What is dose of primaquine in g6pd deficient patient?

Answer 1

Primaquine will cause a degree of hemolysis in ALL individuals with G6PD deficiency, irrespective of their particular mutation.

The clinical significance of this hemolysis will depend mainly on the initial hemoglobin levels of the patient and the dose of drug given.

Mutations that confer lower enzyme levels may have greater risk, but even patients with A- can still have serious hemolytic anemia after primaquine.

When possible, G6PD deficiency should be excluded before the standard therapeutic dosage for radical treatment of P. vivax and P. ovale malaria is administered.

At present, for radical cure of P. vivax (eradication of dormant parasites in the liver), in patients who are G6PD deficient, WHO guidance (see related link) is:

if glucose-6-phosphate dehydrogenase (G6PD) deficiency is known or suspected, 0.75 mg/kg weekly for 8 weeks.