PRIMAQUINE Primaquine may be taken with or the form of hemoglobin that cannot without food. You may take primaquine carry oxygen). These effects are related PHOSPHATE with food to avoid an upset stomach. to the amount of primaquine taken and to persons who may already be Other NAMES: Primaquine What should you do if you FORGET a experiencing low red blood cell levels. dose? WHY is this drug prescribed? Rarely, primaquine may cause If you miss a dose of primaquine, take it leukopenia (a decrease in your white Primaquine is an antibiotic used to treat as soon as possible. However, if it is blood cells which are necessary to help different types of infections. time for your next dose, do not double fight bacterial infections). the dose, just carry on with your regular It can be given in combination with schedule. To ensure that you do not develop these clindamycin (Dalacin  C) for the adverse effects, it is important that you treatment of Pneumocystis carinii Why should you not forget to take come to your regular blood tests. pneumonia (PCP). This combination is this drug? Please notify your doctor if you develop usually used for people who have the following symptoms: fatigue, experienced adverse effects to sulfa If you miss doses of primaquine, your weakness, shortness of breath, rapid drugs such as trimethoprim- infection may continue or worsen. In heartbeat, dark– coloured urine, fever sulfamethoxazole (TMP/SMX, such a situation, you may need to take or chills . Bactrim , Septra ) or dapsone. This other drugs. Therefore, it is extremely combination is a safe and effective important that you take primaquine for It is important that you keep your alternative. the entire duration of the treatment. doctor appointments and come for your laboratory tests so that your It can also be given for the treatment of What ADVERSE EFFECTS can this progress can be followed. parasitic infections such as malaria. drug cause? What should you do about them? What other PRECAUTIONS should HOW should this drug be taken? you follow while using this drug? Primaquine is generally well tolerated. Primaquine is available as 15 mg Occasionally, this drug may cause Before starting primaquine, it is tablets. For the treatment of PCP, the nausea, vomiting, upset stomach, important to inform your doctor if you usual recommended dose is 15 to 30 loss of appetite, and abdominal have or have had in the past any mg once daily for 21 days. cramps . If these symptoms appear and allergies to primaquine, blood disorders, are bothersome, please inform your lupus (systemic lupus erythematosis – Your dosage is: doctor or pharmacist. SLE), or rheumatoid arthritis.

15 mg tablet Primaquine can also cause a variety of A deficiency of glucose – 6 – phosphate adverse effects most having to do with dehydrogenase or NADH- ____tablet(___mg) once a day blood. The most serious of these are methemoglobin reductase may make hemolytic anemia (the breakdown of you more susceptible to the blood red blood cells) and disorders described above. Contact methemoglobinemia (an increase in your doctor if you are deficient in these enzymes. Also, inform your doctor if If you have any questions or you have close relatives who have had concerns about this drug or if you blood disorders such as hemolytic are experiencing adverse effects, anemia or favism. please discuss them with your pharmacist, doctor or nurse. The safety of primaquine has not been PRIMAQUINE established during pregnancy or Write questions or concerns down to breastfeeding. In general, primaquine ensure they are addressed. PHOSPHATE should NOT be given if you are pregnant and breastfeeding is NOT The following pharmacist is available to recommended. Please discuss this with answer questions: your doctor or pharmacist if this is a concern. Pharmacist: ______

Other drugs may affect the way Telephone: ______primaquine works and may increase the chance of developing adverse effects. Also, primaquine may affect the way MEDICATION other drugs work. Inform your doctor and pharmacist of all prescribed and non-prescribed drugs you are taking. FACT SHEET As well, you should inform them of natural products you are taking. If you wish to start a new drug or natural product, please consult with your pharmacist before doing so.

How should this drug be STORED?

Primaquine tablets should be stored in a cool (15 to 30 °C) dry place, protected from light and well out of the reach of children. Ensure that the drug has not expired by checking the expiry date (“EXP”) shown on the outside of the package.

Do not store in your bathroom or Reference: Product Monograph Primaquine (primaquine phosphate). Markham, ON, Canada: Sanofi-Aventis Canada kitchen, as heat and moisture may Inc., 2006. Prepared by the Ontario HIV Pharmacy cause the drug to be less active. Professional Specialty Group, 2003. Reviewed 2009.

Additional medication fact sheets and updates may be found at: www.hivclinic.ca