Last update Jan. 30, 2022

Primaquine Phosphate

Compatible

Safe product and/or breastfeeding is the best option.

It is an 8-aminoquinoline used in the treatment of malaria. Oral administration. Single daily dose for 14 days.

It is excreted in human milk in a clinically non-significant amount, no problems have been observed in infants whose mothers took it and the plasma levels of these infants were either very low or below the limit of detection. (Gilder 2018)

WHO List of Essential Medicines 2002: compatible with breastfeeding in healthy newborns, avoid, if possible, in premature infants and children under one month due to the risk of jaundice. (WHO 2010 and 2002)

Avoid in glucose-6-phosphate-dehydrogenase deficiency (G6PD) (CDC 2019, Lalloo 2016, Chen 2010, WHO 2010 and 2002), although the extremely low dose of primaquine received through the mothers’ milk has been found to be highly unlikely cause hemolysis in G6PD-deficient infants. (Brummaier 2020, Watson 2018, Saito 2018, Gilder 2018)

Alternatives

  • Chloroquine (Safe product and/or breastfeeding is the best option.)
  • Mefloquine Hydrochloride (Safe product and/or breastfeeding is the best option.)
  • Quinine (Safe product and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Primaquine Phosphate in other languages or writings:

Group

Primaquine Phosphate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Primaquine Phosphate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 96 %
Molecular weight 259 daltons
VD 3.8 l/Kg
pKa 17.1 -
Tmax 3 - 4 hours
4 - 7 hours
Theoretical Dose 0.003 mg/Kg/d
Relative Dose 0.6 %
Ped.Relat.Dose 0.76 %

References

  1. Brummaier T, Gilder ME, Gornsawun G, Chu CS, Bancone G, Pimanpanarak M, Chotivanich K, Nosten F, McGready R. Vivax malaria in pregnancy and lactation: a long way to health equity. Malar J. 2020 Jan 22;19(1):40. Abstract Full text (link to original source)
  2. CDC. Centers for Disease Control and Prevention. Tan K, Arguin PM. Chapter 4. Travel-Related Infectious Diseases. Malaria. CDC Health Information for International Travel. 2019 Full text (link to original source)
  3. Saito M, Gilder ME, McGready R, Nosten F. Antimalarial drugs for treating and preventing malaria in pregnant and lactating women. Expert Opin Drug Saf. 2018 Nov;17(11):1129-1144. Abstract Full text (link to original source) Full text (in our servers)
  4. Gilder ME, Hanpithakphong W, Hoglund RM, Tarning J, Win HH, Hilda N, Chu CS, Bancone G, Carrara VI, Singhasivanon P, White NJ, Nosten F, McGready R. Primaquine Pharmacokinetics in Lactating Women and Breastfed Infant Exposures. Clin Infect Dis. 2018 Sep 14;67(7):1000-1007. Abstract Full text (link to original source)
  5. Watson J, Taylor WRJ, Bancone G, Chu CS, Jittamala P, White NJ. Implications of current therapeutic restrictions for primaquine and tafenoquine in the radical cure of vivax malaria. PLoS Negl Trop Dis. 2018 Apr 20;12(4):e0006440. Abstract Full text (link to original source)
  6. Sanofi A. Primaquine. Drug Summary. 2017 Full text (in our servers)
  7. Lalloo DG, Shingadia D, Bell DJ, Beeching NJ, Whitty CJM, Chiodini PL; PHE Advisory Committee on Malaria Prevention in UK Travellers.. UK malaria treatment guidelines 2016. J Infect. 2016 Jun;72(6):635-649. Abstract Full text (link to original source)
  8. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (in our servers)
  9. WHO. Guidelines for the treatment of malaria. 2nd ed. Geneva: WHO, 2010 2nd ed. Geneva: WHO, 2010 Full text (link to original source) Full text (in our servers)
  10. Pérez JL, Carranza C, Mateos F. Antiparasitarios. Revisión de los fármacos útiles en el tratamiento de parasitosis clásicas y emergentes. \ [Antiparasitic drugs. Review of the useful drugs in the treatment of classic and emergent parasitic diseases]. Rev Esp Quimioter. 2009 Jun;22(2):93-105. Review. Spanish. Abstract Full text (link to original source) Full text (in our servers)
  11. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)

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