Tab primaquine dose for plasmodium vivax calculation for 60 kg person and how to give
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primaquine "Plasmodium vivax" radical cure dose
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Primaquine for Plasmodium vivax - 60 kg Patient
What Primaquine Does Here
Primaquine eliminates hypnozoites (dormant liver-stage parasites) to achieve radical cure and prevent relapse. It is given in addition to the blood-stage treatment (chloroquine or an ACT), not instead of it.
Dose Calculation for 60 kg
| Regimen | Dose | Calculation (60 kg) | Duration | Total Dose |
|---|---|---|---|---|
| Standard (most countries incl. India) | 0.25 mg/kg/day | 15 mg/day | 14 days | 210 mg |
| High-dose (SE Asia / Oceania) | 0.5 mg/kg/day | 30 mg/day | 14 days | 420 mg |
| Mild G6PD deficiency | 0.75 mg/kg/week | 45 mg once weekly | 8 weeks | 360 mg |
- Tab primaquine is available as 7.5 mg base and 15 mg base tablets.
- For standard regimen (India): 2 tabs of 7.5 mg OR 1 tab of 15 mg once daily for 14 days.
- For high-dose (SE Asia): 2 tabs of 15 mg once daily for 14 days.
How to Give It
- Always give with food - reduces GI side effects (nausea, abdominal cramps).
- Give once daily, preferably at the same time each day.
- Duration: 14 days (standard) - do not shorten the course.
- Supervised administration is recommended (especially in India per National Programme guidelines) to ensure compliance.
- Give after or alongside the full chloroquine course (not before).
Mandatory Pre-treatment Check: G6PD Status
This is the most important safety step before prescribing.
| G6PD Status | Action |
|---|---|
| Normal | Standard primaquine 0.25 mg/kg/day x 14 days |
| Mild deficiency | 0.75 mg/kg once weekly x 8 weeks (under supervision) |
| Severe deficiency | Primaquine is contraindicated |
| Unknown / not tested | Exercise caution; test first if possible |
Primaquine causes oxidative hemolysis in G6PD-deficient individuals.
Contraindications
- G6PD severe deficiency
- Pregnant women (contraindicated - use chloroquine alone and defer primaquine until after delivery)
- Infants (< 6 months)
- Breastfeeding women whose infant's G6PD is unknown
Warning Signs to Tell the Patient
Stop primaquine immediately and report to a doctor if any of the following appear:
- Dark/cola-coloured urine (hemoglobinuria)
- Yellow eyes or skin (jaundice)
- Bluish discolouration of lips (methemoglobinemia)
- Severe abdominal pain, nausea, vomiting, or pallor
Complete P. vivax Treatment Summary (60 kg adult)
Day 1-3: Chloroquine 25 mg/kg divided over 3 days (e.g. 600 mg on Day 1, 300 mg on Day 2, 300 mg on Day 3)
Day 1-14: Primaquine 15 mg (0.25 mg/kg) once daily with food
Sources:
- Park's Textbook of Preventive and Social Medicine - Indian national programme guidelines
- Harrison's Principles of Internal Medicine 22E (2025) - international dosing table
- Goldman-Cecil Medicine - radical cure regimen overview
- A 2024 Lancet Infectious Diseases systematic review (PMID 37748497) confirms that standard-dose primaquine (0.25 mg/kg/day x 14 days) has an acceptable hemolysis risk profile in G6PD-normal patients - no change to current dosing recommendations.
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