Primaquine
About
Primaquine belongs to the class 'anti-malarials' primarily used for the treatment of malaria. A disease caused by a plasmodium parasite, transmitted by the bite of infected mosquitoes. The severity of malaria varies based on the species of plasmodium. Symptoms are chills, fever and sweating, usually occurring a few weeks after being bitten. People travelling to areas where malaria is common typically take protective drugs before, during and after their trip.
Primaquine contains 'primaquine'. It works by increasing the levels of haeme in the blood, a substance toxic to the malarial parasite. This kills the parasite and stops the infection from spreading. In this way Primaquine used for the prevention of relapse of malaria caused by plasmodium vivax and Plasmodium ovale strains of the parasite.
Primaquine should be taken as prescribed by your doctor, preferably with a meal to avoid stomach upset and at fixed intervals every day for best results. The dose of Primaquine can vary depending upon your condition and the severity of the infection. It is recommended to complete medicine and take this medicine as prescribed by your doctor before visiting a malaria-prone area. The common side effects of Primaquine include rash, vomiting, headache, dizziness, hives, stomach pain, nausea, abdominal pain, itching, heartburn, gastrointestinal discomfort, upper abdominal pain. Everyone need not experience the above side effects. In case of any discomfort, stop the medicine and speak with your doctor.
Before starting Primaquine, please inform your doctor if you are allergic to Primaquine. Do not take Primaquine on your own. Primaquine is used in caution with Pregnant/breast-feeding mother. Primaquine is not recommended in patients with heart disease, liver, kidney problems and rheumatoid-arthritis.
Uses of Primaquine
Medicinal Benefits
Primaquine belongs to the class 'anti-malarials' primarily used for the treatment of malaria. Primaquine contains 'primaquine'. It works by increasing the levels of haeme in the blood, a substance toxic to the malarial parasite. This kills the parasite and stops the infection from spreading. In this way Primaquine used for the prevention of relapse of malaria caused by plasmodium vivax and Plasmodium ovale strains of the parasite. Primaquine can also be given in combination with clindamycin for the treatment of Pneumocystis carinii pneumonia (PCP).
Directions for Use
Storage
Side Effects of Primaquine
- Rash
- Vomiting
- Headache
- Stomach pain
- Dizziness
- Lightheadedness
- Hives
- Dark-coloured urine
- Abdominal pain
- Confusion
- Weakness
- Itching
- Heartburn
- Nausea
- Gastrointestinal discomfort
- Upper abdominal pain
In-Depth Precautions and Warning
Drug Warnings
Before starting Primaquine, please inform your doctor if you are allergic to Primaquine. Do not take Primaquine on your own. Primaquine is used in caution with Pregnant/breast-feeding mother. Primaquine is not recommended in patients of heart disease, liver, kidney problems and rheumatoid arthritis. Primaquine is not recommended in patients of diabetes. Primaquine is not recommended for use in acutely ill patients suffering from a systemic disease like rheumatoid arthritis and lupus erythematosus. There is a marked decrease in the number of granulocytes in such conditions. Primaquine is also not recommended for use if you are receiving a medication that can cause anaemia or suppression of the immune system by affecting bone marrow cells as a side effect. Medicine is not recommended for use if you are consuming Quinacrine or any other combination medicine containing quinacrine (anti-malarial drug). Patients should avoid pregnancy during treatment. It is recommended to take this medicine for the entire prescribed duration even when symptoms improve or resolve. Failure to do so might result in drug resistance. Sexually active women can take effective Contraceptive pills and men should use a condom during and 3months after stopping the treatment. Primaquine should be discontinued immediately when leukopenia (reduced white blood cells) occurs.
Drug Interactions
Drug-Drug Interaction: Primaquine can interact with pain killers (aspirin), antibiotics (ciprofloxacin), antimalarials (quinacrine), corticosteroids (dexamethasone), anti-epileptic (Phenytoin), vitamins (cyanocobalamin, cholecalciferol, riboflavin, pyridoxine, thiamine, ascorbic acid).
Drug-Food Interaction: Limit the consumption of grapefruit or grapefruit juice with Primaquine as it can significantly increase the level of this medicine in the blood.
Drug-Disease Interaction: People affected with eye disorder (oculotoxicity), blood disease (porphyria), heart disease (arrhythmias), bone marrow suppression, seizures, enzyme deficiency (G-6-PD deficiency), liver disease (hepatotoxicity), hemolytic anaemia should not take Primaquine without doctors consultation.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionInteraction of Primaquine with alcohol is unknown. It is advisable to consult your doctor before consumption.
Pregnancy
cautionPrimaquine is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations, if the benefits are more than the potential risks. Please consult your doctor.
Breast Feeding
cautionPrimaquine is recommended for use in breastfeeding women only after diagnostic tests are performed to confirm normal G6PD enzyme levels. Consult your doctor before using this medicine
Driving
cautionPrimaquine may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
Liver
cautionPrimaquine therapy is unlikely to cause liver injury in normal individuals but can trigger an acute worsening of porphyria in rare cases. Thus doctor's consultation is recommended before taking Primaquine
Kidney
cautionPrimaquine administration impairs kidney function in a few cases, so a patient is recommended to consult a doctor before taking Primaquine.
Children
cautionSafe to use in children (<12) yet dose adjustment by a doctor will be done on the basis of age, weight and severity of the infection.
Habit Forming
Diet & Lifestyle Advise
- Adequate nutrition is the key to improvement in malaria induced weakness.
- It is important to allow the patient to eat regularly in small amounts to tolerate the food.
- Increase fluid and protein intake for malaria induced weight loss.
- Proper rest and mosquito-free premises is important for the patient to recover
- Avoid eating fried and processed foods, junk oily and spicy foods can aggravate nausea and can disturb the digestion process in the body.
- High fibre foods like whole-grain cereals must be avoided by malaria patients. Instead, the intake of fruits and pulses should be increased as they provide adequate nutrition
Special Advise
- Always take Primaquine with meals for reduced gastric irritation.
- Eye examination prior to and at 3–6 monthly intervals during use is required if patients are receiving Primaquine at continuous high doses for a longer duration.
- It may cause low blood sugar level. Monitor your blood sugar level regularly, if you are diabetic.
- When Primaquine used long term, your doctor may monitor the amounts of the different types of blood cells in your blood regularly.
Patients Concern
Disease/Condition Glossary
Malaria: It is a severe & fatal parasitic infection caused by a protozoan called Plasmodium. 4 types of parasites can infect humans with malaria: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malaria. Female anopheles mosquito bites cause it. If bitten by an infected mosquito (the Anopheles mosquito), malaria parasites are injected into the blood. These parasites then migrate to the liver where they multiply via the bloodstream. A patient doesn't feel sick at this period because the parasites are in the liver. Then the parasites leave the liver and enter the red blood cells where the parasites are developing and then the red blood cells burst, allowing them to transfer to another blood cell. The parasites release harmful chemicals into the bloodstream at this point and the patient begins to feel ill. Malaria leads to periodic fever-chills, anaemia, kidney failure and jaundice because of excessive red blood cell death due to plasmodium growth inside them.
FAQs
No, as there may be a risk of hemolysis in patients with G6PD deficiency. Doctors consultation is mandatory.
Primaquine works by increasing the levels of haeme in the blood, a substance toxic to the malarial parasite. This kills the parasite and stops the infection from spreading. In this way Primaquine used for the prevention of relapse of malaria caused by plasmodium vivax and Plasmodium ovale strains of the parasite.
Common side effects of Primaquine include rash, vomiting, headache, dizziness, hives, stomach pain, nausea, abdominal pain, itching, heartburn, gastrointestinal discomfort, upper abdominal pain.
No, do not stop taking Primaquine. It is recommended to take this medicine for the entire prescribed duration even when symptoms improve or resolve. Failure to do so might result in drug resistance and treating any subsequent infection with the same medicine would be very difficult.
No, Primaquine is not safe to use in heart problems. The use of this medicine may increase the risk of irregular heart rhythms. Therefore, it should be used with caution in patients with arrhythmias or any other heart diseases. Any symptoms of palpitations, difficulty in breathing should be reported to the doctor.
