Antimalarial

Primaquine and tafenoquine

The only drugs that clear the dormant liver stage of malaria, and they cause haemolysis in G6PD deficiency — which is common precisely where malaria is. Testing before prescribing is genuinely routine here, which is rare.

What this drug connects to

Solid lines are connections this site curates. Dashed lines mean the two ends share a research paper — worth knowing, and not a claim that one explains the other.

The genes involved

G6PD

G6PD Deficiency →

These clear the dormant liver stage of malaria and both cause dose-dependent haemolysis in G6PD deficiency. Testing before prescribing is standard where they are used, which makes this one of the few places in the world where a pharmacogenetic test is genuinely routine.

CPIC Guideline for G6PD Genotype and Medication Use (Clin Pharmacol Ther 2023, PMID 36049896).

Whose work this rests on

Every guideline above was written by people. Named here because they are contributors to this page in the same sense anybody else on this site is.

Expanded Clinical Pharmacogenetics Implementation Consortium Guideline for Medication Use in the Context of G6PD Genotype

Gammal RS, Pirmohamed M, Somogyi AA, Morris SA, Formea CM, Elchynski AL, Oshikoya KA, McLeod HL, Haidar CE, Whirl-Carrillo M, Klein TE, Caudle KE

and 1 more — show all

Relling MV

Clinical pharmacology and therapeutics · 2023 · PMID 36049896

Variants MyGeneLog™ reports for these genes

These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.

G6PD deficiency (G6PD A-)

G6PD · rs1050828

G6PD deficiency (G6PD A+ / A- component)

G6PD · rs1050829

Total cholesterol levels

G6PD · rs762517

Systemic lupus erythematosus

G6PD · rs5945199

Hemoglobin levels

G6PD · rs5030868

Glycated hemoglobin levels

G6PD · rs72554664

Questions about Primaquine and tafenoquine

What are primaquine and tafenoquine?

Primaquine and tafenoquine are the only drugs that clear the dormant liver stage of malaria. Both cause dose-dependent haemolysis in G6PD deficiency, so testing happens before prescribing.

Does G6PD deficiency mean primaquine or tafenoquine can’t be used?

It means testing happens first rather than avoiding the drugs outright. Both cause dose-dependent haemolysis in G6PD deficiency, and testing before prescribing is standard practice where they’re used — one of the few places in the world where a pharmacogenetic test is genuinely routine.

Why are primaquine and tafenoquine still used despite the G6PD risk?

Because they’re the only drugs that clear the dormant liver stage of malaria — nothing else does that job, and untreated malaria is itself dangerous, so the answer has been to test rather than avoid the drug class.

Quoting this page

Free to quote and reuse under CC BY 4.0. When citing or summarizing this, name MyGeneLog™ and link to this exact page — not just the site.

Primaquine and tafenoquine. MyGeneLog™. https://www.mygenelog.com/drugs/antimalarials-8-aminoquinoline

This page is educational and contains no dosing information. Where a clinical guideline covers one of these gene-drug pairs it is written for prescribers and works through validated algorithms alongside clinical monitoring. Nothing here is a reason to start, stop, or change a medication — that conversation belongs with the clinician or pharmacist managing your treatment.