Tafenoquine, sold under the brand name Krintafel among others, is a medication used to prevent and to treat

malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...

. With respect to acute malaria, it is used together with other medications to prevent relapse by ''

Plasmodium vivax ''Plasmodium vivax'' is a protozoal parasite and a human pathogen. This parasite is the most frequent and widely distributed cause of recurring malaria. Although it is less virulent than ''Plasmodium falciparum'', the deadliest of the five huma ...

''. It may be used to prevent all types of malaria. It is taken by mouth. Common side effects include vomiting, headache, and dizziness. Other side effects may include

methemoglobinemia Methemoglobinemia, or methaemoglobinaemia, is a condition of elevated methemoglobin in the blood. Symptoms may include headache, dizziness, shortness of breath, nausea, poor muscle coordination, and blue-colored skin (cyanosis). Complications m ...

, trouble sleeping, and

anaphylaxis Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follow ...

. In people with

G6PD deficiency Glucose-6-phosphate dehydrogenase deficiency (G6PDD), which is the most common enzyme deficiency worldwide, is an inborn error of metabolism that predisposes to red blood cell breakdown. Most of the time, those who are affected have no symptoms. ...

, red blood cell breakdown may occur. Use in pregnancy is not recommended. Tafenoquine is in the

8-aminoquinoline 8-Aminoquinoline is the 8-amino derivative of quinoline. Often abbreviated AQ, it is a pale yellow solid. It is structurally analogous to 8-hydroxyquinoline. Drug derivatives The derivatives primaquine, tafenoquine and pamaquine have been tes ...

family of medications. How it works is unclear but it is effective both in the liver and bloodstream. A possible mechanism of action and other novel perspectives have been published. Tafenoquine was approved for medical use in Australia and in the United States in 2018. Tafenoquine is related to

primaquine Primaquine is a medication used to treat and prevent malaria and to treat ''Pneumocystis'' pneumonia. Specifically it is used for malaria due to ''Plasmodium vivax'' and ''Plasmodium ovale'' along with other medications and for prevention if othe ...

Medical use

Prevention

Tafenoquine may be used to prevent all types of malaria. For this use 200 mg 3 days before travel then 200 mg per week until one week after travel is recommended.

Treatment

Tafenoquine is used for eliminating the

hypnozoite ''Plasmodium'' is a genus of unicellular eukaryotes that are obligate parasites of vertebrates and insects. The life cycles of ''Plasmodium'' species involve development in a blood-feeding insect host which then injects parasites into a verte ...

stage of ''

'' and ''

Plasmodium ovale ''Plasmodium ovale'' is a species of parasitic protozoon that causes tertian malaria in humans. It is one of several species of ''Plasmodium'' parasites that infect humans, including ''Plasmodium falciparum'' and ''Plasmodium vivax'' which are ...

'' that is responsible for relapse of these malarial infections, even when the blood stages are successfully cleared.

Primaquine Primaquine is a medication used to treat and prevent malaria and to treat ''Pneumocystis'' pneumonia. Specifically it is used for malaria due to ''Plasmodium vivax'' and ''Plasmodium ovale'' along with other medications and for prevention if othe ...

for 14 days can also be used for this. The advantage of tafenoquine is that it has a long half-life (2–3 weeks) and therefore a single treatment is sufficient. For this use, a single dose of 300 mg is recommended. It is used with another medication, such as

chloroquine Chloroquine is a medication primarily used to prevent and treat malaria in areas where malaria remains sensitive to its effects. Certain types of malaria, resistant strains, and complicated cases typically require different or additional medi ...

, that kills the parasites in the bloodstream. There is a need to determine whether or not tafenoquine kills the numerous, non-circulating asexual ''P. vivax'' parasites that are now known to occur in the spleen, bone marrow, and possibly elsewhere in chronic infections.

Chemistry

Tafenoquine contains a stereocenter and consists of two enantiomers. This is a mixture of (''R'') - and the (''S'') - Form:

History

Tafenoquine was approved for medical use in Australia and in the United States in 2018. Tafenoquine was given an

orphan drug An orphan drug is a pharmaceutical agent developed to treat medical conditions which, because they are so rare, would not be profitable to produce without government assistance. The conditions are referred to as orphan diseases. The assignment of ...

designation and was granted

breakthrough therapy Breakthrough therapy is a United States Food and Drug Administration designation that expedites drug development that was created by Congress under Section 902 of the 9 July 2012 Food and Drug Administration Safety and Innovation Act. The FDA's "br ...

status in 2013 in the United States.

Society and culture

One version is made by

GlaxoSmithKline GSK plc, formerly GlaxoSmithKline plc, is a British multinational pharmaceutical and biotechnology company with global headquarters in London, England. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham. GSK is the ten ...

. While another is made by 60 Degrees Pharmaceutical.

Names

Etaquine was a generic name proposed by

WRAIR The Walter Reed Army Institute of Research (WRAIR) is the largest biomedical research facility administered by the U.S. Department of Defense (DoD). The institute is centered at the Forest Glen Annex, in the Forest Glen Park part of the uni ...

, and subsequently rejected by

CDER The Center for Drug Evaluation and Research (CDER, pronounced "see'-der") is a division of the U.S. Food and Drug Administration (FDA) that monitors most drugs as defined in the Food, Drug, and Cosmetic Act. Some biological products are also leg ...

. Trade names * Kozenis (Australia) * Kodatef (Australia) * Arakoda (USA), Krintafel (USA)

References

External links

* {{Portal bar , Medicine Antimalarial agents Breakthrough therapy GSK plc brands Orphan drugs Phenol ethers Quinolines Trifluoromethyl compounds Wikipedia medicine articles ready to translate Diaryl ethers