Comparative Pharmacology
Head-to-head clinical analysis: LARIAM versus PRIMAQUINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LARIAM versus PRIMAQUINE.
LARIAM vs PRIMAQUINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Mefloquine is a 4-quinolinemethanol antimalarial agent that acts as a blood schizontocide. Its exact mechanism is unknown, but it is thought to inhibit heme polymerase, leading to toxic accumulation of free heme in the parasite.
Antimalarial agent that eliminates exoerythrocytic forms (hypnozoites) of Plasmodium vivax and P. ovale; also active against gametocytes. Mechanism involves generation of reactive oxygen species via redox cycling, disrupting parasite mitochondrial function.
For malaria prophylaxis: 250 mg (base) orally once weekly starting 1-2 weeks before travel, continuing weekly during stay and for 4 weeks after leaving endemic area. For malaria treatment: 1250 mg (base) orally as a single dose, divided if needed (750 mg followed by 500 mg after 6-12 hours). Route: oral. Frequency: weekly for prophylaxis; single dose for treatment.
15 mg (base) orally once daily for 14 days for radical cure of P. vivax and P. ovale; 30 mg (base) orally once daily for 7 days for terminal prophylaxis.
None Documented
None Documented
Clinical Note
moderatePrimaquine + Norfloxacin
"Primaquine may increase the QTc-prolonging activities of Norfloxacin."
Clinical Note
moderatePrimaquine + Haloperidol
"Primaquine may increase the QTc-prolonging activities of Haloperidol."
Clinical Note
moderatePrimaquine + Ibandronate
"Primaquine may increase the QTc-prolonging activities of Ibandronate."
Clinical Note
moderatePrimaquine + Tenofovir disoproxil
"The metabolism of Tenofovir disoproxil can be decreased when combined with Primaquine."
Terminal elimination half-life: approximately 3 weeks (range 13–33 days); prolonged due to extensive tissue distribution and slow release from erythrocytes.
Terminal elimination half-life of approximately 4-7 hours; in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, half-life may be prolonged due to accumulation in erythrocytes
Hepatic metabolism (primarily CYP3A4) followed by biliary/fecal elimination; ~40% unchanged in feces, ~9% as metabolites in urine, minimal renal excretion of parent drug (<5%).
Primarily renal (60-65% as unchanged drug and metabolites); small amounts in feces (<5%)
Category C
Category D/X
Antimalarial
Antimalarial