      Document 0221
 DOCN  DRG0221
 UNIQUE IDENTIFIER        DRG-0026
 NAME OF SUBSTANCE        Primaquine [USP DI 1995]
 REGISTRY NUMBER          90-34-6
 STANDARD CHEMICAL NAME   N4-(6-Methoxy-8-quinolinyl)-1,4-pentanediamin-
                          e [Merck Index 1989]
 SYNONYMS                 Primaquine phosphate [USAN 1995]
 SYNONYMS                 N4-(6-Methoxy-8-quinolinyl)-1,4-pentanediamin-
                          e, phosphate  [USAN 1995]
 SYNONYMS                 8-((4-Amino-1-methylbutyl)amino)-6-methoxyqui-
                          noline phosphate (1:2) [USAN 1995]
 PROTOCOL ID NUMBERS      NIAID ACTG 044
 PROTOCOL ID NUMBERS      NIAID ACTG 108
 SECONDARY SOURCE ID      SN-13272 [Merck Index 1989]
 PHARMACOLOGICAL ACTION   MODE OF ACTION: The exact mechanism of action
                          is unknown but the drug appears to affect
                          plasmodial DNA. It is active against
                          exoerythrocytic stages of Plasmodium vivax
                          and P. ovale and against primary
                          exoerythrocytic stages of P. falciparum. It
                          is gametocidal against plasmodia, especially
                          P. falciparum gametocytes. Absorption is
                          rapid and bioavailibility is about 96%.
                          Primaquine has a half-life of 3.7-7.4 hours.
                          Peak concentrations are reached in 2-3 hours.
                          Less than 2% of oral doses are excreted in
                          the urine within 24 hours. [USP DI 1995]
 DISEASES STUDIED/TREATED When used with clindamycin, it is effective
                          for acute Pneumocystis carinii pneumonia
                          (PCP) [USP DI 1995]
 CLASSIFICATION CODE      Antimalarial [USAN 1995]
 OTHER MAJOR USES         Treatment of malaria; Pneumocystis carinii
                          pneumonia [USP DI 1995]
 SUBSTANCE INTERACTIONS   When administered concurrently with bone
                          marrow depressants, it may increase
                          leukopenic effects; use with hemolytics may
                          increase the potential for toxic side
                          effects. Primaquine toxicity is increased
                          with the concurrent use of quinacrine. [USP
                          DI 1995]
 ADVERSE EFFECTS          Adverse effects include acute hemolytic
                          anemia in patients with glucose-6-phosphate
                          dehydrogenase deficiency. Methemoglobinemia
                          may occur with high doses or in patients with
                          NADH reductase deficiency. Leukopenia is rare
                          and gastrointestinal side effects occur
                          occasionally. [USP DI 1995]
 CONTRAINDICATIONS        Contraindicated in patients with
                          hypersensitivity to primaquine and in those
                          who received quinacrine, other hemolytic
                          drugs, or depressants of myeloid elements of
                          bone marrow. Also contraindicated for use in
                          pregnant women. [USP DI 1995]
 CHEMICAL/PHYSICAL DATA   DRUG DESCRIPTION: An 8-aminoquinoline
                          derivative [USP DI 1995]
 CHEMICAL/PHYSICAL DATA   MOLECULAR FORMULA: C15H21N3O (Primaquine)
                          [Merck Index 1989] C15H21N3O.2H3PO4
                          (Primaquine phosphate) [USP DI 1989]
 CHEMICAL/PHYSICAL DATA   MOLECULAR WEIGHT: 259.34 (Primaquine); 455.34
                          (Primaquine phosphate) [Merck Index 1989]
 CHEMICAL/PHYSICAL DATA   PERCENT ELEMENTAL COMPOSITION (Primaquine):
                          C69.46%; H8.16%; N16.20%; O6.17% [Merck Index
                          1989]
 CHEMICAL/PHYSICAL DATA   BOILING POINT (Primaquine): 0.2 mm Hg;
                          175-179 degrees C [Merck Index 1989]
 CHEMICAL/PHYSICAL DATA   SOLUBILITY: Soluble in ether (Primaquine);
                          moderately soluble in water (Primaquine
                          Phosphate) [Merck Index 1989]
 CHEMICAL/PHYSICAL DATA   MELTING POINT: 197-198 C (Primaquine
                          Phosphate); 182.5-185 C (Primaquine oxalate)
                          [Merck Index 1989]
 CHEMICAL/PHYSICAL DATA   PHYSICAL DESCRIPTION: Viscous liquid
                          (Primaquine); yellow crystals (Primaquine
                          Phosphate and Primaquine Oxalate) [Merck
                          Index 1989]
 SUBSTANCE DELIVERY DATA  DOSAGE FORM: Primaquine Phosphate tablets
                          containing 15 mg of primaquine base. [USP DI
                          1995]
 SUBSTANCE DELIVERY DATA  MODE OF DELIVERY: Oral. [USP DI 1995]
 SUBSTANCE DELIVERY DATA  STORAGE: Store below 40 C (104 F) in a
                          well-closed, light-resistant container. [USP
                          DI 1995]
 MANUFACTURERS            Winthrop-Breon
 REFERENCES               Toma E, Fournier S, Dumont M, Bolduc P,
                          Deschamps H. Clindamycin/primaquine versus
                          trimethoprim-sulfamethoxazole as primary
                          therapy for Pneumocystis carinii pneumonia in
                          AIDS: a randomized, double-blind pilot trial.
                          Clin Infect Dis. 1993 Aug;17(2):178-84.
 REFERENCES               Toma E, Tremblay C, Passerini L.
                          Clindamycin/primaquine for severe
                          Pneumocystis carinii pneumonia (PCP). Int
                          Conf AIDS. 1993 Jun 6-11;9(1):62 (abstract
                          no. WS-B19-6).
 REFERENCES               Smith N, Blanshard C, Smith D, Gazzard B.
                          Toxicity of clindamycin and primaquine
                          treatment of AIDS-related Pneumocystis
                          carinii pneumonia [letter]. AIDS. 1993
                          May;7(5):749-50.
 REFERENCES               Kantor GS. Primaquine-induced
                          methemoglobinemia during treatment of
                          Pneumocystis carinii pneumonia [letter]. N
                          Engl J Med. 1992 Nov 12;327(20):1461.
 REFERENCES               Noskin GA, Murphy RL, Black JR, Phair JP.
                          Salvage therapy with clindamycin/primaquine
                          for Pneumocystis carinii pneumonia. Clin
                          Infect Dis. 1992 Jan;14(1):183-8.
 REFERENCES               Black JR, Akil B, Murphy R, Fass R, Feinberg
                          J, Mills J, Sattler F. Oral clindamycin plus
                          primaquine therapy for pneumocystis carinii
                          pneumonia (PCP) in AIDS patients. Int Conf
                          AIDS. 1991 Jun 16-21;7(2):66 (abstract no.
                          TH.B.42).
 REFERENCES               Toma E. Clindamycin/primaquine for treatment
                          of Pneumocystis carinii pneumonia in AIDS.
                          Eur J Clin Microbiol Infect Dis. 1991
                          Mar;10(3):210-3.
 REFERENCES               Ruf B, Rohde I, Pohle HD. Efficacy of
                          clindamycin/primaquine versus
                          trimethoprim/sulfamethoxazole in primary
                          treatment of Pneumocystis carinii pneumonia.
                          Eur J Clin Microbiol Infect Dis. 1991
                          Mar;10(3):207-10.
 REFERENCES               Black JR, Feinberg J, Murphy RL, Fass RJ,
                          Carey J, Sattler FR. Clindamycin and
                          primaquine as primary treatment for mild and
                          moderately severe Pneumocystis carinii
                          pneumonia in patients with AIDS. Eur J Clin
                          Microbiol Infect Dis. 1991 Mar;10(3):204-7.
 ENTRY MONTH              8906
 LAST REVISION DATE       951109
 

SOURCE: National Library of Medicine, Bethesda, MD.  Distributed by AEGIS.
