Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Primacin (Boucher & Muir)
7.5 mg tablets
Approved indication: malaria
Australian Medicines Handbook Section 5.4.1
Primaquine has been used in the treatment of malaria for over 50 years; however, it has not been available in Australia for several years. Each year there are approximately 500 requests to use the drug under the Special Access Scheme.
Primaquine acts against the liver (hypnozoite) stage of Plasmodium vivax and Plasmodiumovale. It is therefore indicated for the prevention of relapse (radicalcure) of these infections. Primaquine can also be used as adjunctive therapyin the treatment of Plasmodium falciparum as it is effective against gametocytes.
Usually, primaquine is well tolerated, but all patients should be tested forglucose-6-phosphate dehydrogenase deficiency. This is because of the risk of haemolytic anaemia. Leucocytosis, methaemoglobinaemia and haemolytic anaemia can all occur at therapeutic doses. Gastrointestinal adverse effects are more common, but can be reduced by taking primaquine with food.