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Primaquine: Uses, Dosage, and Side Effects for Malaria Prevention
Summary of Key Points
Primaquine is a prescription medication used to treat and prevent certain types of malaria, particularly relapsing forms caused by Plasmodium vivax and Plasmodium ovale. It is also effective against other parasitic infections. Primaquine works by eliminating parasites from the body. It is important to take this medication exactly as prescribed and consult your healthcare provider before making any changes to your dosage.
Names of Medication
US Brand Name: Primaquine
Generic Name: Primaquine Phosphate
The generic name refers to the active ingredient in the medication. It is the same chemical compound as the brand name but may be sold under different names.
Pharmacologic Category
Category: Antimalarial Agent
Class: Aminoquinoline
Primaquine Dosage
Primaquine is prescribed for various conditions, and the dosage depends on the specific illness being treated. Always follow your healthcare provider’s instructions and consult one of our telemedicine providers before adjusting your dose.
Malaria (Prevention of Relapse due to Plasmodium vivax or Plasmodium ovale)
Dosage: 30 mg (base) once daily
Duration: 14 days
Relapsing Malaria
Dosage: 30 mg (base) once daily
Duration: 14 days
Schistosomiasis
Dosage: 30 mg (base) once daily
Duration: 14 days
Leishmaniasis
Dosage: 30 mg (base) once daily
Duration: 14 days
Babesiosis
Dosage: 30 mg (base) once daily
Duration: 14 days
Pneumocystis Pneumonia (PCP)
Dosage: 30 mg (base) once daily
Duration: 14 days
Toxoplasmosis
Dosage: 30 mg (base) once daily
Duration: 14 days
Dosage Forms and Strengths
Tablet: 26.3 mg (equivalent to 15 mg base)
Administration Instructions for Primaquine
Take Primaquine with food to reduce the risk of stomach upset. It is essential to complete the full course of treatment, even if you start feeling better before finishing the medication. If you miss a dose, take it as soon as you remember, but do not take a double dose. Always consult your healthcare provider if you have any questions or concerns about how to take this medication.
Contraindications for Primaquine
A contraindication is a condition or situation where a medication should not be used because it may cause harm. If you have any of the conditions listed below, taking Primaquine could be dangerous. Always consult your healthcare provider before starting any new medication, including Primaquine.
Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency: Primaquine can cause severe hemolysis (destruction of red blood cells) in individuals with G6PD deficiency, an inherited condition that can lead to serious complications like anemia.
Pregnancy: Primaquine is contraindicated during pregnancy due to the risk of hemolysis in the fetus, particularly if the baby has G6PD deficiency.
Severe Liver Disease: Since Primaquine is metabolized in the liver, severe liver disease may impair the body’s ability to process the drug, leading to potential toxicity.
Autoimmune Disorders (e.g., Rheumatoid Arthritis, Lupus): Primaquine may worsen symptoms of autoimmune disorders, increasing the risk of complications.
Allergy to Primaquine: If you are allergic to Primaquine or any of its components, you should not take this medication, as it could trigger a severe allergic reaction.
Drug Interactions with Primaquine
Primaquine can interact with other medications, potentially causing harmful effects or reducing the effectiveness of either drug. Below are some medications that may interact with Primaquine:
Cimetidine (Tagamet): This drug can increase Primaquine levels in your blood, raising the risk of side effects.
Quinacrine (Atabrine): When taken with Primaquine, this drug may increase the risk of hemolysis, especially in individuals with G6PD deficiency.
Chloroquine (Aralen): Combining these drugs may increase the risk of side effects, such as gastrointestinal issues and hemolysis.
Anticoagulants (e.g., Warfarin, Coumadin): Primaquine may enhance the effects of blood thinners, increasing the risk of bleeding.
Other Antimalarial Drugs (e.g., Mefloquine, Lariam): Combining Primaquine with other antimalarial medications may increase the risk of side effects, including heart rhythm problems and hemolysis.
Primaquine in Pregnancy
Is it safe to take Primaquine when pregnant?
No, Primaquine is not considered safe during pregnancy. This antimalarial medication can cause hemolysis in the fetus, especially if the baby has a G6PD deficiency, which can lead to severe anemia and other complications. If you are pregnant or planning to become pregnant, it’s essential to consult your healthcare provider about safer alternatives for treating malaria or other conditions.
Primaquine while Breastfeeding
Is it safe to take Primaquine while breastfeeding?
Primaquine is generally not recommended during breastfeeding unless both the mother and infant have been tested for G6PD deficiency. If the infant has this deficiency, there is a risk of hemolysis. Always consult your healthcare provider before taking Primaquine while breastfeeding to carefully weigh the risks and benefits.
Estimated Cost of Primaquine Medication
The estimated cost of a 30-day supply of Primaquine without insurance, using a GoodRX coupon, typically ranges from $50 to $100. Prices may vary depending on the pharmacy and location. If cost is a concern, consider speaking with one of our providers through telemedicine to explore more affordable antimalarial medication options.
Possible Alternatives to Primaquine
Depending on the condition being treated, there may be alternative medications or lifestyle changes available. Always discuss any changes to your treatment plan with your healthcare provider before making adjustments.
Malaria
Alternative medications for malaria include Atovaquone-Proguanil (Malarone), Doxycycline, or Mefloquine (Lariam). In addition to medication, preventive measures such as using insect repellent and sleeping under mosquito nets can significantly reduce the risk of contracting malaria.
Plasmodium vivax and Plasmodium ovale
Chloroquine is often used as an alternative for these types of malaria. Additionally, Tafenoquine (Krintafel) may be considered to prevent relapses of Plasmodium vivax malaria.
Relapsing Malaria
Tafenoquine (Krintafel) is another option for preventing relapses. Always consult your healthcare provider to determine the best treatment plan for relapsing malaria.
Schistosomiasis
Praziquantel is the standard treatment for schistosomiasis. To reduce the risk of infection, it’s important to avoid contact with contaminated water sources.
Leishmaniasis
Amphotericin B or Miltefosine may be used as alternatives for treating leishmaniasis. Preventive measures include avoiding sandfly bites by using insect repellent and wearing protective clothing.
Babesiosis
Atovaquone and Azithromycin are commonly used alternatives for treating babesiosis. Preventing tick bites by wearing long sleeves and using tick repellents can help reduce the risk of this parasitic infection.
Pneumocystis Pneumonia
Trimethoprim-Sulfamethoxazole (Bactrim) is often used as an alternative for treating Pneumocystis pneumonia. Maintaining a strong immune system through a healthy lifestyle can also help prevent infections.
Toxoplasmosis
Pyrimethamine and Sulfadiazine are alternative treatments for toxoplasmosis. To prevent infection, avoid undercooked meat and practice good hygiene, especially when handling raw food or cleaning litter boxes.
Recent Updates on Primaquine Research
Recent studies have focused on the safety and efficacy of Primaquine in various populations, including those with G6PD deficiency. Researchers are also exploring the potential of combining Primaquine with other antimalarial drugs to improve treatment outcomes. Additionally, ongoing research is investigating the use of Primaquine for other parasitic infections, such as leishmaniasis and babesiosis. As new findings emerge, staying informed is crucial. Be sure to consult your healthcare provider about the latest treatment options. If you have questions about whether Primaquine is right for you, schedule a telemedicine appointment with one of our providers today.
