Effect of primaquine standard dose (15 mg/day for 14 days) in the treatment of vivax malaria patients in Thailand.
Primaquine (8-aminoquinoline), the only effective drug to prevent relapses of the persistent liver forms of Plasmodium vivax and Plasmodium ovale, can induce hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The severity varies considerably among affected individuals. Three hundred and sixty-four Plasmodium vivax cases (342 G6PD-normal and 22 G6PD-deficient) were given a 3-day course of chloroquine (total dose 1,500 mg) followed by primaquine 15 mg a day for 14 days and completed a 28-day follow-up. All G6PD-deficient patients were male; there were no relapses or serious adverse events during the study. Although a significant decrease in hematocrit levels and an increase in the percent reduction of hematocrit levels were observed on day 7 (34.9+/-5.0 vs 26.7+/-5.4; (-1.2)+/-14.4 vs (-24.5) +/-13.9 respectively) and on day 14 (35.7+/-4.3 vs 30.9+/-3.1; 1.6+/-17.8 vs (-11.0) +/-19.3 respectively) blood transfusion was not required. Daily doses of 15 mg of primaquine for 14 days following a full course of chloroquine when prescribed to Thai G6PD deficient patients where Mahidol variant is predominant, are relatively safe.
Buchachart
K
K
Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Krudsood
S
S
Singhasivanon
P
P
Treeprasertsuk
S
S
Phophak
N
N
Srivilairit
S
S
Chalermrut
K
K
Rattanapong
Y
Y
Supeeranuntha
L
L
Wilairatana
P
P
Brittenham
G
G
Looareesuwan
S
S
D000328:Adult; D000743:Anemia, Hemolytic / Q000139:chemically induced; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D002738:Chloroquine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005954:Glucosephosphate Dehydrogenase / Q000378:metabolism; D006400:Hematocrit; D006801:Humans; D016780:Malaria, Vivax / Q000097:blood / Q000188:drug therapy*; D008297:Male; D011319:Primaquine / Q000008:administration & dosage* / Q000009:adverse effects; D013785:Thailand
D000962:Antimalarials; D002738:Chloroquine; D005954:Glucosephosphate Dehydrogenase; D011319:Primaquine