primaquine (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 26.3mg
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Prevention of relapse of P. vivax malaria

30 mg PO qDay for 14 days

Uncomplicated P. vivax and P. ovale malaria (off-label)

30 mg PO qDay for 14 days with chloroquine or hydroxychloroquine

Alternatively, for mild G6PD deficiency or as alternative to daily regimen: 45 mg PO qDay for 8 weeks (only to be used after consultation with an infectious disease/tropical medicine expert

Chemoprophylaxis (Off-label)

P. vivax and P. ovale maleria: 30 mg PO qDay for 14 days after departure from malaria-endemic area

P. Jiroveci Pneumonia (Orphan)

For use in combination with clindamycin in the treatment of P. Jiroveci pneumonia associated with AIDS

15-30 mg base PO qD for 21 days (with clindamycin IV or PO)

Orphan indication sponsor

  • Sanofi Winthrop, Inc; 90 Park Avenue; New York, NY 10016

Other Information

Monitor: CBC

Dosage Forms & Strengths

tablet

  • 26.3mg
more...

Uncomplicated P. vivax and P. ovale malaria (Off-label)

0.5 mg/kg (30 mg/day maximum) qDay for 14 days with chloroquine or hydroxychloroquine 

Chemoprophylaxis

0.5 mg/kg PO qDay (30 mg/day maximum); start 1-2 days prior to travel and continue for 7 days after departure from malaria endemic area 

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Interactions

Interaction Checker

primaquine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Abdominal pain

            Hemolytic anemia in G6PD deficiency

            Nausea

            Vomiting

            <1-10%

            Methemoglobinemia in NADH-methemoglobin reductase-deficient individuals

            <1%

            Agranulocytosis

            Arrhythmias

            Headache

            Interference with visual accommodation

            Leukopenia

            Leukocytosis

            Rash

            Dizziness

            Pruritus

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            Warnings

            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

            Cautions

            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

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            Pregnancy & Lactation

            Safe usage in pregnancy not established; use during pregnancy should be avoided except when in judgment of the physician benefit outweighs possible hazard

            Lactation: CDC recommends do not use in nursing women unless breast-fed infant has been determined not to have G6PD deficiency

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Absorption: well absorbed

            Metabolism: hepatic to carboxyprimaquine (active)

            Half-life, Elimination: 3.7-9.6 hr

            Peak Plasma Time: 1-2 hr

            Excretion: urine (small amounts as unchanged drug)

            Mechanism of Action

            Disrupts Plasmodium mitochondria

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            Images

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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