Possible Interaction: Primaquine and Quinine

“Artesunate reduced the appearance of gametocytemia (relative risk [95% confidence interval] = 0.34 [0.17 to 0.70]), whereas combinations containing primaquine resulted in shorter gametocyte clearance times (medians of 66 versus 271 h for quinine groups and 73 versus 137 h for artesunate groups; P≤ 0.038).”

“Relapse occurred in 32 of 41 (78%) subjects administered artesunate alone (2.71 attacks/person-year), 7 of 36 (19%) administered quinine plus primaquine (0.23 attack/person-year), and 2 of 36 (6%) administered dihydroartemisinin-piperaquine plus primaquine (0.06 attack/person-year).”

“The efficacy of primaquine against relapse was 92% (95% confidence interval [CI] = 81% to 96%) for quinine plus primaquine and 98% (95% CI = 91% to 99%) for dihydroartemisinin-piperaquine plus primaquine.”

“The gametocytogenicity of quinine could be improved, especially in combination with primaquine that accelerates gametocyte clearance in malaria due to Plasmodium falciparum.”

“Transmission-blocking activity of quinine and primaquine was observed at relatively high concentrations (SDs): EC50 of quinine , 642 (111) ng/ml; EC50 of primaquine, 181 (23) ng/ml; EC90 of quinine, 816 (96) ng/ml; EC90 of primaquine, 543 (43) ng/ml.”

“The combinations of pyrimethamine or primaquine , with quinine disrupted more rosettes than quinine alone.”

“Compounds which have a curative effect on … phase of this infection, namely, primaquine administered in … with either quinine , chloroquine, or mepacrine, have a toxic, or sporocidal effect on the sporozoites of the sporogonous cycle … P. vivax, eventually producing destruction of these forms and sterilizing the mosquito of its infection.”