Primaquine Side Effects
Medically reviewed by Drugs.com. Last updated on Jun 1, 2024.
Applies to primaquine: oral tablet.
Important warnings
This medicine can cause some serious health issues
Oral route (tablet)
Physicians should completely familiarize themselves with the complete contents of this leaflet before prescribing primaquine phosphate.
Precautions
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests are needed to check for unwanted effects.
Do not use this medicine together with quinacrine or medicines that can cause bleeding or bone marrow problems.
If your symptoms do not improve within a few days, or if they become worse, check with your doctor.
Using this medicine while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Female patients should use effective birth control during and after treatment with this medicine. Male patients who have female partners should use effective birth control during treatment with this medicine and for at least 3 months after the last dose. If you think you have become pregnant while using this medicine, tell your doctor right away.
Before taking this medicine, you should be tested for G6PD deficiency or favism (blood disorder). Primaquine may cause hemolytic anemia in patients with these conditions. Talk to your doctor if you have concerns about this.
This medicine may cause heart rhythm problems. Tell your doctor right away if you get dizzy or lightheaded, have fast or irregular heart beats, or feel like fainting.
Malaria is spread by the bites of certain kinds of infected female mosquitoes. If you are living in or will be traveling to an area where there is a chance of getting malaria, the following mosquito-control measures will help to prevent infection:
- If possible, avoid going out between dusk and dawn because it is at these times that mosquitoes most commonly bite.
- Remain in air-conditioned or well-screened rooms to reduce contact with mosquitoes.
- Wear long-sleeved shirts or blouses and long trousers to protect your arms and legs, especially from dusk through dawn when mosquitoes are out.
- Apply insect repellant, preferably one containing DEET, to uncovered areas of the skin from dusk through dawn when mosquitoes are out.
- If possible, sleep in a screened or air-conditioned room or under mosquito netting, preferably coated or soaked with pyrethrum, to avoid being bitten by malaria-carrying mosquitoes.
- Use mosquito coils or sprays to kill mosquitoes in living and sleeping quarters during evening and nighttime hours.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Common side effects of primaquine
Some side effects of primaquine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common side effects
Serious side effects of primaquine
Along with its needed effects, primaquine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking primaquine:
Incidence not known
- back, leg, or stomach pains
- black, tarry stools
- bleeding gums
- bluish-colored lips, fingernails, or palms
- chest pain
- chills
- cough
- dark urine
- difficulty breathing
- dizziness, faintness, or lightheadedness
- fast, slow, pounding, or irregular heartbeat
- fever
- general body swelling
- headache
- loss of appetite
- nausea or vomiting
- nosebleeds
- painful or difficult urination
- pale skin
- rapid heart rate
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- swollen glands
- unusual bleeding or bruising
- unusual tiredness or weakness
- yellowing of the eyes or skin
For healthcare professionals
Applies to primaquine: compounding powder, oral tablet.
Hematologic adverse events
- Frequency not reported: Hemolytic anemia, hemolysis, methemoglobinemia, leukopenia, agranulocytosis, mild anemia, leukocytosis, neutropenia[Ref]
Hemolytic anemia in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD) and methemoglobinemia in patients with nicotinamide adenine dinucleotide methemoglobin reductase deficiency have been reported.
Patients from Africa, Southern Europe, Mediterranean region, Middle East, Southeast Asia, and Oceania had a greater tendency to develop hemolytic anemia (due to congenital deficiency of erythrocytic G6PD) while using this drug.
Leukopenia and agranulocytosis have been reported in patients taking very high doses (120 mg/day for 14 days).[Ref]
Gastrointestinal
- Common (1% to 10%): Nausea, vomiting, abdominal cramps, abdominal pains
- Frequency not reported: Epigastric distress[Ref]
Gastrointestinal symptoms were dose related.[Ref]
Nervous system
- Common (1% to 10%): Dizziness, headache[Ref]
Cardiovascular
- Frequency not reported: Cardiac arrhythmia, QT interval prolongation, hypertension[Ref]
Metabolic
- Frequency not reported: Increased methemoglobin level
Hypersensitivity
- Frequency not reported: Hypersensitivity skin rashes[Ref]
Hypersensitivity skin rashes have been reported in AIDS patients using this drug with clindamycin for treatment of Pneumocystis pneumonia.[Ref]
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References
1. Ziai M, Amirhakimi GH, Reinhold JG, Tabatabee M, Gettner ME, Bowman JE (1967) "Malaria prophylaxis and treatment in G-6-PD deficiency. An observation on the toxicity of primaquine and chloroquine." Clin Pediatr (Phila), 6, p. 42-3
2. George JN, Sears DA, McCurdy PR, Conrad ME (1967) "Primaquine sensitivity in Caucasians: hemolytic reactions induced by primaquine in G-6-PD deficient subjects." J Lab Clin Med, 70, p. 0-93
3. Reeve PA, Toaliu H, Kaneko A, Hall JJ, Ganczakowski M (1992) "Acute intravascular haemolysis in Vanuatu following a single dose of primaquine in individuals with glucose-6-phosphate dehydrogenase deficiency." J Trop Med Hyg, 95, p. 49-51
4. Kantor GS (1992) "Primaquine-induced methemoglobinemia during treatment of Pneumocystis carinii pneumonia ." N Engl J Med, 327, p. 461
5. Kay R, DuBois RE (1990) "Clindamycin/primaquine therapy and secondary prophylaxis against Pneumocystis carinii pneumonia in patients with AIDS." South Med J, 83, p. 03-4
6. Ruf B, Rohde I, Pohle HD (1991) "Efficacy of clindamycin/primaquine versus trimethoprim/sulfamethoxazole in primary treatment of Pneumocystis carinii pneumonia." Eur J Clin Microbiol Infect Dis, 10, p. 07-10
7. (2001) "Product Information. Primaquine (primaquine)." Sanofi Winthrop Pharmaceuticals
8. Fryauff DJ, Baird JK, Basri H, Sumawinata I, Purnomo, Richie TL, Ohrt CK, Mouzin E, Church CJ, Richards AL, Subianto B, Sand (1995) "Randomised placebo-controlled trial of primaquine for prophylaxis of falciparum and vivax malaria." Lancet, 346, p. 1190-3
9. Bolchoz LJC, Budinsky RA, McMillan DC, Jollow DJ (2001) "Primaquine-induced hemolytic anemia: formation and hemotoxicity of the arylhydroxylamine metabolite 6-methoxy-8-hydroxylaminoquinoline." J Pharmacol Exp Ther, 297, p. 509-15
10. Cerner Multum, Inc. "Australian Product Information."
11. Freedman DO (2008) "Clinical practice. Malaria prevention in short-term travelers." N Engl J Med, 359, p. 603-12
12. World Health Organization (2015) Guidelines for the Treatment of Malaria – Third edition. http://apps.who.int/iris/bitstream/10665/162441/1/9789241549127_eng.pdf?ua=1
13. Baird JK, Fryauff DJ, Basri H, Bangs MJ, Subianto B, Wiady I, Purnomo, Leksana B, Masbar S, Richie TL, Jones TR, Tjitra E, (1995) "Primaquine for prophylaxis against malaria among nonimmune transmigrants in irian jaya, indonesia." Am J Trop Med Hyg, 52, p. 479-84
14. Black JR, Feinberg J, Murphy RL, Fass RJ, Finkelstein D, Akil B, Safrin S, Carey JT, Stansell J, Plouffe JF, He WL, Shelto (1994) "Clindamycin and primaquine therapy for mild-to-moderate episodes of pneumocystis carinii pneumonia in patients with AIDS: AIDS clinical trials group 044." Clin Infect Dis, 18, p. 905-13
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Further information
Primaquine side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.