Antimicrobials
Primaquine

Primaquine

None
Excellent

Spectrum of Activity

Dosing

General Information

Non-formulary at MSH

  • Pneumocystic jirovecii pneumonia (PJP) treatment
  • Malaria treatment or relapse prevention
  • Monitor QTc in patients with increased risk
  • G6PD testing prior to therapy or baseline hematocrit and hemoglobin testing with periodic CBC 
  • Pregnancy test prior to therapy in sexually active females
  • Cardiac arrhythmia and QT prolongation
  • Nausea, vomiting, epigastric distress, abdominal pain
  • Leukopenia, hemolytic anemia (G-6-PD deficient)
  • Neutropenia
  • Methemoglobinemia (NADH methemoglobin reductase deficient)
  • Dizziness
  • Maculo-papular rash, pruritus
  • CYP2D6, CYP3A4 inhibitors – Increased serum concentration 
  • Other QTc prolonging agents
  • Phenothiazines – Increased serum concentration of Phenothiazines
  • Beta-blockers – Decreased metabolism of Beta-blockers
  • Cardiac glycosides – Increased serum concentration of Cardiac Glycosides
  • Chloroquine – Increased serum concentration
  • Dapsone – Enhanced toxicity of Dapsone (G-6-PD deficient)
  • Local Anesthetics, Nitric oxide, Prilocaine, Sodium nitrite – Increased risk of methemoglobinemia 
  • Potential worsening of bone marrow suppression when added to other bone marrow suppressive agents
  • Antimicrobial class: Aminoquinolone
  • Pregnancy: Contraindicated
  • Average serum half life: 3 – 6 hours
  • Lung penetration: Therapeutic
  • Likely widely distributed though specific data is lacking