• Primaquine comes as a tablet and to be taken by mouth.
• It should be taken at the same time every day.
• Skipping the doses or stop taking the tablets may not completely cure the infection and may come back.
a) For preventing relapses of malaria:
Adult dose: The recommended dose is 15mg base once daily for 14 days
b) For preventing spread of falciparum malaria:
45 mg single dose on the second day of treatment (Ref: Guidelines for Diagnosis and Treatment of Malaria in India 2014; National Institute of Malaria Research / National Vector Borne Disease Control Program, New Delhi)
c) For treating Pneumocystis jiroveci pneumonia:
The recommended dose in treating AIDS(HIV infected) patients is 30mg orally once daily for 21 days in combination with clindamycin.
d) Travellers to malaria-infected areas:
Persons should start taking primaquine before 2 days, during the stay and for 7 days after leaving the infected area. Travelers who were continuously exposed to P. vivax or P.ovale should take it for 14 days after leaving the place along with another antimalarial drug (Ref: CDC). The recommendations however vary depending on the country being visited.
• Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency. Lack of the enzyme leads to red blood cell destruction on administration of drugs like primaquine
• Autoimmune diseases (in which the body immune system mistakenly produces antibodies and attacks its tissues) such as rheumatoid arthritis and lupus erythematosus, since there is a tendency for granulocytopenia (reduced number of granulocytes-a type of white blood cells)
• Hemolytic anemia or patients taking hemolytic drugs (that cause destruction of red blood cell)
• Methemoglobinemia (higher blood levels of methemoglobin, an atypical form of hemoglobin)
• Bone marrow depression and leukopenia as it has toxic effects on the blood
• Pregnant women and infants
• Patients who are taking or have recently taken quinacrine, since quinacrine increases the toxicity of primaquine
• It should be taken at the same time every day.
• Skipping the doses or stop taking the tablets may not completely cure the infection and may come back.
Dosage & When it is to be taken
The dosage of the drug is usually calculated as a base. Each 26.3mg tablet of primaquine phosphate is equivalent to 15mg primaquine base. The dosage may vary according to local or regional recommendations.a) For preventing relapses of malaria:
Adult dose: The recommended dose is 15mg base once daily for 14 days
b) For preventing spread of falciparum malaria:
45 mg single dose on the second day of treatment (Ref: Guidelines for Diagnosis and Treatment of Malaria in India 2014; National Institute of Malaria Research / National Vector Borne Disease Control Program, New Delhi)
c) For treating Pneumocystis jiroveci pneumonia:
The recommended dose in treating AIDS(HIV infected) patients is 30mg orally once daily for 21 days in combination with clindamycin.
d) Travellers to malaria-infected areas:
Persons should start taking primaquine before 2 days, during the stay and for 7 days after leaving the infected area. Travelers who were continuously exposed to P. vivax or P.ovale should take it for 14 days after leaving the place along with another antimalarial drug (Ref: CDC). The recommendations however vary depending on the country being visited.
When it is not to be taken (Contraindications)
Primaquine should not be taken in the following conditions:• Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency. Lack of the enzyme leads to red blood cell destruction on administration of drugs like primaquine
• Autoimmune diseases (in which the body immune system mistakenly produces antibodies and attacks its tissues) such as rheumatoid arthritis and lupus erythematosus, since there is a tendency for granulocytopenia (reduced number of granulocytes-a type of white blood cells)
• Hemolytic anemia or patients taking hemolytic drugs (that cause destruction of red blood cell)
• Methemoglobinemia (higher blood levels of methemoglobin, an atypical form of hemoglobin)
• Bone marrow depression and leukopenia as it has toxic effects on the blood
• Pregnant women and infants
• Patients who are taking or have recently taken quinacrine, since quinacrine increases the toxicity of primaquine
