraindications
  1. G6PD Deficiency
  2. NADH Methemoglobin Reductase Deficiency
  3. Age <16 years
  • Medications
  1. Tafenoquine Succinate Tablets: 100 mg (Arakoda) or 150 mg (Krintafel)
    1. Do not break or chew tablets
  • Mechanism
  1. Tafenoquine Succinate is a long acting Primaquine analog
  2. Tafenoquine is an 8-aminoquinolone antimalarial
  • Dosing
  1. Malaria Prophylaxis (Adults or age >16 years)
    1. Start 200 mg orally daily for 3 days before travel
    2. Next 200 mg orally once weekly until 1 week after last exposure
    3. Avoid prolonged use >6 months
  2. Plasmodium Vivax Prevention of Relapse (Adults or age >16 years)
    1. Take 300 mg orally for one dose on the first or second day of acute Malaria treatment
  • Pharmacokinetics
  1. Half-Life: 15 to 17 days
  2. Minimal metabolism
  • Adverse Effects
  1. Common
    1. Gastrointestinal
    2. Corneal deposits (vortex keratopathy)
    3. Insomnia
    4. Depression or anxiety
  2. Serious
    1. QT Prolongation does NOT appear to occur at standard doses
    2. Hypersensitivity Reaction
    3. Hemolytic Anemia in G6PD Deficiency
      1. Screen for G6PD before use (including Breastfed infants)
  • Safety
  1. Avoid in pregnancy
    1. Use reliable Contraception for 3 months after last dose
  2. Avoid in Lactation (unless G6PD is excluded in infant)
  • Resources
  1. Tafenoquine (Arakoda, DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=299e49d8-470f-4779-a010-4a1ee0e0c6cd
  2. Tafenoquine (Krintafel, DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5cf989d5-36f5-4561-a30b-9fcb9deb6b6a
  • References
  1. (2019) Drugs for Malaria Prophylaxis, Med Lett Drugs Ther, p. e104-5
  2. (2019) Tafenoquine, Med Lett Drugs Ther, p. 101-4
  3. (2023) Presc Lett, Malaria Prophylaxis, Resource #350806