Primaquine

Should be taken with food. Take w/ meals to avoid GI discomfort.

Acutely ill patients with systemic disease manifested by a tendency to develop granulocytopenia (e.g. SLE, rheumatoid arthritis); severe G6PD deficiency. Pregnancy. Concomitant use with other drugs causing haemolytic anaemia or myeloid bone marrow suppression; concomitant use with or recent use of mepacrine.

Patient with family or personal history of favism, haemolytic anaemia, or nicotinamide adenine dinucleotide (NADH) methaemoglobin reductase deficiency; mild to moderate G6PD deficiency or unknown G6PD status (when testing is unavailable); cardiac disease, long QT syndrome, bradycardia (<50 bpm), uncorrected hypokalaemia and/or hypomagnesaemia, history of ventricular arrhythmias; previous idiosyncratic reaction to primaquine. Children. Lactation. Monitoring Parameters Screen for G6PD deficiency before starting treatment. Obtain CBC (in G6PD normal patients), glucose, electrolytes, and visual colour check of urine periodically. If haemolysis is suspected, obtain haptoglobin, peripheral smear, CBC, and urinalysis dipstick for occult blood prior to starting treatment. In patients with mild to moderate G6PD deficiency or unknown G6PD status (when testing is unavailable), obtain haematocrit and Hb at baseline and monitor CBC periodically (e.g. at Day 3 and 8). Monitor ECG in patients at risk for QT prolongation. Assess for signs of haemolytic anaemia and other haematologic effects. Perform pregnancy test in sexually active females prior to treatment.

Significant: Moderate to severe haemolytic reactions (particularly in patients with G6PD deficiency and those with family or personal history of favism), methaemoglobinaemia (in patients with NADH methaemoglobin reductase deficiency), leucopenia, anaemia, QT interval prolongation, cardiac arrhythmia. Eye disorders: Visual disturbances. Gastrointestinal disorders: Nausea, epigastric distress, vomiting, abdominal cramps. Nervous system disorders: Headache, dizziness. Skin and subcutaneous tissue disorders: Rash, pruritus.

May enhance the QTc-prolonging effect of QT-prolonging agents.

Antimalarials

P01BA03 - primaquine ; Belongs to the class of aminoquinoline antimalarials.