Names and pronunciation
(prim′a-kween)
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Drug reference
(prim′a-kween)
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Func. class.: Antimalarial
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Chem. class.: Synthetic 8-aminoqui- nolone
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ACTION: Unknown; thought to destroy exoerythrocytic forms by gametocidal action
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USES: Malaria caused by Plasmodium vivax; in combination with clindamycin for Pneumocystis jiroveci pneumonia
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CONTRAINDICATIONS: Lupus erythematosus, rheumatoid arthritis; hypersensitivity to this product or iodoquinol Precautions: Pregnancy, breastfeed- ing, methemoglobin reductase defi- ciency, bone marrow suppression, hemolytic anemia, G6PD deficiency
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SIDE EFFECTS CNS: Headache, dizziness CV: Hypertension, dysrhythmias EENT: Blurred vision, difficulty focusing GI: Nausea, vomiting, anorexia, cramps HEMA: Agranulocytosis, granulocytopenia, leukopenia, hemolytic anemia, leukocytosis, mild anemia, methemoglobinemia INTEG: Pruritus, skin eruptions, pallor, weakness
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INTERACTIONS • Increase: Toxicity: quinacrine Decrease: effect of carBAMazepine, PHENo- barbital, phenytoins, rifamycins, nafcillin Drug/Food Increase: primaquine effect—food Decrease: primaquine effect—grapefruit juice Drug/Lab Test Increase: WBC Decrease: WBC, RBC, HB
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DOSAGE AND ROUTES • Adult: PO 15-30 mg (base)/day × 2 wk or 45 mg (base)/wk × 8 wk; 26.3-mg tab is 15-mg base • Child: PO 0.5 mg/kg (0.3 mg/base/ day) daily × 2 wk
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Available forms: Tabs 26.3 mg (15 mg base)
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Administer: PO route • Before or after meals at same time each day to maintain product level; take with food to decrease GI upset
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Assess: • Hepatic studies weekly: AST, ALT, bili- rubin if patient receiving long-term ther- apy • Blood studies: CBC; blood dyscrasias occur • Allergic reactions: pruritus, rash, urti- caria • Blood dyscrasias: malaise, fever, bruising, bleeding (rare) • Renal status: dark urine, hematuria, decreased output • Hemolytic reaction: chills, fever, chest pain, cyanosis; product should be discontinued immediately; hemolytic anemia, G6PD deficiency may be severe in patients of Asian, Mediterranean de- scent • Pregnancy/breastfeeding: do not use in pregnancy/breastfeeding; pregnancy testing should be completed in sexually active females of childbearing age; ade- quate contraception should be used while taking this product
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Evaluate: • Therapeutic response: decreased symp toms of malaria
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To report visual problems, fever, fa- tigue, dark urine, bruising, bleeding; may indicate blood dyscrasias • To complete full course of therapy; to take with food to decrease GI upset; if vomiting occurs within 30 min of taking dose, to repeat the dose
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PHARMACOKINETICS PO: Metabolized by liver (metabolites), half-life 3.7-9.6 hr
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• Adult: PO 15-30 mg (base)/day × 2 wk or 45 mg (base)/wk × 8 wk; 26.3-mg tab is 15-mg base
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• Child: PO 0.5 mg/kg (0.3 mg/base/ day) daily × 2 wk
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