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# TAFENPISOQUINE (TAVVOI)
## Overview
Tafenquine is an 8-aminoquinoline antimalarial medication used for the radical cure and prophylaxis of *Plasmodium vivax* malaria. It is a single-dose radical cure treatment.
## Primary Indications
* Radical cure (prevention of relapse) of *Plasmodium vivax* malaria in patients 18 years of age and older.
* Prophylaxis (prevention) of malaria caused by *Plasmodium falciparum* in patients 18 years of age and older.
## Adult Dosing
* **Radical Cure of *P. vivax* Malaria:** A single oral dose of 500 mcg/kg (maximum single dose of 200 mg).
* **Prophylaxis of Malaria:** A single oral dose of 200 mg taken 24 hours before malaria risk area travel, a single oral dose of 100 mg on day 1 and day 2 of travel, and a single oral dose of 100 mg taken 7 days after leaving the malaria risk area.
## Pediatric Dosing
Tafenquine is not approved for use in pediatric patients. Safety and efficacy have not been established.
## Dose Adjustments
No dose adjustments are specified for hepatic or renal impairment. However, caution and consideration for G6PD deficiency testing are paramount.
## Contraindications
* Known hypersensitivity to tafenquine or other 8-aminoquinolines.
* Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (unless G6PD status is unknown and malaria risk is high, requiring concomitant administration with a G6PD-deficient drug like chloroquine).
* Concurrent use with other drugs that can cause hemolytic anemia (e.g., other 8-aminoquinolines, primaquine).
## Adverse Effects
* **Common:** Headache, nausea, vomiting, diarrhea, abdominal pain, dizziness, fatigue, insomnia, anorexia, pyrexia, chills, rash.
* **Serious:** Hemolytic anemia (especially in G6PD deficient individuals), methemoglobinemia, neuropsychiatric events (anxiety, confusion, hallucinations, insomnia, nightmares).
## Key Drug Interactions
* **Drugs causing hemolytic anemia:** Concurrent use with other 8-aminoquinolines or drugs known to cause hemolytic anemia is contraindicated.
* **CYP1A2 inhibitors:** May increase tafenquine plasma concentrations. Caution is advised.
* **CYP1A2 inducers:** May decrease tafenquine plasma concentrations.
## Monitoring
* **G6PD Deficiency Screening:** Crucial before initiating therapy. If G6PD status is unknown and malaria risk is high, administer tafenquine with chloroquine and monitor for signs of hemolysis.
* **Hemoglobin and Hematocrit:** Monitor for signs of hemolysis.
* **Methemoglobin Levels:** Monitor if clinically indicated.
* **Neuropsychiatric Symptoms:** Assess for any changes in mental status.
## Clinical Pearls
* Tafenquine provides a single-dose radical cure for *P. vivax* malaria, simplifying treatment compared to multi-day regimens of primaquine.
* It is also approved for malaria prophylaxis.
* Strict adherence to G6PD deficiency testing is essential due to the risk of severe hemolytic anemia. If a patient is G6PD deficient, tafenquine is contraindicated for radical cure and should not be used for prophylaxis.
* The prophylactic regimen involves doses taken before, during, and after travel to a malaria-endemic area.
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*Disclaimer: This information is intended for healthcare professionals and is not a substitute for clinical judgment. Always consult the most current prescribing information and institutional protocols before administering any medication.*
