Home Drug Guide Tafenoquine succinate

Drug Guide

Generic Name

Tafenoquine succinate

Brand Names Arakoda, Krintafel

Classification

Therapeutic: Antimalarial agent

Pharmacological: Aminoquinoline compound

FDA Approved Indications

  • Prevention of malaria caused by Plasmodium falciparum in areas with chloroquine-resistant malaria (Arakoda)
  • Prevention of malaria caused by Plasmodium vivax (Arakoda)
  • Treatment of Plasmodium vivax malaria (Krintafel)

Mechanism of Action

Tafenoquine disrupts the mitochondrial electron transport chain of the malaria parasite, leading to their death. It is active against dormant hypnozoites of P. vivax and P. ovale, preventing relapse.

Dosage and Administration

Adult: For prophylaxis: 200 mg once weekly, starting 1-2 days before travel and continuing during travel and for 1 week after leaving endemic area. For radical cure: 300 mg as a single dose.

Pediatric: Use is not well established; doses should be determined based on weight and clinical judgment.

Geriatric: No specific dosage adjustment provided; caution advised due to potential comorbidities.

Renal Impairment: Use with caution. No specific dose adjustment recommended; monitor renal function.

Hepatic Impairment: Contraindicated in patients with G6PD deficiency and caution advised in those with hepatic impairment.

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Distribution: Widely distributed in the body including tissues and plasma.

Metabolism: Metabolized minimally in the liver, primarily via CYP enzymes.

Excretion: Excreted mainly in the urine.

Half Life: Approximately 14 days, supporting weekly dosing.

Contraindications

  • G6PD deficiency
  • History of psychiatric disorders
  • Known hypersensitivity to tafenoquine

Precautions

  • Screen for G6PD deficiency before use to prevent hemolysis.
  • Caution in patients with liver impairment.
  • Monitor for neuropsychiatric symptoms during therapy.

Adverse Reactions - Common

  • Gastrointestinal symptoms (nausea, abdominal pain) (Common)
  • Dizziness (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Hemolytic anemia in G6PD-deficient patients (Serious and potentially life-threatening)
  • Psychiatric disturbances (depression, anxiety, hallucinations) (Serious but rare)
  • Leukopenia, thrombocytopenia (Rare)

Drug-Drug Interactions

  • CYP450 inhibitors or inducers may alter tafenoquine levels.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess G6PD status prior to initiation. Monitor for neuropsychiatric symptoms, hemolysis, hepatic function.

Diagnoses:

  • Risk for hemolytic anemia
  • Risk for neuropsychiatric effects

Implementation: Administer with food to reduce gastrointestinal upset. Educate patient on importance of adherence and monitoring.

Evaluation: Evaluate for side effects, adherence, and effectiveness in preventing malaria.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any signs of hemolysis (fatigue, pallor, dark urine).
  • Avoid alcohol and hepatotoxic substances.
  • Inform about potential neuropsychiatric effects.

Special Considerations

Black Box Warnings:

  • G6PD deficiency screening is mandatory prior to use due to risk of hemolytic anemia.
  • Neuropsychiatric reactions including hallucinations, paranoia, psychosis have been reported.

Genetic Factors: G6PD deficiency status is critical to determine before starting therapy.

Lab Test Interference: May interfere with certain blood tests but not specifically known for tafenoquine.

Overdose Management

Signs/Symptoms: Hemolytic anemia, neuropsychiatric symptoms, nausea, vomiting.

Treatment: Supportive care; consider hospitalization for monitoring and management of hemolysis.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.