[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antimalarials](https://durgical.com/en/pharmacology/classes/antimalarials/) › Tafenoquine # Tafenoquine ## Antimalarials? Antimalarials ## Pregnancy: contraindicated? Contraindicated in pregnancy because it may cause haemolysis in a G6PD-deficient fetus; a pregnancy test is done before use. Long-acting 8-aminoquinoline, a single dose with chloroquine for P. vivax radical cure; G6PD must be shown normal first. Updated Nov 1, 2026 ## Quick facts **Group** [Antimalarials](https://durgical.com/en/pharmacology/classes/antimalarials/) **Target** Not fully known: like primaquine, acts on liver hypnozoites and gametocytes **Used for** Radical cure · Prophylaxis in travellers **Key effects** Nausea · Headache and dizziness · Insomnia **Monitor** Quantitative G6PD test before use **ATC** P01BA07 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action A derivative of primaquine with presumably the same mechanism: oxidant metabolites kill the dormant liver forms (hypnozoites) of P. vivax and act on other stages. Its main difference is pharmacokinetic: it is absorbed slowly and eliminated over weeks, so one dose replaces a two-week primaquine course for radical cure. Like primaquine, it causes haemolysis in G6PD deficiency. - Primaquine-like 8-aminoquinoline - Kills P. vivax liver hypnozoites - Very long half-life: one dose for radical cure - Haemolysis if G6PD is deficient ## Indications - Radical cure (prevention of relapse) of P. vivax malaria, as a single dose together with chloroquine or hydroxychloroquine, in people aged 16 or older [Malaria →](https://durgical.com/en/conditions/malaria/) - Prophylaxis in travellers (a separate product, for up to six months) [Malaria →](https://durgical.com/en/conditions/malaria/) ## Adverse effects ### Common - Nausea, vomiting and diarrhoea - Headache and dizziness - Insomnia, anxiety, unusual dreams and mood changes - Blurred vision or light sensitivity; vortex keratopathy - Raised liver enzymes ### Serious (rare, important) - Haemolytic anaemia in G6PD deficiency - Methaemoglobinaemia - Psychiatric reactions: hallucinations, delusions, psychosis - Allergic reactions ## Contraindications - G6PD deficiency or unknown G6PD status - Pregnancy - Current or past psychosis or psychotic symptoms - Hypersensitivity to tafenoquine or primaquine ## Key interactions **Chloroquine or hydroxychloroquine** Required partner for radical cure; tafenoquine is used only with them in that indication **Drugs that cause haemolysis or methaemoglobinaemia (e.g. dapsone, primaquine)** Additive red-cell toxicity is expected, as with primaquine ## What is monitored - Quantitative G6PD test before use (qualitative tests can miss intermediate activity in women) - Pregnancy test before use - Haemoglobin and urine colour after the dose; effects can appear late because the drug persists - Mood and behaviour changes ## Administration and safety - Oral, with food; tablets are swallowed whole, not split, chewed or crushed. - Given on the first or second day of the chloroquine course. - If vomiting occurs within an hour of the dose, the prescriber decides whether to repeat it. - Two products exist for different uses (radical cure, prophylaxis): confirm which one is ordered. ## Pregnancy and breastfeeding Contraindicated in pregnancy because it may cause haemolysis in a G6PD-deficient fetus; a pregnancy test is done before use. ## Nursing care - Confirm a normal quantitative G6PD result and a negative pregnancy test before giving it. - Ask about psychiatric history. - Teaching: report dark urine, pallor, shortness of breath, blue-grey lips, yellow eyes or hallucinations, even weeks later. - Contraception during treatment and for about three months after. ## Pharmacokinetics **Absorption** Oral, slow (peak about half a day after dosing); taken with food **Distribution** Large volume of distribution **Metabolism** Not well characterised **Elimination** Low clearance, very slow elimination **Half-life** About 14 days ## Memory aid «TAFenoquine: one TAp for vivax»: a single dose, but only after a quantitative G6PD test, and only with chloroquine. ## Test yourself Think of the answer, then tap the question to see it. ## What is the main advantage of tafenoquine over primaquine? Its half-life of about two weeks lets a single dose replace a long primaquine course, which improves adherence. ## What test is mandatory before tafenoquine, and why quantitative? G6PD activity; quantitative tests are needed because qualitative tests can miss intermediate deficiency, which is common in heterozygous women. ## With which drug is it given for P. vivax radical cure? With chloroquine (or hydroxychloroquine), which treats the blood stage. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/tafenoquine/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **Pregnancy: contraindicated** Contraindicated in pregnancy because it may cause haemolysis in a G6PD-deficient fetus; a pregnancy test is done before use. ## Connections ## Related drugs 3 - [Primaquine](https://durgical.com/en/pharmacology/primaquine/) - [Chloroquine](https://durgical.com/en/pharmacology/chloroquine/) - [Hydroxychloroquine](https://durgical.com/en/pharmacology/hydroxychloroquine/) ## Related conditions 1 - [Malaria](https://durgical.com/en/conditions/malaria/) [← Back to the class: Antimalarials](https://durgical.com/en/pharmacology/classes/antimalarials/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Tafenoquine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a618050.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [Malaria in the United States: Treatment Tables](https://www.cdc.gov/malaria/hcp/clinical-guidance/appendix-a-treatment-tables.html) (Centers for Disease Control and Prevention (CDC), 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/tafenoquine/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/tafenoquine/