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?

Primaquine is a medication used to treat and prevent malaria caused by certain types of parasites. It is important to use primaquine exactly as prescribed by your healthcare provider. Here are general guidelines for the use of primaquine, but always follow the specific instructions provided by your doctor:

• Dosage: The dosage of primaquine will depend on the specific condition being treated and your individual health status. Follow your healthcare provider’s instructions regarding the dose and duration of treatment.
• Administration: Primaquine is usually taken by mouth with food or milk to reduce stomach upset. Swallow the tablets whole; do not crush or chew them.
• Timing: Take primaquine at the same time each day to maintain a consistent level in your bloodstream. This helps ensure its effectiveness.
• Completion of Course: It’s essential to complete the full course of treatment, even if your symptoms improve before the medication is finished. Failure to complete the prescribed course may result in the infection not being fully treated.
• Food and Drink: Taking primaquine with food or milk can help reduce stomach upset. Follow your healthcare provider’s recommendations regarding food and drink.
• Avoid Alcohol: Avoid consuming alcoholic beverages while taking primaquine, as it may increase the risk of side effects.
• Special Instructions: Inform your healthcare provider about any other medications, supplements, or herbal products you are taking, as they may interact with primaquine. Certain medications may need to be adjusted or avoided during primaquine treatment.
• Monitoring: Your healthcare provider may perform blood tests to monitor your response to primaquine and check for any potential side effects.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, inform your healthcare provider. Primaquine may not be suitable for pregnant women or nursing mothers, and your doctor will weigh the potential risks and benefits.
• Side Effects: Be aware of potential side effects and contact your healthcare provider if you experience any unusual symptoms or reactions. Common side effects may include nausea, vomiting, and abdominal cramps.

It is crucial to consult with your healthcare provider for personalized guidance on the use of primaquine based on your specific health condition and medical history. Never self-prescribe or adjust your dosage without consulting a healthcare professional.

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?

When using primaquine, certain precautions are important to ensure safe and effective treatment. Here are some special precautions to keep in mind:

• G6PD Deficiency: Primaquine can cause hemolysis (breakdown of red blood cells) in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Before starting primaquine, your healthcare provider may perform a G6PD screening test to determine if you are deficient. If you have G6PD deficiency, primaquine may not be suitable for you, or your doctor may adjust the dosage under close supervision.
• Pregnancy and Breastfeeding: Primaquine may not be recommended during pregnancy, especially in the first trimester. If you are pregnant, planning to become pregnant, or breastfeeding, inform your healthcare provider. The potential risks and benefits should be carefully assessed, and alternative treatments may be considered.
• Children: Primaquine may have different dosing recommendations for children, and the safety and effectiveness in pediatric populations may vary. Follow your healthcare provider’s guidance for the appropriate dosage and duration of treatment for children.
• Hematologic Monitoring: Regular monitoring of blood cell counts may be necessary during primaquine therapy. Your healthcare provider may order blood tests to check for signs of hemolysis or other hematologic abnormalities.
• Drug Interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking. Primaquine may interact with certain drugs, including other antimalarial medications, and adjustments may be necessary.
• Liver and Kidney Function: Primaquine is metabolized in the liver, and individuals with liver disease may require dose adjustments. Your healthcare provider may also consider kidney function when determining the appropriate dosage.
• Eye Examinations: In cases of prolonged use, especially in individuals with pre-existing eye conditions, periodic eye examinations may be recommended. Primaquine has been associated with retinal toxicity in some cases.
• Allergies: Inform your healthcare provider if you have a history of allergies or sensitivities to medications. Allergic reactions to primaquine are rare but can occur.
• Alcohol Consumption: Avoid consuming alcoholic beverages while taking primaquine, as it may increase the risk of certain side effects.
• Geographic Considerations: Primaquine is often used for the prevention of relapse in malaria caused by Plasmodium vivax or Plasmodium ovale. It is important to consider the geographical location and the specific type of malaria in the region to determine the appropriateness of primaquine treatment.

Always follow your healthcare provider’s recommendations and inform them of any changes in your health status or the development of new symptoms during treatment with primaquine. Never self-prescribe or adjust your dosage without consulting a healthcare professional.

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, can cause side effects. Not everyone will experience these side effects, and they can vary in severity. Common side effects of primaquine include:

• Gastrointestinal Effects:
  • Nausea
  • Vomiting
  • Abdominal cramps
• Hematologic Effects:
  • Hemolysis (breakdown of red blood cells), especially in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Methemoglobinemia (an abnormal increase in methemoglobin, reducing the oxygen-carrying capacity of blood)
• Central Nervous System Effects:
  • Headache
• Dermatologic Effects:
  • Itching (pruritus)
  • Rash
• Gastrointestinal Effects:
  • Epigastric distress
  • Loss of appetite
• Other Effects:
  • Dizziness
  • Weakness
  • Darkening of urine (due to the excretion of byproducts from the breakdown of red blood cells)

Serious side effects are rare but can occur. Seek immediate medical attention if you experience any of the following:

• Signs of an allergic reaction, such as difficulty breathing, swelling of the face, lips, or tongue, or severe rash
• Symptoms of hemolysis, including pale or yellowed skin, dark urine, fatigue, or shortness of breath
• Symptoms of methemoglobinemia, such as bluish or grayish discoloration of the skin, lips, or nails, headache, or rapid heart rate

It’s important to note that primaquine can cause hemolysis in individuals with G6PD deficiency. Therefore, before starting primaquine, your healthcare provider may perform a G6PD screening test to identify those at risk.

This list is not exhaustive, and individual responses to medication can vary. Always report any unusual or severe symptoms to your healthcare provider promptly. Additionally, inform your healthcare provider of any other medications or supplements you are taking, as drug interactions can occur. Your healthcare provider will weigh the potential benefits against the risks when prescribing primaquine based on your specific health status and medical history.

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

Storage of Primaquine:

• Store primaquine at room temperature, away from moisture and heat.
• Keep the medication in its original packaging, and ensure it is tightly closed.
• Keep it out of reach of children and pets.

Disposal of Primaquine:

• Dispose of expired or unused medication properly, following local regulations or guidelines.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Check with your local pharmacy or waste disposal facility for proper disposal methods.

In case of emergency/overdose

In case of an overdose or emergency, contact your local poison control center (1-800-222-1222 in the United States) or seek emergency medical attention. Symptoms of an overdose may include nausea, vomiting, abdominal cramps, dizziness, weakness, and other adverse effects. Provide information about the amount of medication taken and any symptoms experienced.

What other information should I know?

• Follow Healthcare Provider’s Instructions: Take primaquine exactly as prescribed by your healthcare provider. Do not change the dosage or stop taking the medication without consulting your doctor.
• Regular Monitoring: Your healthcare provider may perform blood tests to monitor your response to primaquine and check for any potential side effects.
• Inform Healthcare Provider: Report any unusual symptoms, side effects, or changes in health to your healthcare provider promptly.
• G6PD Deficiency: Inform your healthcare provider if you have a history of G6PD deficiency, as primaquine can cause hemolysis in individuals with this condition.
• Other Medications: Inform your healthcare provider about all medications, supplements, and herbal products you are taking to avoid potential interactions.
• Geographic Considerations: Primaquine is often used for the prevention of relapse in malaria caused by specific parasites. Follow your healthcare provider’s recommendations based on the geographical location and type of malaria in the region.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of primaquine with your healthcare provider.
• Alcohol Consumption: Avoid consuming alcoholic beverages while taking primaquine, as it may increase the risk of certain side effects.

Always seek guidance from your healthcare provider for personalized advice regarding the use of primaquine based on your individual health circumstances. If you have any concerns or questions, don’t hesitate to contact your healthcare provider or pharmacist for clarification.