Why is this medication prescribed?

Primaquine is a medication primarily prescribed for the treatment and prevention of malaria. It is effective against the liver stage of the malaria parasite (Plasmodium vivax and Plasmodium ovale) and helps prevent relapses of these types of malaria. Primaquine is often used in combination with other antimalarial drugs for a more comprehensive treatment approach.

How should this medicine be used?

Here are some general guidelines on how Primaquine is commonly used:

• Dosage: The dosage of Primaquine can vary based on factors such as the patient’s age, weight, and the specific type of malaria being treated or prevented. It is crucial to follow the prescribed dosage provided by the healthcare professional.
• Administration: Primaquine is usually taken orally with food to reduce stomach upset. The tablets should be swallowed whole, not crushed or chewed.
• Duration of Treatment:
  • For the treatment of malaria: The duration of treatment with Primaquine can vary, but it is typically taken for a specified number of days as prescribed by the healthcare provider.
  • For the prevention of relapse: Primaquine may be prescribed for a longer duration to prevent relapses of malaria caused by Plasmodium vivax or Plasmodium ovale.
• Adherence to Treatment Plan: It is essential to complete the full course of treatment, even if symptoms improve before completion. Failure to complete the prescribed course may result in the recurrence of malaria.
• Monitoring: Regular monitoring by healthcare professionals may be necessary during and after treatment to assess the effectiveness of the medication and check for any potential side effects.
• G6PD Deficiency Screening: Before prescribing Primaquine, healthcare providers may screen individuals for glucose-6-phosphate dehydrogenase (G6PD) deficiency. Primaquine can cause hemolysis (destruction of red blood cells) in individuals with G6PD deficiency, and caution or an alternative treatment may be required.

It is crucial to consult with a healthcare professional for personalized advice and information regarding the use of Primaquine, as individual circumstances may vary. Additionally, adherence to recommended malaria prevention measures, such as insecticide-treated bed nets and mosquito bite prevention, is important in conjunction with antimalarial medications.

Other uses for this medicine

In addition to its primary use in the treatment and prevention of malaria, Primaquine may also be used for other medical purposes. It is sometimes prescribed for the management of certain types of pneumonia (Pneumocystis jiroveci pneumonia or PCP) and as a part of combination therapy for the treatment of leishmaniasis, a parasitic infection.

What special precautions should I follow?

Special precautions should be taken when using Primaquine. Here are some important considerations:

• G6PD Deficiency: Primaquine can cause hemolysis (destruction of red blood cells) in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Before starting Primaquine, healthcare providers often screen individuals for G6PD deficiency. If a person is found to be deficient, alternative treatments may be considered, or the dosage may be adjusted with close monitoring.
• Pregnancy and Breastfeeding: Primaquine is generally avoided during pregnancy, especially in the first trimester, due to the potential risk to the developing fetus. It may be used during pregnancy only if the benefits outweigh the risks. Breastfeeding individuals should consult their healthcare providers before taking Primaquine, as it may be excreted in breast milk.
• Contraindications: Primaquine is contraindicated in individuals with a known hypersensitivity to the drug.
• Drug Interactions: Primaquine may interact with other medications. Inform your healthcare provider about all the medications, supplements, and herbal products you are currently taking to avoid potential interactions.
• Monitoring: Regular monitoring of blood parameters may be required during Primaquine therapy, especially in individuals with G6PD deficiency. This helps healthcare providers assess the drug’s safety and efficacy and detect any potential adverse effects.
• Methemoglobinemia: Primaquine may cause methemoglobinemia, a condition where the oxygen-carrying capacity of hemoglobin is reduced. This can lead to shortness of breath and other symptoms. Monitoring for signs and symptoms of methemoglobinemia is essential, and treatment adjustments may be needed if this condition occurs.
• Psychiatric Effects: Primaquine has been associated with psychiatric effects, including vivid dreams and nightmares. Individuals experiencing such effects should notify their healthcare provider.

It is crucial to provide your healthcare provider with a comprehensive medical history and adhere to their recommendations when using Primaquine or any medication. If you have any concerns or experience adverse effects while taking Primaquine, promptly contact your healthcare professional for guidance.

What special dietary instructions should I follow?

There are generally no specific dietary restrictions associated with Primaquine. However, taking the medication with food can help reduce the risk of stomach upset. It is advisable to follow your healthcare provider’s instructions regarding food and medication interactions.

What should I do if I forget a dose?

If you forget to take a dose of Primaquine, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.

What side effects can this medication cause?

Primaquine, like any medication, may cause side effects. It’s important to note that not everyone will experience these side effects, and the severity can vary from person to person. Common side effects of Primaquine include:

• Gastrointestinal Disturbances: Nausea, vomiting, and abdominal pain are among the most common gastrointestinal side effects. Taking Primaquine with food can help alleviate these symptoms.
• Hemolysis in G6PD-Deficient Individuals: Primaquine can cause hemolysis (destruction of red blood cells) in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. This can lead to anemia and other complications.
• Methemoglobinemia: Primaquine may cause an increase in methemoglobin levels, reducing the oxygen-carrying capacity of hemoglobin. Symptoms of methemoglobinemia include shortness of breath and cyanosis (bluish discoloration of the skin and mucous membranes).
• Psychiatric Effects: Some individuals may experience vivid dreams or nightmares while taking Primaquine.
• Hypersensitivity Reactions: Allergic reactions to Primaquine are rare but can include rash, itching, and swelling.
• Dizziness or Headache: Some people may experience dizziness or headaches as side effects.
• Hemolytic Anemia in Pregnancy: Primaquine is generally avoided during pregnancy, especially in the first trimester, as it may cause hemolytic anemia in the fetus.
• Other Rare Side Effects: Other rare side effects may include changes in liver function tests, changes in blood counts, and photosensitivity.

It’s important to seek medical attention if you experience severe or persistent side effects. Additionally, before starting Primaquine, healthcare providers often screen individuals for G6PD deficiency and other conditions to identify those at higher risk of adverse effects.

If you are prescribed Primaquine, your healthcare provider will weigh the potential benefits against the risks and monitor you for any adverse effects. Always inform your healthcare provider of any existing medical conditions, medications you are taking, or if you are pregnant or breastfeeding.

This list is not exhaustive, and individual reactions can vary. If you have concerns about the side effects of Primaquine, discuss them with your healthcare provider for personalized guidance.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Store Primaquine at room temperature, away from moisture and heat. Keep the medication in its original container, and ensure it is tightly closed. Protect it from light.
• Keep Out of Reach of Children: Store medications in a location that is out of reach of children and pets to prevent accidental ingestion.
• Disposal: Dispose of expired or unused Primaquine properly according to local regulations. Do not flush medications down the toilet or throw them in the trash. Check with your local pharmacy or healthcare provider for guidance on proper disposal.

In case of emergency/overdose

In case of an overdose or emergency, contact your local poison control center or emergency room immediately. Overdose symptoms may include nausea, vomiting, dizziness, headache, and other adverse reactions. Provide as much information as possible, including the amount of Primaquine ingested, the time of ingestion, and the person’s age and weight.

What other information should I know?

• Follow Healthcare Provider’s Instructions: Take Primaquine exactly as prescribed by your healthcare provider. Do not alter the dosage or stop taking the medication without consulting your healthcare professional.
• Regular Monitoring: Your healthcare provider may conduct regular blood tests to monitor your response to Primaquine and check for any potential side effects.
• G6PD Deficiency Screening: Before starting Primaquine, individuals are often screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency to identify those at higher risk of hemolysis.
• Avoid Alcohol: Alcohol consumption may increase the risk of certain side effects. It’s advisable to consult with your healthcare provider regarding alcohol use while taking Primaquine.
• Inform Healthcare Provider: Inform your healthcare provider about all the medications, supplements, and herbal products you are taking, as Primaquine may interact with other drugs.
• Malaria Prevention Measures: While taking Primaquine for malaria prevention, continue to take other recommended measures to prevent mosquito bites, such as using bed nets and insect repellent.
• Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, inform your healthcare provider before starting Primaquine, as the medication may have specific considerations during these periods.
• Travel Advice: If you are taking Primaquine for travel-related purposes, ensure you follow any additional recommendations for malaria prevention in the specific region you are visiting.

Always consult with your healthcare provider for personalized advice and information based on your individual health status and medical history. If you have any concerns or experience unexpected reactions, contact your healthcare provider promptly.