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Flecainide: Major Due to the potential for QT interval prolongation with primaquine, caution is advised with other drugs that prolong the QT interval. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with primaquine include flecainide. Fluconazole: Moderate Exercise caution when administering primaquine in combination with fluconazole as concurrent use may increase the risk of QT prolongation.

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Fluconazole has been associated with QT prolongation and rare cases of torsade de pointes TdP. Fluoxetine: Moderate Use fluoxetine and primaquine together with caution due to the potential for additive QT prolongation and risk of torsade de pointes TdP. QT prolongation and TdP have been reported in patients treated with fluoxetine. Primaquine has also been associated with QT prolongation. Fluoxetine; Olanzapine: Moderate Exercise caution when administering primaquine in combination with olanzapine as concurrent use may increase the risk of QT prolongation.

Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval. Moderate Use fluoxetine and primaquine together with caution due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Fluphenazine: Minor Exercise caution when administering primaquine in combination with fluphenazine as concurrent use may increase the risk of QT prolongation. Fluphenazine is associated with a possible risk for QT prolongation.

Theoretically, this phenothiazine may increase the risk of QT prolongation if coadministered with drugs with a risk of QT prolongation..

Fluvoxamine: Moderate Exercise caution when administering primaquine in combination with fluvoxamine as concurrent use may increase the risk of QT prolongation. QT prolongation and torsade de pointes TdP has been reported during fluvoxamine post-marketing use. Food: Moderate Overall, the mean bioavailability of primaquine is increased by administration with food; the increase is not thought to be clinically harmful and may contribute to antimalarial efficacy.

How should this medicine be used?

Administration with food is often recommended to limit GI intolerance. Foscarnet: Major When possible, avoid concurrent use of foscarnet with other drugs known to prolong the QT interval, such as primaquine. Foscarnet has been associated with postmarketing reports of both QT prolongation and torsade de pointes TdP.

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Primaquine may also prolong the QT interval. If these drugs are administered together, obtain an electrocardiogram and electrolyte concentrations before and periodically during treatment. Gemifloxacin: Moderate Exercise caution when administering primaquine in combination with gemifloxacin as concurrent use may increase the risk of QT prolongation.

Gemifloxacin may prolong the QT interval in some patients. The maximal change in the QTc interval occurs approximately 5 to 10 hours following oral administration of gemifloxacin. The likelihood of QTc prolongation may increase with increasing dose of the drug; therefore, the recommended dose should not be exceeded especially in patients with renal or hepatic impairment where the Cmax and AUC are slightly higher. Gemtuzumab Ozogamicin: Moderate Use gemtuzumab ozogamicin and primaquine together with caution due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP.

If these agents are used together, obtain an ECG and serum electrolytes prior to the start of gemtuzumab and as needed during treatment. Although QT interval prolongation has not been reported with gemtuzumab, it has been reported with other drugs that contain calicheamicin. Primaquine may prolong the QT interval. Gilteritinib: Moderate Use caution and monitor for additive QT prolongation if concurrent use of gilteritinib and primaquine is necessary.

Both drugs have been associated with QT prolongation. Glasdegib: Major Avoid coadministration of glasdegib with primaquine due to the potential for additive QT prolongation.

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If coadministration cannot be avoided, monitor patients for increased risk of QT prolongation with increased frequency of ECG monitoring. Glasdegib therapy may result in QT prolongation and ventricular arrhythmias including ventricular fibrillation and ventricular tachycardia. Goserelin: Moderate Consider whether the benefits of androgen deprivation therapy i. Primaquine has the potential to cause QT prolongation. Granisetron: Moderate Use granisetron with caution in combination with primaquine due to increased risk for QT prolongation.

Grapefruit juice: Moderate Administration of primaquine with grapefruit juice requires caution. The metabolism of primaquine may be reduced when taken with grapefruit juice. The authors of the study suggest avoidance of grapefruit juice during primaquine therapy. Alternatively, significant alterations in grapefruit juice intake should be avoided as a precaution during primaquine treatment. Halogenated Anesthetics: Major Due to the potential for QT interval prolongation with primaquine, caution is advised with other drugs that prolong the QT interval. Haloperidol: Moderate Due to the potential for QT interval prolongation with primaquine, caution is advised with haloperidol.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with primaquine include haloperidol. QT prolongation and torsade de pointes TdP have been observed during haloperidol treatment. Excessive doses particularly in the overdose setting or IV administration of haloperidol may be associated with a higher risk of QT prolongation. Halothane: Major Due to the potential for QT interval prolongation with primaquine, caution is advised with other drugs that prolong the QT interval.

What is Hydroxychloroquine?

Histrelin: Moderate Consider whether the benefits of androgen deprivation therapy i. Hydroxychloroquine: Major Avoid coadministration of hydroxychloroquine and primaquine. Hydroxychloroquine increases the QT interval and should not be administered with other drugs known to prolong the QT interval. Ventricular arrhythmias and torsade de pointes have been reported with the use of hydroxychloroquine. Primaquine is associated with the potential for QT prolongation.

Hydroxyzine: Moderate Caution is recommended if hydroxyzine is administered with primaquine due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Postmarketing data indicate that hydroxyzine causes QT prolongation and TdP. Primaquine has been associated with prolongation of the QT interval. Ibutilide: Major Due to the potential for QT interval prolongation with primaquine, caution is advised with other drugs that prolong the QT interval.

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Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with primaquine include ibutilide. Iloperidone: Major Due to the potential for QT interval prolongation with primaquine, caution is advised with other drugs that prolong the QT interval.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with primaquine include iloperidone. Imipramine: Minor Exercise caution when administering primaquine in combination with tricyclic antidepressants TCAs as concurrent use may increase the risk of QT prolongation. Inotuzumab Ozogamicin: Major Avoid coadministration of inotuzumab ozogamicin with primaquine in due to the potential for additive QT prolongation and risk of torsade de pointes TdP.

If coadministration is unavoidable, obtain an ECG and serum electrolytes prior to the start of treatment, after treatment initiation, and periodically during treatment. Both inotuzumab and primaquine have been associated with QT interval prolongation.


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Isoflurane: Major Due to the potential for QT interval prolongation with primaquine, caution is advised with other drugs that prolong the QT interval. Itraconazole: Moderate Caution is advised during concurrent use of itraconazole and primaquine as both drugs may cause QT prolongation. Ivosidenib: Major Avoid coadministration of ivosidenib with primaquine due to an increased risk of QT prolongation.

If concomitant use is unavoidable, monitor ECGs for QTc prolongation and monitor electrolytes; correct any electrolyte abnormalities as clinically appropriate. An interruption of therapy and dose reduction of ivosidenib may be necessary if QT prolongation occurs. Prolongation of the QTc interval and ventricular arrhythmias have been reported in patients treated with ivosidenib. Ketoconazole: Moderate Use ketoconazole with caution in combination with primaquine. Both ketoconazole and primaquine have been associated with QT prolongation.

Lapatinib: Moderate Monitor for evidence of QT prolongation if lapatinib is administered with primaquine. Lapatinib has been associated with concentration-dependent QT prolongation; ventricular arrhythmias and torsade de pointes TdP have been reported in postmarketing experience with lapatinib.

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Primaquine also has the potential for QT prolongation. Lefamulin: Major Avoid coadministration of lefamulin with primaquine as concurrent use may increase the risk of QT prolongation. If coadministration cannot be avoided, monitor ECG during treatment. Lefamulin has a concentration dependent QTc prolongation effect. The pharmacodynamic interaction potential to prolong the QT interval of the electrocardiogram between lefamulin and other drugs that effect cardiac conduction is unknown. Lenvatinib: Major Avoid coadministration of lenvatinib with primaquine due to the risk of QT prolongation.

Prolongation of the QT interval has been reported with lenvatinib therapy. Primaquine also prolongs the QT interval. Leuprolide: Moderate Consider whether the benefits of androgen deprivation therapy i. Leuprolide; Norethindrone: Moderate Consider whether the benefits of androgen deprivation therapy i.