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# Tab%252525252525252525252525252525252525252525252525252525252525252525252525252520voihep ## Overview Tafenoquine is an 8-aminoquinoline antimalarial and prophylactic agent. It is a dihydrofolate reductase inhibitor. ## Primary Indications * Prevention of *Plasmodium vivax* malaria in individuals 17 years of age and older who are traveling to or from or residing in endemic areas. Tafenoquine is administered as a single dose for radical cure of *P. vivax* malaria (prevention of relapse). ## Adult Dosing * **Prevention of *P. vivax* malaria:** A single dose of 200 mg (base). * **Radical cure of *P. vivax* malaria:** A single dose of 200 mg (base). ## Pediatric Dosing Tafenoquine is **not approved** for use in pediatric patients. ## Dose Adjustments * **Renal Impairment:** No dose adjustment is necessary in patients with mild to severe renal impairment. * **Hepatic Impairment:** No dose adjustment is necessary in patients with mild to moderate hepatic impairment. Caution is advised in severe hepatic impairment due to limited data. ## Contraindications * Known hypersensitivity to tafenoquine or other 8-aminoquinolines. * Individuals with a Body Mass Index (BMI) less than 18.5 kg/m$^2$. * Individuals with a history of glucose-6-phosphate dehydrogenase (G6PD) deficiency. * Individuals with a history of primaquine-induced hemolytic anemia. * Breastfeeding women whose infants are G6PD deficient or whose G6PD status is unknown. ## Adverse Effects Common adverse effects include headache, nausea, vomiting, dizziness, abdominal pain, and diarrhea. Hemolytic anemia can occur in patients with G6PD deficiency. Methemoglobinemia is also a risk. ## Key Drug Interactions * **CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine):** May increase tafenoquine plasma concentrations, potentially increasing the risk of adverse events. Concomitant use is not recommended. * **Drugs that prolong the QT interval:** Use with caution due to potential additive QT prolongation. ## Monitoring * **G6PD deficiency screening:** Mandatory prior to initiation of tafenoquine due to the risk of hemolytic anemia. * Monitor for signs and symptoms of hemolytic anemia (e.g., pallor, dark urine, jaundice, fatigue). * Monitor for signs and symptoms of methemoglobinemia. ## Clinical Pearls * Tafenoquine's long half-life allows for single-dose regimens, which may improve adherence compared to daily or weekly antimalarials. * It is crucial to confirm a patient's G6PD status before administration to avoid severe hemolytic reactions. *** **Disclaimer:** This information is intended for healthcare professionals. It is essential to consult the most current prescribing information and relevant clinical guidelines for complete and up-to-date details before making any treatment decisions.