primaquine / Generic mfg. - LARVOL DELTA

Registration and characterization of patients with Glucose-6-Phosphate Dehydrogenase Deficiency in Spain: A real-world study of the Spanish Erythropathology Group (GEE) (ASH 2025) - "Drug-relatedcauses accounted for 5%, with the most common medications being primaquine, rasburicase, COX-2inhibitors, and chemotherapy/antibiotics.The median hemoglobin during crises was 7.5 g/dL (range 3.9–11.1), while outside of crises it was 13.1g/dL (range 10.9–15.3). Our data highlight the importance of diagnosis to prevent acute hemolytic crises—the main reason fortesting in our cohort. In contrast, pre-treatment testing represented a small percentage of cases.We must reconsider the target population for screening and the most appropriate method to implementit, in order to identify not only affected individuals but also carriers of the disease. Finally, it is worthnoting the high genetic variability observed in our country, attributable to the inclusion of patients fromdiverse geographic Background s.No conflicts of interest."

Clinical • Real-world • Real-world evidence • Gastroenterology • Genetic Disorders • Hematological Disorders • Infectious Disease • Malaria • Metabolic Disorders • G6PD

Haematologic responses to primaquine used for radical cure of Plasmodium vivax in public health facilities in Ethiopia: a prospective observational study. (PubMed, Malar J) - "In this study, conducted in a population with a low prevalence of G6PD deficiency, a 14-day regimen of low-dose primaquine was well tolerated and resulted in few mild adverse events only. These findings support the current national policy for low-dose primaquine in Ethiopia without prior G6PD testing, if systems for monitoring adverse events are in place."

Journal • Observational data • CNS Disorders • Hematological Disorders • Infectious Disease • Malaria • Metabolic Disorders • Psychiatry • Schizophrenia

Tafenoquine lactation pharmacokinetics: a pilot study. (PubMed, Malar J) - "This pilot study demonstrated measurable tafenoquine in breastmilk, with very small amounts of drug passing to babies on any given day but overall estimated RIDs around the conventional 10% threshold for safety concerns. Further studies are needed to determine with greater certainty the excretion of tafenoquine in breastmilk and drug concentrations in infant blood to inform recommendations for breastfeeding women."

Journal • PK/PD data • Hematological Disorders • Infectious Disease • Malaria

First documented case of imported human babesiosis in Honduras: Diagnostic challenges with malaria falciparum. (PubMed, IJID Reg) - "Thick smears suggested P. falciparum; he was treated with chloroquine-primaquine followed by artemether-lumefantrine, but hyperparasitemia persisted and he developed multiorgan failure, dying on day 33. This fatal case illustrates the diagnostic challenge of distinguishing babesiosis from malaria and underscores the need to consider babesiosis in febrile travelers unresponsive to antimalarials. Strengthening molecular diagnostic capacity is essential in malaria-endemic regions."

Journal • Cardiovascular • Infectious Disease • Ischemic stroke • Malaria

Glucose-6-phosphate dehydrogenase variants in Kachin, Myanmar. (PubMed, Parasites Hosts Dis) - "This risk is particularly relevant in patients treated with the antimalarial drug primaquine...Blood samples from 440 participants were analyzed; however, the Mahidol variant (G487A) was identified in 21 individuals (4.8%). A major limitation of this study was the absence of G6PD enzyme activity data to confirm whether the Mahidol variant induces G6PD deficiency."

Journal • Genetic Disorders • Hematological Disorders • Infectious Disease • Malaria • Metabolic Disorders

Travel-Related Malaria Diagnosis on Karius Test Despite Negative Blood Smear. (PubMed, Trop Med Infect Dis) - "The patient needed several treatment regimens for the recurrent attacks, including chloroquine and primaquine, artemether-lumefantrine, and eventually a combination of quinine and doxycycline together with a prolonged course of primaquine. This case demonstrates the limitations of smear microscopy diagnosis in P. vivax infections, highlights the role of molecular diagnostics like the Karius test, and stresses the importance of preventing relapses with adequate hypnozoite clearance. It further highlights the importance of clinician awareness and diligent follow-up in cases of travel-related Malaria, especially those with unusual presentations or recurrent symptoms."

Journal • Hematological Disorders • Infectious Disease • Leukopenia • Malaria • Musculoskeletal Pain • Pain • Thrombocytopenia

Identification of antimalarial drugs and bradykinin as ligands of the Plasmodium membrane protein PfSR10. (PubMed, iScience) - "In this study, we found that antimalarial drugs including chloroquine (CQ), dihydroartemisinin (DHA), piperaquine-tetraphosphatetetrahydrate (PIP-TT), and primaquine diphosphate (PQ) are PfSR10 agonists that induce coupling with human Gi/Gq proteins, confirmed through biochemical reconstitution and cryo-EM analysis. Ligand binding and conformational changes were characterized via mutagenesis and FlAsH-BRET assays. These results establish PfSR10 as a receptor for both antimalarials and host peptides, highlighting its dual role in drug action and host-parasite communication, with broad implications in understanding malaria pathogenesis and developing new therapeutics."

Journal • Infectious Disease • Malaria

Out of Sight, Should not be out of mind: A perplexing case of Malaria. (PubMed, Indian J Med Microbiol) - "He completely recovered after treatment with Artemether-Lumefantrine and Primaquine. This case underscores the value of bone marrow microscopy and PCR in diagnosing malaria in patients with unexplained cytopenias and splenomegaly."

Journal • Hematological Disorders • Infectious Disease • Malaria

SCOPE: Short Course Primaquine for the Radical Cure of P. Vivax - Papua New Guinea (clinicaltrials.gov) - P=N/A | N=794 | Completed | Sponsor: Macfarlane Burnet Institute for Medical Research and Public Health Ltd | Recruiting ➔ Completed

Trial completion • Infectious Disease • Malaria • Metabolic Disorders

WITHDRAWN Treatment of partial artemisinin-resistant Plasmodium falciparum malaria with pyronaridine-artesunate (Pyramax®) in Gia Lai province Vietnam (ASTMH 2025) - "Patients received Pyramax® once daily for 3 days, dosed according to body weight, plus single-dose primaquine (0.25 mg/kg) on Day 0. The eight patients who experienced a recrudescence of infection had lower (P=0.065) blood pyronaridine concentrations (median 33.3 ng/mL, range: 12.4 to 90.5) compared to the 95 patients who were malaria-free by Day 42 (median 47.6 ng/mL, range: 10.6 to 123.0). Although Pyramax® remains efficacious in treating P. falciparum the lower pyronaridine concentrations in those patients who recrudesced is of concern with reduced exposure of the long acting pyronaridine."

Infectious Disease • Malaria

When Malaria Hides: a Case Report of Sudden Coma Without Prior Fever in Cerebral Malaria. (PubMed, J Infect Chemother) - "The patient was treated with intravenous artesunate, followed by primaquine and dihydroartemisinin-piperaquine (DHP). The patient improved following treatment; follow-up microscopy confirmed parasite clearance."

Journal • Infectious Disease • Malaria

Pharmacological Tools to Modulate Ordered Membrane Domains and Order-Dependent Protein Function. (PubMed, bioRxiv) - "Two compounds were seen to both decrease PMP22 raft partitioning and to destabilize ordered domains (VU0607402 and VU0519975) while a third (primaquine diphosphate) increased PMP22 partitioning and stabilized ordered domains...Acute treatment of live cells with the raft destabilizing compound, VU0607402 was seen to modulate TRPM8 channel function, highlighting the utility of this compound in live-cell experiments for dissecting the role that membrane order and fluidity play in cell signaling. These compounds provide novel pharmacological tools for probing lipid raft properties and function in biophysical experiments and in living cells."

Journal • TRPM8

Effectiveness of tafenoquine and primaquine for radical cure of Plasmodium vivax: a meeting report from dissemination of results of the EFFORT trial to stakeholders in Pakistan. (PubMed, Malar J) - "The meeting brought together national and provincial stakeholders to review study results and explore implications for radical cure policy and implementation in Pakistan. Key themes included policy alignment, phased implementation of tafenoquine and G6PD testing, planning and funding constraints, private sector engagement, and the importance of sustained dialogue between researchers and malaria program leaders."

Journal • Infectious Disease • Malaria

WITHDRAWN Probabilistically deciphering hidden reservoirs of Plasmodium vivax in Ethiopia using identity-by-descent and time-to-event data (ASTMH 2025) - "We sequenced P. vivax infections from 526 individuals enrolled in longitudinal OPRA and IMPROV clinical trials in Ethiopia comparing the effectiveness of long- and short-course radical cure with primaquine (PQ)...Microhaplotype genotyping also permitted analysis of recurrent infections at the patient-level. Using a threshold of IBD >95%, it was possible to confirm the ability of a single parasite to persist within individuals across multiple infections, up to 320 days from the initial infection, if no radical cure was given."

Infectious Disease

Automated reporting of primaquine dose efficacy, tolerability and safety for Plasmodium vivax malaria using a systematic review and individual patient data meta-analysis. (PubMed, Malar J) - "These automated reports leverage a large database to provide accessible data for national and regional policy makers and researchers to assess the clinical consequences of different primaquine regimens in different endemic settings. The reports will inform local and regional policy decisions and research priorities in vivax-endemic areas."

Journal • Retrospective data • Hematological Disorders • Infectious Disease • Malaria

Biliverdin Reductase B Protects Against Primaquine Induced Hemolysis – Identification of a Novel Anti-Oxidant Pathway in Murine Erythrocytes (ASH 2023) - "All mouse strains were healthy at baseline, with normal measured hematological parameters (i.e., Hct 40, RET 1.5%). No change in HCT or RET was observed in hG6PD(ND) or BlvrB-KOxhG6PD(ND) mice receiving PQ or in any strain receiving PBS. PQ induced hemolytic anemia in hG6PD(A-) mice, with an average HCT of 32.7 (18% drop) with RET of 3.1%."

Preclinical • Anemia • Hematological Disorders • Hepatology • Metabolic Disorders • GAPDH • TFRC

Mechanisms of Primaquine Induced Hemolysis in a Novel Humanized Murine Model of Mediterranean G6PD Deficiency (ASH 2023) - "vivax) (i.e. primaquine and tafenoquine) are contraindicated in G6PDd patients due to risks of hemolysis. Recombinant hG6PD(MED) enzyme had a 2.6-fold lower specific activity compared to hG6PD(ND). Thermal gradient crosslinking proteomics identified specific amino acid spacing (less than 26 angstroms) that was higher in hG6PD(ND) [82-95 and 91-432] vs. higher in hG6PD(MED) [89-205, 97-429, and 429-497]."

Preclinical • Hematological Disorders • Metabolic Disorders • G6PD • GAPDH

The G6PD a- Variant Does Not Modulate Pulmonary Hypertension Phenotypes in Mice (ASH 2024) - "To determine if repeated hemolysis results in the development of PH, WT and G6PD A- mice were exposed to primaquine, a common antimalarial that induces hemolysis in erythrocytes with limited oxidative capacity...These findings suggest that G6PD A- variant does not modulate pulmonary hypertension phenotypes in mice. These findings are in line with a dearth of clinical data associating incidences of PH in G6PD-deficient individuals."

Preclinical • Anemia • Cardiovascular • Hematological Disorders • Hepatology • Infectious Disease • Inflammation • Metabolic Disorders • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Formulation and evaluation of hydrogel-forming microarray patches for transdermal primaquine and chloroquine delivery in malaria therapy. (PubMed, Biomater Adv) - "Efficacy studies in a murine malaria model demonstrated that MAP-delivered PQ and CQ reduced parasitaemia by 99.8 % in treated animals. These findings highlight the potential of MAP technology as a minimally-invasive, sustained drug delivery platform for malaria treatment, potentially offering improved patient adherence, reduced hepatoxicity, and enhanced therapeutic outcomes."

Journal • Infectious Disease • Malaria

SEVERE PNEUMOCYSTIS PNEUMONIA IN A NON-HIV PATIENT: A CAN'T-MISS DIAGNOSIS (CHEST 2025) - "She had received several cycles of chemotherapy and atezolizumab before developing ICI colitis, which was treated with infliximab and steroids...Initial testing revealed a positive beta-D-glucan (BDG), prompting empiric treatment for PJP with atovaquone, given her sulfa allergy...Her prednisone dosage was increased, and she was transitioned to clindamycin and primaquine for severe PJP pneumonia... Identifying PJP in non-HIV patients can be challenging, but it has significant implications for treatment and prognosis. Diagnosis can be straightforward if BDG is positive and if sputum samples are obtainable, but results may take several days to return. Treatment should not be delayed if there is high clinical suspicion, with trimethoprim-sulfamethoxazole being the first line choice."

Clinical • Cough • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Infectious Disease • Lung Cancer • Pneumonia • Respiratory Diseases • Small Cell Lung Cancer • Solid Tumor

A PATIENT WITH WALDENSTROM MACROGLOBULINEMIA AND BILATERAL INFILTRATES: WHAT CAN IT BE? (CHEST 2025) - "Trimethoprim-sulfamethoxazole remains the corner stone for therapy with atovaquone and combination of clindamycin - primaquine serving as alternative agents. Ibrutinib should be held during active infection. Currently, the incidence rates of PJP infection in patients with Waldenstrom macroglobulinemia on ibrutinib therapy being less than 5%, there are no guidelines to start PJP prophylaxis in such patients."

Clinical • Cough • Dermatology • Fatigue • Hematological Malignancies • Immunology • Infectious Disease • Lymphoma • Lymphoplasmacytic Lymphoma • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Solid Tumor • Vasculitis • Waldenstrom Macroglobulinemia

A NOVEL SALVAGE THERAPY FOR PNEUMOCYSTIS JIROVECII PNEUMONIA (CHEST 2025) - "He showed marked improvement after transitioning to clindamycin and micafungin and ultimately completed successful treatment with the addition of primaquine...His outpatient regimen included methotrexate and infliximab...He had completed an empiric course of moxifloxacin for atypical pneumonia and prednisone for possible pneumonitis...He was started empirically on solumedrol for possible methotrexate pneumonitis and later transitioned to high-dose prednisone...Despite two weeks of TMP-SMX, however, he reported worsening dyspnea and required increasing oxygen support through high flow nasal cannula... Our case suggests that the micafungin and clindamycin may be a safe and effective option for non-HIV patients with refractory PJP and could serve as a bridge to more established salvage therapies. More large-scale trials are needed to assess the effectiveness of micafungin and clindamycin as salvage therapy."

Fatigue • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Pneumonia • Psoriatic Arthritis • Rheumatoid Arthritis • Rheumatology • Seronegative Spondyloarthropathies

CONCURRENT SEVERE PNEUMOCYSTIS AND HISTOPLASMA PNEUMONIA IN A RENAL AND STEM CELL TRANSPLANT RECIPIENT: A CONUNDRUM IN EMPIRIC MANAGEMENT AND BRONCHOSCOPIC EVALUATION (CHEST 2025) - "Her medical history also included coronary artery disease, chronic CMV viremia, and adrenal insufficiency.She presented to the emergency department with fever and dysuria, diagnosed with a complicated UTI due to Vancomycin-resistant Enterococcus, and started on IV Daptomycin...On Day 9, she developed hypoxia, worsening thrombocytopenia, and was started on itraconazole, valacyclovir, and cefepime...The infectious disease team switched her to IV Clindamycin and Primaquine...Balancing steroids and anti-infectives was challenging due to her multiple transplants—steroids can inhibit graft-versus-tumor effects, while TMP-SMX and valganciclovir may affect the transplanted kidney... Itraconazole and Iv steroids should be initiated early in this cohort."

Clinical • Atrial Fibrillation • Cardiovascular • CNS Lymphoma • Coronary Artery Disease • Endocrine Disorders • Glomerulonephritis • Hematological Disorders • Hematological Malignancies • Human Immunodeficiency Virus • IgA Nephropathy • Infectious Disease • Lymphoma • Metabolic Disorders • Nephrology • Pneumonia • Respiratory Diseases • Thrombocytopenia • Transplantation

ADDING FUEL TO THE FIRE: PNEUMOMEDIASTINUM, PNEUMOPERICARDIUM, AND BILATERAL PNEUMOTHORACES IN PNEUMOCYSTIS JIROVECII PNEUMONIA WITH CONCOMITANT POSITIVE AIRWAY-PRESSURE THERAPY (CHEST 2025) - "Biktarvy was initiated for HIV/AIDS along with Bactrim for PJP, which was confirmed with bronchoalveolar lavage after patient underwent diagnostic bronchoscopy...Diagnosis of PJP involves microbiologic identification of the organism in induced sputum or bronchoalveolar lavage, although, beta-D-glucan, LDH and clinical presentation can lead to presumptive diagnosis and guide treatment with Trimethoprim-Sulfamethoxazole or alternatives such as Atovaquone, Clindamycin with Primaquine, Trimethoprim with Dapsone or Pentamidine along with adjunctive steroids, if indicated... Severe PJP is associated with higher mortality in patients who develop respiratory complications such as hypoxemia and pneumothorax. Timely diagnosis, aggressive treatment with correct antimicrobials, and, if indicated, adjunctive glucocorticoids are all crucial to improving outcomes while providing supportive treatment. Further investigation into outcomes related to positive pressure ventilation and lung..."

Asthma • Cardiovascular • Cough • Fibrosis • Human Immunodeficiency Virus • Hypertension • Immunology • Infectious Disease • Inflammation • Obstructive Sleep Apnea • Pneumonia • Respiratory Diseases • Sleep Disorder • CD4

WHEN A LUMP IN YOUR THROAT ISN'T JUST NERVES: A CASE OF LARYNGEAL INVOLVEMENT IN DISSEMINATED HISTOPLASMOSIS (CHEST 2025) - "Given concern for disseminated histoplasmosis with concomitant bacterial pneumonia, he was started on a regimen of itraconazole and cefepime by infectious diseases in addition to clindamycin and primaquine prophylaxis. Laryngeal involvement is a rare complication of disseminated histoplasmosis. In patients with laryngeal masses, especially in those who are immunocompromised or who have had potential significant exposure, histoplasmosis should be considered."

Clinical • Acute Kidney Injury • Cardiovascular • Chronic Obstructive Pulmonary Disease • CNS Disorders • Dysphonia • Gastrointestinal Disorder • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Laryngeal Cancer • Nephrology • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Tobacco Addiction • CD4