Precautions
Before taking primaquine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: immune system disease (such as lupus, rheumatoid arthritis), blood problems (such as low white blood cell counts, anemia), history of blood problems due to primaquine (such as hemolytic anemia, methemoglobinemia), personal/family history of favism, low levels of certain blood enzymes (glucose-6-phosphate dehydrogenase-G6PD, NADH methemoglobin reductase).
Your doctor may order a blood test to see if you have any enzyme deficiency before starting primaquine.
Primaquine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.
The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using primaquine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using primaquine safely.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).
The manufacturer states that during pregnancy, this medication should be used only when clearly needed. While you are pregnant, traveling to an area with malaria places you and your infant at a much higher risk for death and other problems. The CDC recommends continuing your other malaria treatment (such as chloroquine) throughout pregnancy until delivery to prevent harm to your unborn baby (hemolytic anemia). After delivery, you may finish treatment with primaquine. Discuss the risks and benefits with your doctor.
It is not known whether this drug passes into breast milk and the effect on a nursing infant is unknown. The doctor should test your infant for G6PD deficiency before breastfeeding. Consult your doctor before breast-feeding.
Interactions
The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.
To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor’s approval.
Some products that may interact with this drug include: penicillamine, quinacrine, drugs that may cause decreased blood cells (such as trimethoprim, zidovudine, pyrimethamine, azathioprine).
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
