Primaquine

Primaquine Brand Name– Primaquine

What is Primaquine

Primaquine is an oral antimalarial agent chemically related to chloroquine.

Primaquine is used for the treatment of malaria caused by Plasmodium vivax, P. ovale, and P. falciparum.

However, a blood schizonticidal agent, such as chloroquine, should be used in conjunction with primaquine for treatment of P. ovale and P. vivax malaria, since primaquine is not effective against asexual erythrocytic forms.

Primaquine was approved by the FDA in 1951.

More recently, primaquine has been identified as an alternative agent for the treatment of mild-to-moderate Pneumocystis pneumonia (PCP) when administered in combination with oral clindamycin

Indications

1. malaria
2. malaria prophylaxis
3. Plasmodium falciparum
4. Plasmodium malariae
5. Plasmodium ovale
6. Plasmodium vivax
7. Pneumocystis jirovecii (formerly Pneumocystis carinii)
8. Pneumocystis pneumonia (PCP)

Side Effects

1. dizziness
2. hemolytic anemia
3. leukopenia
4. methemoglobinemia
5. nausea
6. pruritus
7. QT prolongation
8. rash
9. vomiting

Monitoring Parameters

• CBC
• glucose-6-phosphate dehydrogenase (G6PD) activity
• pregnancy testing

Contraindications

• apheresis
• AV block
• bone marrow suppression
• bradycardia
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• cardiomyopathy
• celiac disease
• contraception requirements
• females
• fever
• G6PD deficiency
• geriatric
• heart failure
• hematological disease
• hemolytic anemia
• human immunodeficiency virus (HIV) infection
• hyperparathyroidism
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypothermia
• hypothyroidism
• iodoquinol hypersensitivity
• long QT syndrome
• male-mediated teratogenicity
• methemoglobin reductase deficiency
• myocardial infarction
• pheochromocytoma
• pregnancy
• pregnancy testing
• primaquine hypersensitivity
• QT prolongation
• reproductive risk
• rheumatoid arthritis
• sickle cell disease
• sleep deprivation
• stroke
• systemic lupus erythematosus (SLE)

Interactions

• Alfuzosin
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• Amoxicillin; Clarithromycin; Omeprazole
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• Articaine; Epinephrine
• Asenapine
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• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bupivacaine
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• Buprenorphine
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• Ceritinib
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• Chlorpromazine
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• Clofazimine
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• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
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• Dasatinib
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