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Indications and Dosage
Oral
Radical treatment of vivax or ovale malaria Adult: A course of treatment w/ a blood schizontocide should be given 1st 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 once daily for 14 days. Max: 15 mg daily. |
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Special Patient Group
Patients w/ G6PD deficiency: Up to 45 mg or 750 mcg/kg once every 7 days for 8 wk.
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Administration
Should be taken with food. Take w/ meals to avoid GI discomfort.
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Contraindications
Acutely ill patients suffering from systemic disease manifested by tendency to develop granulocytopenia (e.g. rheumatoid arthritis, lupus erythematosus). Concurrent use w/ other potentially haemolytic drugs or depressants of myeloid elements of the bone marrow. Concomitant admin w/ mepacrine.
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Special Precautions
Patient w/ G6PD deficiency, NADH methaemoglobin reductase deficiency. Childn. Pregnancy and lactation.
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Adverse Reactions
Abdominal pain, gastric distress, nausea, vomiting; methaemoglobinaemia, haemolytic anaemia (in patients w/ G6PD deficiency), mild anaemia, leucocytosis; HTN, cardiac arrhythmias, prolonged QT interval on ECG, accommodation disturbance. Rarely, leucopenia, agranulocytosis.
Potentially Fatal: Fatal haemolysis in patients w/ G6PD deficiency. |
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Monitoring Parameters
Monitor Hb levels and blood counts routinely.
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Drug Interactions
Enhanced effect w/ other drugs that prolong the QT interval.
Potentially Fatal: Concomitant use w/ other bone marrow depressants or haemolytics can increase the possibility of adverse haematological effects. Mepacrine may increase plasma concentrations and potentiate toxicity of primaquine. |
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Action
Description: Primaquine is an 8-aminoquinoline antimalarial which eliminates the exoerythrocytic forms of malarial parasite P. vivax, P. ovale and P. falciparum by disrupting mitochondria and binding to DNA.
Pharmacokinetics: Absorption: Readily absorbed from the GI tract. Time to peak plasma concentration: Approx 1-2 hr. Distribution: Widely distributed throughout body tissues. Apparent volume of distribution: Approx 150-250 L. Metabolism: Undergoes rapid hepatic metabolism and converted to carboxyprimaquine (major metabolite). Excretion: Via urine as unchanged drug in small amounts. Elimination half-life: 3-6 hr. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Primaquine, CID=4908, https://pubchem.ncbi.nlm.nih.gov/compound/Primaquine (accessed on Jan. 23, 2020) |
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Storage
Store at 25°C. Protect from light.
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MIMS Class
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ATC Classification
P01BA03 - primaquine ; Belongs to the class of aminoquinoline antimalarials.
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References
Anon. Primaquine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/02/2016. Buckingham R (ed). Primaquine Phosphate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/02/2016. Joint Formulary Committee. Primaquine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/02/2016. McEvoy GK, Snow EK, Miller J et al (eds). Primaquine Phosphate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 04/02/2016. Primaquine Phosphate Tablet, Film Coated (Sanofi-Aventis US LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/02/2016. Primaquine. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com/. Accessed 04/02/2016.
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