Primaquine information from DrugsUpdate
P - Contraindicated in pregnancy
L - Contraindicated in lactation
Primaquine (or primaquine phosphate) is a medication used in the treatment of malaria and Pneumocystis pneumonia. It is a member of the 8-aminoquinoline group of drugs that includes tafenoquine and pamaquine.
Pharmacodynamics
Pharmacokinetics
Primaquine is an 8-aminoquinoline antimalarial which eliminates the exoerythrocytic forms of malarial parasite P.vivax, P. falciparum by disrupting mitochondria and binding to DNA. By this action primaquine achieves radical cure of vivax malaria. It is also active against gametocytes of P.falciparum.
Absorption
Readily absorbed from the GIT; peak plasma concentrations after 1-2 hours (oral).
Distribution
Widely distributed throughout body tissues. Protein-binding: 98%
Metabolism
Hepatic; converted to carboxyprimaquine (major metabolite).
Excretion
Urine (as unchanged drug); 3-6 hours (elimination half-life).
Primaquine Indications / Primaquine Uses
Information Not Available
Primaquine Adverse Reactions / Primaquine Side Effects
Nausea, vomiting, epigastric distress, abdominal cramps, leukopaenia, leucocytosis, agranulocytosis, methaemoglobinemia in NADH methaemoglobin reductase-deficient individuals.
Potentially Fatal: Haemolytic anaemia (G6PD deficient), thrombocytopaenia, leucopaenia, AV block.
Precautions
Information Not Available
Special Precautions
G6PD deficiency; pregnancy; NADH methaemoglobin reductase deficient patients. Monitor Hb levels and blood counts routinely. Patients with systemic diseases that have an increased risk of granulocytopenia. Withdraw treatment if signs of haemolysis or methaemogloinaemia occur.
Other Drug Interactions
Primaquine may inhibit metabolism of chloroquine. Avoid ethanol.
Potentially Fatal: Mepacrine may potentiate toxicity of primaquine. Potentially haemolytic drugs eg, sulphonamides, nitrofurans and bone marrow suppressants eg, methotrexate, phenylbutazone, chloramphenicol should not be co-admin with primaquine.
Other Interactions
Information Not Available
Dosage
Oral
Radical treatment of vivax or ovale malaria
Adult: A course of treatment with a blood schizontocide should be given first to kill any erythrocytic parasites. 15 mg daily for 14 days, increased to higher doses or longer course if resistance in P.vivax occurs.
Child: 250 mcg/kg daily for 14 days.
Oral
Prophylaxis of chloroquine-resistant malaria
Adult: 30 mg once daily; to be started 1-2 days before travel and continue for 7 days after departure from the malaria-endemic area.
Child: 0.5 mg/kg once daily for 14 days. Max: 30 mg/day. Alternatively, for patients with mild G6PD deficiency: 45 mg once weekly for 8 weeks.
Special Populations
For patients with G6PD deficiency: Adult: 30-45 mg/dose and children: 500-750 mcg/kg/dose. Dose to be taken once every 7 days for 8 weeks.
Food(before/after)
Should be taken with food. (Take with meals to avoid GI discomfort.)
List of Contraindications
Primaquine and Pregnancy
Contraindicated in pregnancy
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Primaquine and Lactation
Contraindicated in lactation
Primaquine and Children
Information Not Available
Primaquine and Geriatic
Information Not Available
Primaquine and Other Contraindications
Hypersensitivity. Children <1 year. Acute flare-ups of systemic diseases (RA, SLE) having tendency for agranulocytopaenia, Pregnancy and lactation.
Storage
Oral
Store at 25°C
Lab interference
Oral
Store at 25°C
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