Primaquine
About Primaquine
Primaquine is a prescription medication used primarily to prevent the relapse of certain types of malaria. It works by targeting malaria parasites that remain dormant in the liver, ensuring the infection is completely cleared from your body. This medication is essential for patients recovering from specific mosquito-borne infections to stop the disease from returning.
To achieve the best results, you must take Primaquine consistently and exactly as prescribed, without skipping any doses, even if you start to feel better. It is typically taken once daily for a specific number of days, and you should always take it with a meal or a glass of milk to help protect your stomach. Along with taking this medicine, getting plenty of rest and staying well-hydrated will support your body's recovery process.
While taking Primaquine, some people may experience mild side effects like nausea or stomach cramps. However, you must contact your doctor immediately if you notice serious signs such as dark-coloured urine, unusual tiredness, or pale skin. These symptoms can indicate a serious blood problem that requires urgent medical evaluation.
Talk to your doctor before starting Primaquine if you have any pre-existing health conditions, especially a genetic enzyme deficiency known as G6PD deficiency. Do not take this if you have G6PD deficiency or if you are pregnant, as the medicine can cause severe blood issues in both you and the unborn baby.
This medicine can interact with other drugs that affect your blood or immune system, so be sure to share your complete medication list with your healthcare provider. Avoid drinking alcohol while on this treatment to prevent excessive stomach irritation and avoid unnecessary strain on your liver. If you are breastfeeding or caring for an elderly patient, talk to your doctor or pharmacist to ensure this medicine is safe to use.
Uses of Primaquine
Medicinal Benefits
Primaquine offers several important benefits that help ensure:
- Helps Prevent Malaria Relapse: Primaquine destroys the dormant liver forms of malaria parasites that are not eliminated by standard antimalarial medicines, helping achieve a complete cure.
- Reduces the Risk of Future Episodes: By preventing the return of malaria, it helps you recover fully and return to your normal daily activities without the worry of repeated illness.
- Helps Prevent the Spread of Malaria: By reducing the number of parasites that mosquitoes can transmit, Primaquine helps protect your family, community, and others from infection.
- Supports Long-Term Recovery: Completing the full course of Primaquine helps ensure that hidden parasites are eliminated, reducing the likelihood of ongoing or recurrent malaria infections.
Directions for Use
- Take Primaquine with food to decrease the risk of stomach upset.
- Follow your doctor’s recommendations on the dosage and timing of this medication to achieve optimal results.
- Swallow it as a whole with a glass of water.
- Do not crush, chew, or break it.
Storage
Side Effects of Primaquine
Common Side Effects (Usually mild):
- Upset stomach or mild abdominal cramps
- Nausea and vomiting
- Loss of appetite
- Mild dizziness
Serious Side Effects (Call a doctor right away):
- Dark, tea-coloured, or brown urine
- Sudden, extreme tiredness or pale skin
- Yellowing of your skin or the whites of your eyes
- Shortness of breath or rapid heart rate
- Signs of a severe allergic reaction, such as skin rash, itching, swelling of the face, lips, or throat, and difficulty breathing
Medicines Containing this Salt
View AllDrug Warnings
- Get tested for G6PD deficiency first: You must undergo a blood test for G6PD enzyme deficiency before taking Primaquine, as this medicine can cause life-threatening red blood cell breakdown in people with this condition.
- Watch your urine colour: Pay close attention to the colour of your urine; if it turns dark brown or tea-coloured, stop taking the medicine and seek medical help immediately.
- Do not take if pregnant: This medicine is unsafe during pregnancy. Use reliable birth control during treatment, and notify your doctor immediately if you suspect you are pregnant.
- Complete the full course: Even if your symptoms disappear after a few days, you must finish the entire duration of the prescribed treatment to ensure the parasites in your liver are completely eradicated.
- Inform all healthcare providers: Let any doctor, dentist, or pharmacist you visit know that you are currently taking or have recently finished a course of Primaquine.
Drug Interactions
Primaquine may interact with certain medicines, increasing the risk of side effects or affecting how well your treatment works. Inform your doctor about all prescription medicines, over-the-counter products, and supplements you are taking, including:
- Quinacrine: Taking Primaquine with quinacrine can increase the toxic effects of Primaquine, significantly raising the risk of severe side effects.
- Bone marrow suppressing drugs: Combining this medicine with drugs that suppress bone marrow function can increase the risk of serious blood disorders
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
- Take with a fatty meal or milk: Taking your dose with food, especially meals containing a small amount of healthy fat or a glass of whole milk, can significantly reduce stomach irritation.
- Stay well-hydrated: Drink plenty of water throughout the day to support your liver and kidneys as your body processes the medication and clears the infection.
- Avoid alcohol: Do not consume alcohol while taking this medicine, as it can strain your liver and increase the risk of stomach upset.
- Use mosquito protection: Continue to protect yourself from mosquito bites by using insect repellent, wearing long sleeves, and sleeping under a treated mosquito net to prevent new infections.
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
Primaquine is used for the treatment of malaria.
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.
Primaquine is contraindicated in patients taking medications that may cause haemolysis or depress the myeloid elements of the bone marrow. It should not be taken by pregnant women and acutely ill patients with conditions like granulocytopenia (rheumatoid arthritis or lupus), or those who have recently taken quinacrine, as it may increase the risk of toxicity.
You should tell your doctor if you are taking cephalosporins such as cefaclor, cephalexin, cefuroxime, penicillin, cefdinir, or cefpodoxime, levodopa, medications to treat cancer, methyldopa or quinidine, or if you are taking or planning to take vitamins, nutritional supplements, and herbal products. Let the doctor know if you have or have ever had haemolytic anaemia (a condition with an abnormally low number of RBC), rheumatoid arthritis, lupus erythematosus (a disease that occurs when the body's tissues are attacked by antibodies from its immune system), methemoglobinemia (a condition with defective red blood cells that are unable to carry oxygen to the tissues in the body), nicotinamide adenine dinucleotide (NADH) deficiency (a genetic condition), glucose-6-phosphate dehydrogenase (G6PD) deficiency (a genetic condition) and if you are pregnant or breastfeeding.
Yes, Primaquine is safe if it is taken in the dose and duration prescribed by the doctor. Therefore, take Primaquine exactly prescribed by the doctor based on your medical condition.
If you have missed the dose, take it as soon as you remember and if it's already time for the next dose, skip the missed one and take the scheduled dose. Do not double the dose.
Swallow Primaquine as a whole with water; do not crush or chew it. Primaquine should be taken with food to decrease the risk of stomach upset.
Primaquine should be taken exactly as prescribed by the doctor, preferably with a meal to minimize stomach discomfort. For best results, take it at the same time every day.
No, Primaquine is not an antibiotic. It belongs to the group of medications called antimalarials used to treat and prevent malaria caused by the Plasmodium parasite. It is also used to prevent relapse of malaria caused by Plasmodium vivax and Plasmodium ovale.
Primaquine may impair kidney function in a few cases. Therefore, consult the doctor before taking Primaquine if you have any kidney problems.
Yes, Primaquine may cause drowsiness as a side effect. Avoid driving and operating machinery if you feel drowsiness and there is no evidence suggesting that Primaquine has any effect on blood pressure.
You need a blood test to check for G6PD deficiency, a common genetic trait. Taking Primaquine if you have this deficiency can cause your red blood cells to break down rapidly, leading to severe anaemia. Talk to your doctor to schedule this test before starting treatment.
It is highly recommended to take Primaquine with food or a glass of milk. Taking it on an empty stomach can cause significant nausea, vomiting, and stomach cramps. Talk to your doctor or pharmacist if you struggle with stomach upset.
If your urine turns dark brown or tea-coloured, stop taking the medicine and contact your doctor immediately. This is a primary sign of red blood cell breakdown, which requires prompt medical attention.
You must finish the full course to ensure all dormant malaria parasites in your liver are completely destroyed. Stopping early may leave sleeping parasites alive, which can wake up later and cause a relapse of malaria.
Primaquine is primarily used to prevent a relapse of certain types of malaria or to stop transmission, rather than as a primary preventive medicine for travellers. Talk to your doctor or pharmacist about the correct medications for malaria prevention before travelling.
Breastfeeding is generally not recommended unless both you and your infant have been tested and cleared of G6PD deficiency. The drug can pass into breast milk and harm a G6PD-deficient infant. Talk to your doctor to weigh the risks and benefits.
You should avoid alcohol while taking Primaquine. Alcohol can increase stomach irritation, worsen dizziness, and place extra stress on your liver during your recovery. Talk to your doctor if you have questions about alcohol use
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