II. Indications
- Malaria Prophylaxis
- Plasmodium Vivax Prevention of Relapse
III. Contraindications
- G6PD Deficiency
- NADH Methemoglobin Reductase Deficiency
- Age <16 years
IV. Medications
- Tafenoquine Succinate Tablets: 100 mg (Arakoda) or 150 mg (Krintafel)
- Do not break or chew tablets
V. Mechanism
- Tafenoquine Succinate is a long acting Primaquine analog
- Tafenoquine is an 8-aminoquinolone antimalarial
VI. Dosing
-
Malaria Prophylaxis (Adults or age >16 years)
- Start 200 mg orally daily for 3 days before travel
- Next 200 mg orally once weekly until 1 week after last exposure
- Avoid prolonged use >6 months
-
Plasmodium Vivax Prevention of Relapse (Adults or age >16 years)
- Take 300 mg orally for one dose on the first or second day of acute Malaria treatment
VII. Pharmacokinetics
- Half-Life: 15 to 17 days
- Minimal metabolism
VIII. Adverse Effects
- Common
- Serious
- QT Prolongation does NOT appear to occur at standard doses
- Hypersensitivity Reaction
- Hemolytic Anemia in G6PD Deficiency
IX. Safety
- Avoid in pregnancy
- Use reliable Contraception for 3 months after last dose
- Avoid in Lactation (unless G6PD is excluded in infant)
X. Resources
- Tafenoquine (Arakoda, DailyMed)
- Tafenoquine (Krintafel, DailyMed)
XI. References
- (2019) Drugs for Malaria Prophylaxis, Med Lett Drugs Ther, p. e104-5
- (2019) Tafenoquine, Med Lett Drugs Ther, p. 101-4
- (2023) Presc Lett, Malaria Prophylaxis, Resource #350806