Tafenoquine is a safe and effective drug that is prescribed for prevention of malaria caused by Plasmodium vivax and not for acute malarial episodes. It is prescribed to patients either returning or traveling to endemic areas. The advantage of this drug is that only a single dose is required whereas the current drug Primaquine requires to be given for two weeks.
It is an antimalarial drug used in patients who are aged 16 years and above prescribed with the intention to eliminate the malarial parasite from the body completely.
Tafenoquine enters the disease-causing parasite and releases certain chemicals which lead to its death.
Tafenoquine should not be used in patients with-
Allergic to tafenoquine and other chemically related drugs to tafenoquine
Pregnancy and breastfeeding
Deficiency of Glucose-6-phosphate dehydrogenase (G6PD) (due to the risk of breakdown of red blood cells)
Children below 16 years of age
The recommended dose of tafenoquine is 300 mg which is achieved by taking two tablets of tafenoquine 150 mg.
Tafenoquine is taken either on the first or the second day of the appropriate antimalarial treatment such as chloroquine therapy for treating Plasmodium vivax infection.
If vomiting occurs just within 1 hour after taking tafenoquine, take another dose immediately but do not repeat more than once as this may be harmful.
Tafenoquine comes as a tablet taken by mouth with food.
Taking tafenoquine tablets with food helps to increase the absorption of tafenoquine.
The tablets of tafenoquine should not be broken or crushed but have to be swallowed as a whole with a sufficient quantity of water.
Patients should be tested for the following parameters before taking tafenoquine tablets and should stop taking tafenoquine if the result is positive.
Presence of G6PD deficiency
Patients should be monitored for the symptoms and signs of hemolysis or breakdown of red blood cells and should be provided with adequate medical support without delay to manage hemolytic risk.
Women of reproductive potential living with male partners should perform a pregnancy test and must take tafenoquine tablets only if the test is negative.
Breastfeeding is not advised for at least three months after the dose of tafenoquine if the child is found to have a G6PD deficiency or the status of G6PD is not known.
A blood test should be done to detect the presence of any increased levels of methemoglobin after taking tafenoquine and medical attention should be sought if any symptoms or signs of methemoglobinemia (high levels of methemoglobin in the blood) occur.
If patients with nicotinamide adenine dinucleotide (NADH)-dependent methemoglobin reductase deficiency are taking tafenoquine, they should also be carefully monitored to manage the conditions of methemoglobinemia.
Tafenoquine treated patients should be watched for symptoms or signs of psychosis or depression as tafenoquine can cause psychiatric side effects particularly in patients with a history of psychiatric illness.
As tafenoquine tablets effect can stay in the body for nearly 15 days, the occurrence of psychiatric effects can be delayed.
Gastrointestinal: Nausea and vomiting
Nervous system: Dizziness, headache, weakness, abnormal dreams, anxiety, inability to sleep
Eye: Corneal deposits, sensitivity or intolerance to light
Others: Itching, high levels of methemoglobin, creatinine, and liver enzyme (ALT) in blood, allergic reactions such as breathing difficulty, hives, swelling of face and eyelids.
Women of childbearing age must be clearly advised to take effective contraceptives when tafenoquine tablets are taken and to follow the contraception for at least three months after the dose of tafenoquine.
Monitor patients carefully to avoid some severe side effects when tafenoquine is given to patients with kidney or liver disease.
Tafenoquine tablets come in a pack of 30 tablets and once opened should be used within three months. Discard unused tablets if any, after three months.
Drugs such as metformin and dofetilide should not be given together with tafenoquine as it may lead to toxicity of these drugs as this may be harmful.
If co-administration of tafenoquine with metformin and dofetilide cannot be avoided, patients should be monitored for drug-related side effects, and dose reduction of these drugs should be considered when given with tafenoquine.
Store tafenoquine tablets at room temperature between 20°C and 25°C.
Keep all the tablets in their original container.
Do not remove the desiccant provided in the container and protect the tablets from moisture and light.
Keep tafenoquine tablets away from the reach of children and pets.
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