What is Tafenoquine: Uses, Dosage, Side Effects and More

Tafenoquine is a prescription antimalarial medication that helps prevent and treat malaria infections. This relatively new drug offers a powerful option for protecting against malaria when you're traveling to high-risk areas or need treatment for certain types of malaria infections.

As part of a group of medications called 8-aminoquinolines, tafenoquine works differently from many other malaria drugs. It targets the parasite at multiple stages of its life cycle, making it particularly effective for comprehensive malaria prevention and treatment.

What is Tafenoquine?

Tafenoquine is an antimalarial drug that prevents and treats malaria caused by Plasmodium parasites. It belongs to a class of medications called 8-aminoquinolines, which are known for their ability to eliminate malaria parasites from your body completely.

This medication was approved by the FDA in 2018 and represents a significant advancement in malaria treatment. Unlike some older antimalarial drugs, tafenoquine can target dormant parasites that hide in your liver, preventing future malaria episodes.

The drug comes as oral tablets and is available only by prescription. Your doctor will determine if tafenoquine is right for you based on your specific situation and medical history.

What is Tafenoquine Used For?

Tafenoquine serves two main purposes in malaria care: prevention and treatment. Your doctor might prescribe it to protect you from getting malaria or to treat an existing infection.

For prevention, tafenoquine works as malaria prophylaxis when you're traveling to areas where malaria is common. It's particularly useful for longer trips or when you need extended protection after returning home.

The medication is also used to treat Plasmodium vivax malaria, a specific type that can cause recurring infections. Here's when your doctor might recommend tafenoquine:

• Preventing malaria during travel to endemic areas
• Treating confirmed P. vivax malaria infections
• Preventing malaria relapses from dormant liver parasites
• Post-travel prophylaxis after extended exposure

Your healthcare provider will consider your travel plans, medical history, and the specific malaria risks in your destination when deciding if tafenoquine is appropriate for you.

How Does Tafenoquine Work?

Tafenoquine is considered a strong antimalarial medication that works by attacking malaria parasites at different stages of their life cycle. It disrupts the parasite's ability to survive and reproduce in your body.

The drug is particularly effective because it can eliminate hypnozoites, which are dormant forms of the malaria parasite that hide in your liver. These sleeping parasites can reactivate weeks or months later, causing recurring malaria episodes.

By targeting both active and dormant parasites, tafenoquine provides comprehensive protection. The medication interferes with the parasite's cellular processes, ultimately leading to their destruction and preventing them from causing illness.

How Should I Take Tafenoquine?

Take tafenoquine exactly as your doctor prescribes, typically with food to reduce stomach upset. The medication should be taken with a full glass of water during or right after a meal.

For malaria prevention, you'll usually take one tablet weekly, starting 1-2 weeks before travel and continuing for one week after returning. Your doctor will give you specific timing instructions based on your travel plans.

When treating malaria, the dosing schedule may be different and often involves taking the medication daily for a shorter period. Here are important guidelines to follow:

• Take with food or milk to improve absorption and reduce nausea
• Swallow tablets whole with plenty of water
• Take at the same time each day to maintain consistent levels
• Don't crush, chew, or split the tablets
• Continue taking even if you feel better

If you have trouble swallowing tablets, talk to your doctor about alternatives. Never adjust your dose without medical guidance, as this can affect the medication's effectiveness.

How Long Should I Take Tafenoquine For?

The duration of tafenoquine treatment depends on whether you're using it for prevention or treatment. Your doctor will provide specific instructions based on your individual situation.

For malaria prevention during travel, you'll typically take tafenoquine for the duration of your trip plus additional time before and after. This usually means starting 1-2 weeks before departure and continuing for one week after returning home.

When treating an active malaria infection, the course is usually shorter but more intensive. Treatment duration can range from a few days to several weeks, depending on the type of malaria and your response to the medication.

Never stop taking tafenoquine early, even if you feel completely better. Incomplete treatment can lead to recurring infections or drug resistance, making future malaria more difficult to treat.

What Are the Side Effects of Tafenoquine?

Like all medications, tafenoquine can cause side effects, though not everyone experiences them. Most side effects are mild and manageable, but some can be more serious.

Common side effects that many people experience include nausea, vomiting, and stomach discomfort. These digestive issues often improve when you take the medication with food.

Here are the most frequently reported side effects you might notice:

• Nausea and vomiting
• Stomach pain or cramps
• Headache
• Dizziness
• Fatigue or weakness
• Trouble sleeping
• Loss of appetite

More serious side effects can occur, particularly in people with certain genetic conditions. These include severe anemia, psychiatric symptoms like anxiety or depression, and heart rhythm changes.

Rare but serious side effects that require immediate medical attention include severe allergic reactions, persistent vomiting, unusual fatigue, yellowing of skin or eyes, and significant mood changes. Contact your doctor right away if you experience any concerning symptoms.

Who Should Not Take Tafenoquine?

Tafenoquine isn't safe for everyone, and certain people should avoid this medication entirely. Your doctor will screen you for specific conditions before prescribing tafenoquine.

People with G6PD deficiency, a genetic condition that affects red blood cells, should never take tafenoquine. This medication can cause severe anemia in people with this condition, which can be life-threatening.

Before prescribing tafenoquine, your doctor will likely order a blood test to check for G6PD deficiency. Here are other situations where tafenoquine may not be appropriate:

• Known G6PD deficiency
• Severe kidney or liver disease
• History of psychiatric disorders
• Pregnancy or breastfeeding
• Certain heart rhythm problems
• Severe allergic reactions to similar medications

Your doctor will carefully review your medical history and may order additional tests to ensure tafenoquine is safe for you. Always tell your healthcare provider about all medications you're taking and any medical conditions you have.

Tafenoquine Brand Names

Tafenoquine is available under the brand name Arakoda for malaria prevention and Krintafel for malaria treatment. Both contain the same active ingredient but may have different dosing schedules.

Arakoda is specifically approved for malaria prevention in adults traveling to areas where malaria is common. Krintafel is used alongside other antimalarial medications to treat P. vivax malaria.

Your doctor will prescribe the appropriate brand based on whether you need prevention or treatment. Both forms require a prescription and should only be used under medical supervision.

Tafenoquine Alternatives

Several other antimalarial medications are available if tafenoquine isn't suitable for you. Your doctor can recommend alternatives based on your specific needs and medical history.

Common alternatives for malaria prevention include atovaquone-proguanil (Malarone), doxycycline, and mefloquine. Each has different benefits and side effect profiles.

For treating malaria, alternatives might include chloroquine, artemisinin-based combination therapies, or primaquine. The choice depends on the type of malaria, your location, and local resistance patterns.

Your healthcare provider will consider factors like your destination, length of travel, medical history, and other medications when selecting the best antimalarial option for you.

Is Tafenoquine Better Than Primaquine?

Tafenoquine and primaquine are both 8-aminoquinoline antimalarials, but tafenoquine offers some advantages over primaquine. The main benefit is that tafenoquine requires fewer doses due to its longer-lasting effects in your body.

While primaquine typically requires daily dosing for 14 days, tafenoquine can often be given as a single dose or short course. This makes it easier to complete treatment and reduces the risk of missed doses.

Both medications carry similar risks, particularly for people with G6PD deficiency. However, tafenoquine's longer duration of action means it stays in your system longer, which can be both an advantage and a concern.

Your doctor will consider your specific situation, including your ability to take daily medications and your risk factors, when choosing between these options.