primaquine

Generic Name: primaquine (PRIM a kwin)
Brand Names:

What is primaquine?

Primaquine is an antimalarial drug. The exact way that primaquine works is unknown.

Primaquine is used to treat and prevent malaria.

Primaquine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about primaquine?

Notify your doctor if your urine turns dark.

Use caution when driving or performing other hazardous activities until you know how this medication affects you. Primaquine may cause visual disturbances such as blurred vision, misty vision, and difficulty focusing. Report any vision or hearing changes to your doctor.

Who should not take primaquine?

Before taking this medication, tell your doctor if you have

• a history of an allergic reaction to previous primaquine therapy,

• glucose-6-phosphate dehydrogenase (G-6-PD) deficiency,

• rheumatoid arthritis,

• lupus erythematosus, or

• quinacrine (Atabrine) therapy.

You may not be able to take primaquine, or you may require a lower dose or special monitoring during your therapy if you have any of the conditions listed above.

It is not known whether primaquine will harm an unborn baby. Do not take primaquine without first talking to your doctor if you are pregnant. It is not known how primaquine will affect a nursing baby. Do not take primaquine without first talking to your doctor if you are breast-feeding a baby.

How should I take primaquine?

Take primaquine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Take primaquine with food to lessen stomach upset. Store primaquine at room temperature away from moisture and heat.

See also: Primaquine dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a primaquine overdose include nausea, vomiting, stomach upset, and stomach cramps.

What should I avoid while taking primaquine?

Use caution when driving or performing other hazardous activities until you know how this medication affects you. Primaquine may cause visual disturbances such as blurred vision, misty vision, and difficulty focusing. Report any vision or hearing changes to your doctor.

Primaquine side effects

Stop taking primaquine and seek emergency medical attention if you experience an allergic reaction (flushing; swelling of your lips, tongue, or face, difficulty breathing; closing of your throat; vision problems; a rash; or itching).

Notify your doctor if you experience darkening of your urine.

Nausea, stomach pain or upset, vomiting, and loss of appetite may also occur during therapy.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: primaquine side effects (in more detail)

Primaquine Dosing Information

Usual Adult Dose for Malaria:

Manufacturer recommendation: 15 mg base (26.3 mg salt) orally once a day for 14 days

Centers for Disease Control and Prevention (CDC) recommendation: 30 mg base (52.6 mg salt) orally once a day for 14 days; for patients with borderline glucose-6-phosphate dehydrogenase (G6PD) deficiency or as an alternative regimen, 45 mg base (78.9 mg salt) orally once a week for 8 weeks has been recommended

Usual Adult Dose for Malaria Prophylaxis:

Primary prophylaxis of malaria (including chloroquine-resistant malaria):
CDC recommendation: 30 mg base (52.6 mg salt) orally once a day

Primaquine should be taken 1 to 2 days before travel to malarious areas, while in such areas, and for 7 days after leaving the areas. It is generally used for short-duration travel to areas with primarily P vivax.

Terminal prophylaxis of P vivax or P ovale malaria:
Manufacturer recommendation: 15 mg base (26.3 mg salt) orally once a day for 14 days
CDC recommendation: 30 mg base (52.6 mg salt) orally once a day for 14 days

Usual Adult Dose for Pneumocystis Pneumonia:

15 to 30 mg base (26.3 to 52.6 mg salt) orally once a day for 21 days; effective in combination with clindamycin

Primaquine plus clindamycin is recommended as an alternative regimen by the CDC, National Institutes of Health (NIH), and Infectious Diseases Society of America (IDSA). Seriously ill patients should receive IV trimethoprim-sulfamethoxazole or pentamidine therapy.

Usual Pediatric Dose for Malaria:

Manufacturer recommendation: 0.3 mg/kg base (0.526 mg/kg salt) orally once a day for 14 days (not to exceed 15 mg base/day)

CDC recommendation: 0.5 mg/kg base (0.88 mg/kg salt) orally once a day for 14 days (not to exceed 30 mg base/day); for patients with borderline G6PD deficiency or as an alternative regimen, 0.75 mg/kg base (1.3 mg/kg salt) orally once a week for 8 weeks (not to exceed 45 mg base/week) has been recommended

Usual Pediatric Dose for Malaria Prophylaxis:

Primary prophylaxis of malaria (including chloroquine-resistant malaria):
CDC recommendation: 0.5 mg/kg base (0.88 mg/kg salt) orally once a day (not to exceed 30 mg base/day)

Primaquine should be taken 1 to 2 days before travel to malarious areas, while in such areas, and for 7 days after leaving the areas. It is generally used for short-duration travel to areas with primarily P vivax.

Terminal prophylaxis of P vivax or P ovale malaria:
Manufacturer recommendation: 0.3 mg/kg base (0.526 mg/kg salt) orally once a day for 14 days (not to exceed 15 mg base/day)
CDC recommendation: 0.5 mg/kg base (0.88 mg/kg salt) orally once a day for 14 days (not to exceed 30 mg base/day)

Usual Pediatric Dose for Pneumocystis Pneumonia:

0.3 mg/kg base (0.526 mg/kg salt) orally once a day for 21 days (not to exceed 30 mg base/day); effective in combination with clindamycin

Primaquine plus clindamycin is recommended as an alternative regimen by the CDC, NIH, IDSA, Pediatric Infectious Diseases Society, and American Academy of Pediatrics. Seriously ill patients should receive IV trimethoprim-sulfamethoxazole or pentamidine therapy.

What other drugs will affect primaquine?

Do not take primaquine if you have recently taken quinacrine (Atabrine). These two drugs are similar and can cause dangerous side effects if they are taken together.

Drugs other than those listed here may also interact with primaquine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist can provide more information about primaquine.