How does primaquine work?
Primaquine is a medication to treat or prevent malaria, a disease caused by parasites. primaquine works by interfering with the growth of parasites in the body. Parasites that cause malaria typically enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America,...
Can I take primaquine on a short trip?
When taking primaquine for the prevention of malaria on a short trip, both adults and children should take one dose of primaquine per day starting a day or two before traveling to the area where malaria transmission occurs. They should take one dose per day while there, and for 7 consecutive days after leaving.
Can primaquine be used to treat chloroquine resistance?
Furthermore, primaquine does not act in isolation and resistance to it (if any) has to be defined in relation to the concurrently administered blood schizontocidal agent as well. Artemisinin based therapies are a successful alternative in areas of chloroquine resistance against vivax malaria.
Why is primaquine used to treat P falciparum?
Because of its action against gametocytes, the WHO recommends it for use in reducing transmission to control P. falciparum infections. Primaquine is also used in the treatment of Pneumocystis pneumonia (PCP), a fungal infection commonly occurring in people with AIDS and, more rarely, in those taking immunosuppressive drugs.
What is the mechanism of action of primaquine?
Primaquine acts by interfering with a part of the parasite (mitochondria) that is responsible for supplying it with energy. Without energy the parasite dies. This stops the infection from continuing and allows the person to recover.
How does primaquine treat malaria?
Primaquine is used after other medications (such as chloroquine) have killed the malaria parasites living inside red blood cells. Primaquine then kills the malaria parasites living in other body tissues. This prevents the return of the infection. Both drugs are needed for a complete cure.
Why do we give primaquine?
Primaquine is used alone or with another medication to treat malaria (a serious infection that is spread by mosquitoes in certain parts of the world and can cause death) and to prevent the disease from coming back in people that are infected with malaria. Primaquine is in a class of medications called antimalarials.
What stage of malaria does primaquine treat?
Transmission-blocking therapy. A single dose of 45 mg of primaquine is routinely prescribed for P. falciparum malaria in areas where it is endemic, to reduce the risk of transmission.
How does primaquine cause hemolytic anemia?
Unfortunately, primaquine causes dangerous side effects in certain individuals who are deficient in an enzyme called G6PD, which helps defend red blood cells against stresses. Primaquine damages these cells so that they burst, leading to anaemia.
Why is primaquine given in vivax malaria?
vivax malaria are treated with chloroquine for three days to eliminate the parasites in the blood that cause the symptoms of malaria, followed by 15 mg/day of primaquine for 14 days to treat the liver stage of the infection to prevent the disease recurring.
When do you use primaquine?
When taking primaquine for the prevention of malaria on a short trip, both adults and children should take one dose of primaquine per day starting a day or two before traveling to the area where malaria transmission occurs. They should take one dose per day while there, and for 7 consecutive days after leaving.
For which condition would a patient receive the drug primaquine as a treatment?
Primaquine is a prescription medication used for preventing the relapse of malaria caused by P. vivax. Primaquine may available under different brand names.
Is primaquine an antibiotic?
Primaquine is an antibiotic used to treat different types of infections. It can be given in combination with clindamycin (Dalacin® C) for the treatment of Pneumocystis carinii pneumonia (PCP).
What is the first line treatment of malaria?
As of April 2019, artesunate, the WHO-recommended first-line treatment of severe malaria, will become the first-line treatment for severe malaria in the U.S. Malaria has long been a major cause of illness and deaths with an estimated 219 million cases of malaria worldwide and 435,000 deaths in 2017.
Why does primaquine cause methemoglobinemia?
There is evidence that metabolites of primaquine formed by the cytochrome pathway are responsible for methemoglobin formation; a genetic polymorphism of cytochrome isoforms; and a potential influence of gender in the activities of these enzymes requiring the establishment of dose × response curves profiles in different ...
What is the best treatment for malaria?
The most common antimalarial drugs include:Chloroquine phosphate. Chloroquine is the preferred treatment for any parasite that is sensitive to the drug. ... Artemisinin-based combination therapies (ACTs). ACT is a combination of two or more drugs that work against the malaria parasite in different ways.
When to prescribe Primaquine?
In case of mild to moderate G6PD deficiency, a decision to prescribe Primaquine must be based on an assessment of the risks and benefits of using Primaquine. If Primaquine administration is considered, baseline hematocrit and hemoglobin must be checked before treatment and close hematological monitoring (e.g. at day 3 and 8) is required. Adequate medical support to manage hemolytic risk should be available.
What is primaquine phosphate?
CLINICAL PHARMACOLOGY. Primaquine phosphate is an 8-amino-quinoline compound which eliminates tissue (exoerythrocytic) infection. Thereby, it prevents the development of the blood (erythrocytic) forms of the parasite which are responsible for relapses in vivax malaria.
What are the symptoms of overdosage of primaquine phosphate?
Symptoms of overdosage of Primaquine phosphate include abdominal cramps, vomiting, burning epigastric distress, central nervous system and cardiovascular disturbances, including cardiac arrhythmia and QT interval prolongation, cyanosis, methemoglobinemia, moderate leukocytosis or leukopenia, and anemia. The most striking symptoms are granulocytopenia and acute hemolytic anemia in G6PD deficient patients. Acute hemolysis occurs, but patients recover completely if the dosage is discontinued.
How much primaquine phosphate is in a tablet?
Each tablet contains 26.3 mg of Primaquine phosphate (equivalent to 15 mg of Primaquine base). The dosage is customarily expressed in terms of the base.
When to discontinue primaquine phosphate?
Discontinue the use of Primaquine phosphate promptly if signs suggestive of hemolytic anemia occur (darkening of the urine, marked fall of hemoglobin or erythrocytic count).
Can primaquine be used for G6PD?
Primaquine should not be prescribed for patients with severe G6PD deficiency (see CONTRAINDICATIONS ).
Is primaquine phosphate safe for lupus?
Primaquine phosphate is contraindicated in acutely ill patients suffering from systemic disease manifested by tendency to granulocytopenia, such as rheumatoid arthritis and lupus erythematosus. The drug is also contraindicated in patients receiving concurrently other potentially hemolytic drugs or depressants of myeloid elements of the bone marrow.
How is primaquine absorbed?
Primaquine is well-absorbed in the gut and extensively distributed in the body without accumulating in red blood cells. Administration of primaquine with food or grapefruit juice increases its oral bioavailibity. In blood, about 20% of circulating primaquine is protein-bound, with preferential binding to the acute phase protein orosomucoid. With a half-life on the order of 6 hours, it is quickly metabolized by liver enzymes to carboxyprimaquine, which does not have anti-malarial activity. Renal excretion of the parent drug is less than 4%.
What is primaquine used for?
Primaquine is a medication used to treat and prevent malaria and to treat Pneumocystis pneumonia. Specifically it is used for malaria due to Plasmodium vivax and Plasmodium ovale along with other medications and for prevention if other options cannot be used. It is an alternative treatment for Pneumocystis pneumonia together with clindamycin.
How does primaquine help with malaria?
Primaquine is primarily used to prevent relapse of malaria due to Plasmodium vivax and Plasmodium ovale. It eliminates hypnozoites, the dormant liver form of the parasite, after the organisms have been cleared from the bloodstream. If primaquine is not administered to patients with proven P. vivax or P. ovale infection, a very high likelihood of relapse exists for weeks or months (sometimes years). Use in combination with quinine or chloroquine each of which is very effective at clearing P. vivax from blood, improves outcomes; they appear to also potentiate the action of primaquine.
How long does primaquine stay in your system?
With a half-life on the order of 6 hours, it is quickly metabolized by liver enzymes to carboxyprimaquine, which does not have anti-malarial activity.
When was primaquine first made?
Primaquine was first made in 1946 . It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system. It is available as a generic medication.
Is primaquine used for AIDS?
Primaquine is also used in the treatment of Pneumocystis pneumonia (PCP), a fungal infection commonly occurring in people with AIDS and, more rarely, in those taking immunosuppressive drugs. To treat PCP effectively, it is usually combined with clindamycin.
Can primaquine be used during pregnancy?
It is often recommended that primaquine not be used during pregnancy. It may be used while breastfeeding if the baby is known not to have G6PD deficiency. The mechanisms of action is not entirely clear but is believed to involve effects on the malaria parasites' DNA. Primaquine was first made in 1946.
What is primaquine?
Primaquine is a medication to treat or prevent malaria, a disease caused by parasites. This medicine works by interfering with the growth of parasites in the body.
What is the most important information I should know about primaquine?
You should not use primaquine if you have an autoimmune disorder, such as lupus or rheumatoid arthritis, or if you also use quinacrine (Atabrine).
What are the possible side effects of primaquine?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
What should I avoid while taking primaquine?
This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.
What other drugs will affect primaquine?
Primaquine can cause a serious heart problem, especially if you use certain medicines at the same time, including antibiotics, antidepressants, heart rhythm medicine, antipsychotic medicines, and medicines to treat cancer, malaria, HIV or AIDS. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with primaquine.
How long does primaquine last?
The usual dose of primaquine is 1 tablet daily for 14 days.
How long after stopping primaquine can you use condoms?
If you are a man, keep using condoms for at least 3 months after your last dose. Tell your doctor right away if a pregnancy occurs while either the mother or the father is using primaquine.
Description
Clinical Pharmacology
- Primaquine phosphate is an 8-amino-quinoline compound which eliminates tissue (exoerythrocytic) infection. Thereby, it prevents the development of the blood (erythrocytic) forms of the parasite which are responsible for relapses in vivax malaria. Primaquine phosphate is also active against gametocytes of Plasmodium falciparum.
Contraindications
- Severe glucose-6-phosphate dehydrogenase (G6PD) deficiency (see WARNINGS). Pregnant women (see WARNINGS, Usage in Pregnancy). Primaquine phosphate is contraindicated in acutely ill patients suffering from systemic disease manifested by tendency to granulocytopenia, such as rheumatoid arthritis and lupus erythematosus. The drug is also contraindicated in patie…
Warnings
- Hemolytic anemia and G6PD deficiency Due to the risk of hemolytic anemia in patients with G6PD deficiency, G6PD testing has to be performed before using Primaquine. Due to the limitations of G6PD tests, physicians need to be aware of residual risk of hemolysis and adequate medical support and follow-up to manage hemolytic risk should be available. Primaquine should not be p…
Precautions
- Blood Monitoring
Since anemia, methemoglobinemia, and leukopenia have been observed following administration of large doses of Primaquine, the adult dosage of 1 tablet (= 15 mg base) daily for fourteen days should not be exceeded. In G6PD normal patients it is also advisable to perform routine blood ex…
Adverse Reactions
- To report SUSPECTED ADVERSE REACTIONS, please call AvKARE, Inc. at 1-855-361-3993 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch Gastrointestinal:Nausea, vomiting, epigastric distress, and abdominal cramps. Hematologic:Leukopenia, hemolytic anemia in G6PD deficient individuals, and methemoglobinemia in nicotinamide adenine dinucleotide (NADH) methemoglo…
Overdosage
- Symptoms of overdosage of Primaquine phosphate include abdominal cramps, vomiting, burning epigastric distress, central nervous system and cardiovascular disturbances, including cardiac arrhythmia and QT interval prolongation, cyanosis, methemoglobinemia, moderate leukocytosis or leukopenia, and anemia. The most striking symptoms are granulocytopenia and acute hemolyti…
Dosage and Administration
- Primaquine phosphate is recommended only for the radical cure of vivax malaria, the prevention of relapse in vivax malaria, or following the termination of chloroquine phosphate suppressive therapy in an area where vivax malaria is endemic. Patients suffering from an attack of vivax malaria or having parasitized red blood cells should receive a course of chloroquine phosphate, …
How Is Primaquine Supplied
- Primaquine Phosphate Tablets, USP are supplied as orange colored, round, biconvex, film-coated tablets of 26.3 mg (= 15 mg base), debossed with a "059" on one side and plain on the other side. Available in bottles of 100 (NDC 42291-510-01) Store at 25° C (77° F); excursions permitted to 15° C – 30° C (59° F – 86° F) [see USP Controlled Room Temperature] Dispense in tight, light-resista…
Clinical Studies
- Persons with acute attacks of vivax malaria, provoked by the release of erythrocytic forms of the parasite, respond readily to therapy, particularly to chloroquine phosphate. Primaquine eliminate tissue (exoerythrocytic) infection and prevents relapses in experimentally induced vivax malaria in human volunteers and in persons with naturally occurring infections and is a valuable adjunct to …