Classes
DEA Class; Rx
Common Brand Names; Primaquine
- Antimalarials;
- Antimalarials, Aminoquinoline
Description
Oral antimalarial agent; chemically related to chloroquine; not effective against asexual erythrocytic forms; alternative agent for PCP in combination with clindamycin.
Indications
Indicated for the radical cure (prevention of relapse) of malaria due to P. vivax or P. ovale in patients who are receiving appropriate antimalarial therapy for acute infection.
Contraindications
Severe glucose-6-phosphate dehydrogenase (G6PD) deficiency
Coadministration with quinacrine in patients who have received quinacrine recently
Concurrent administration with other potentially hemolytic drugs or depressants of myeloid elements of the bone marrow
Acutely ill patients suffering from systemic disease manifested by tendency to granulocytopenia, such as rheumatoid arthritis and lupus erythematosus
Adverse Effects
- Abdominal pain
- Hemolytic anemia in G6PD deficiency
- Nausea
- Vomiting
- Methemoglobinemia in NADH-methemoglobin reductase-deficient individuals
- Agranulocytosis
- Arrhythmias
- Headache
- Interference with visual accommodation
- Leukopenia
- Leukocytosis
- Rash
- Dizziness
- Pruritus
Warnings
Since anemia, methemoglobinemia, and leukopenia may occur following administration of large doses of primaquine, do not exceed adult dosage of 1 tablet (= 15 mg base) daily for fourteen days; make routine blood examinations (particularly blood cell counts and hemoglobin determinations) during therapy; drug should be discontinued immediately if marked darkening of urine or sudden decrease in hemoglobin concentration or leukocyte count occurs
Observe patient for tolerance if primaquine phosphate is prescribed for an individual who has shown a previous idiosyncrasy to primaquine phosphate (as manifested by hemolytic anemia, methemoglobinemia, or leukopenia), an individual with a family or personal history of favism, or an individual with erythrocytic glucose-6-phosphate dehydrogenase (G-6-PD) deficiency or nicotinamide adenine dinucleotide (NADH) methemoglobin reductase deficiency; discontinue therapy immediately if marked darkening of the urine or sudden decrease in hemoglobin concentration or leukocyte count occurs
Due to potential for QT interval prolongation, monitor ECG when using primaquine in patients with cardiac disease, long QT syndrome, a history of ventricular arrhythmias, uncorrected hypokalemia and/or hypomagnesemia, or bradycardia (<50 bpm), and during concomitant administration with QT interval prolonging agents
Pregnancy and Lactation
Contraindicated in pregnant women; even if a pregnant woman is G6PD normal, the fetus may not be; safe usage in pregnancy not established; use during pregnancy should be avoided except when in judgment of the physician benefit outweighs possible hazard
CDC recommends do not use in nursing women unless breast-fed infant has been determined not to have G6PD deficiency
Maximum Dosage
15 mg base PO daily is FDA-approved; however, doses of 30 mg base PO daily are recommended off-label.
15 mg base PO daily is FDA-approved; however, doses of 30 mg base PO daily are recommended off-label.
Safety and efficacy have not been established; however, doses up to 0.5 mg/kg/day base PO (Max: 30 mg base) have been used off-label.
Safety and efficacy have not been established; however, doses up to 0.5 mg/kg/day base PO (Max: 30 mg base) have been used off-label.
Safety and efficacy have not been established; however, doses up to 0.5 mg/kg/day base PO have been used off-label.
Safety and efficacy have not been established.
How supplied
Primaquine phosphate
tablet
- 26.3mg
