Pronunciation: PRIM-uh-kween FOSS-fate
- Tablets 26.3 mg (equiv. to 15 mg base)
Disrupts metabolic processes of parasitic organism, eliminating tissue (exoerythrocytic) infection and preventing development of blood (erythrocytic) forms of parasite responsible for relapses of vivax malaria.
Rapid. Bioavailability is approximately 96%. T max is approximately 2 to 3 h (primaquine), approximately 7 h (metabolite carboxyprimaquine). C max is 50 to 66 ng/mL (15 mg); 104 ng/mL (30 mg).
Extensively distributed. Vd is 248 L. C max is 291 to 736 ng/mL (metabolite) and 432 to 1240 ng/mL (metabolite).
Rapidly converted to carboxyprimaquine. Undetermined if the main plasma metabolite has activity.
Urine (less than 2% of dose). The t ½ is 5.8 h (primaquine); 22 to 30 h (metabolite carboxyprimaquine).
Indications and Usage
Radical cure or prevention of relapse in vivax malaria; after termination of chloroquine phosphate suppressive therapy in areas where vivax malaria is endemic.
With clindamycin, treatment of Pneumocystis carinii pneumonia associated with AIDS.
Concomitant administration of quinacrine and primaquine; acutely ill patient with systemic disease manifested by granulocytopenia (eg, rheumatoid arthritis, lupus erythematosus); concurrent administration of other potentially hemolytic or bone marrow depressant medications.
Dosage and Administration
Begin therapy during last 2 wk of or after course of suppression with chloroquine or comparable drug.Adults
PO 26.3 mg (15 mg base) for 14 days.Children
PO 0.5 mg/kg/day (0.3 mg/kg/day of base) for 14 days (max, 15 mg/day of base).
Administer without regard to meals. Administer with food if GI upset occurs.
Store at room temperature in tightly closed, light-resistant container.
May potentiate toxicity of antimalarial compounds that are structurally related to primaquine.
Laboratory Test Interactions
None well documented.
Nausea; vomiting; epigastric distress; abdominal cramps.
Leukopenia; hemolytic anemia in G-6-PD deficiency; methemoglobinemia in NADH methemoglobin reductase deficiency.
Pregnancy category undetermined.
Undetermined. To avoid adverse reactions in the infant, do not give to lactating women.
May occur in patients with following conditions: G-6-PD deficiency, NADH methemoglobin reductase deficiency; idiosyncratic reactions (leukopenia, methemoglobinemia; hemolytic anemia). Discontinue drug if marked darkening of urine or sudden decrease in Hgb or leukocyte count occurs.
Hemolytic reactions may occur with doses of drug exceeding recommended dose.
Anemia, methemoglobinemia, leukopenia, acute abdominal cramps, vomiting, epigastric distress, CNS and cardiovascular disturbances, granulocytopenia, hemolytic anemia.
- Tell patient that medicine may be taken with food if stomach upset (eg, nausea, vomiting, abdominal cramps) occurs, and advise patient to contact health care provider if upset persists.
- Emphasize importance of compliance with drug regimen.
- Advise patient to report marked darkening of urine to health care provider.
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