Radical treatment of vivax or ovale malaria
Adult: A course of treatment with a blood schizontocide should be given first to kill any erythrocytic parasites. 15 mg daily for 14 days, increased to higher doses or longer course if resistance in P.vivax occurs.
Child: 250 mcg/kg daily for 14 days.
Prophylaxis of chloroquine-resistant malaria
Adult: 30 mg once daily; to be started 1-2 days before travel and continue for 7 days after departure from the malaria-endemic area.
Child: 0.5 mg/kg once daily for 14 days. Max: 30 mg/day. Alternatively, for patients with mild G6PD deficiency: 45 mg once wkly for 8 wk.
Hypersensitivity. Childn <1 yr. Acute flare-ups of systemic diseases (RA, SLE) having tendency for agranulocytopaenia, Pregnancy and lactation.
Warnings / Precautions
G6PD deficiency; pregnancy; NADH methaemoglobin reductase deficient patients. Monitor Hb levels and blood counts routinely. Patients with systemic diseases that have an increased risk of granulocytopenia. Withdraw treatment if signs of haemolysis or methaemogloinaemia occur.
Adverse Reactions
Nausea, vomiting, epigastric distress, abdominal cramps, leukopaenia, leucocytosis, agranulocytosis, methaemoglobinemia in NADH methaemoglobin reductase-deficient individuals.
Potentially Fatal: Haemolytic anaemia (G6PD deficient), thrombocytopaenia, leucopaenia, AV block.
Drug Interactions
Primaquine may inhibit metabolism of chloroquine. Avoid ethanol.
Potentially Fatal: Mepacrine may potentiate toxicity of primaquine. Potentially haemolytic drugs eg, sulphonamides, nitrofurans and bone marrow suppressants eg, methotrexate, phenylbutazone, chloramphenicol should not be co-admin with primaquine.
See Below for More primaquine Drug Interactions
Mechanism of Actions
Primaquine is an 8-aminoquinoline antimalarial which eliminates the exoerythrocytic forms of malarial parasite P.vivax, P. falciparum by disrupting mitochondria and binding to DNA. By this action primaquine achieves radical cure of vivax malaria. It is also active against gametocytes of P.falciparum.
Absorption: Readily absorbed from the GIT; peak plasma concentrations after 1-2 hr (oral).
Distribution: Widely distributed throughout body tissues. Protein-binding: 98%
Metabolism: Hepatic; converted to carboxyprimaquine (major metabolite).
Excretion: Urine (as unchanged drug); 3-6 hr (elimination half-life).
Should be taken with food. (Take w/ meals to avoid GI discomfort.)
Storage Conditions
Oral: Store at 25°C.
ATC Classification
P01BA03 - primaquine ; Belongs to the class of aminoquinoline antimalarials.
Oral: Store at 25°C.
Available As
  • Primaquine 15 mg
  • Primaquine 2.5 mg
  • Primaquine 7.5 mg
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