{"id":60221,"date":"2024-02-28T06:39:05","date_gmt":"2024-02-28T06:39:05","guid":{"rendered":"https:\/\/medsname.com\/primaquine\/"},"modified":"2026-04-30T10:23:49","modified_gmt":"2026-04-30T10:23:49","slug":"primaquine","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/primaquine\/","title":{"rendered":"Primaquin"},"content":{"rendered":"

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Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Primaquin<\/strong> obsahuje primaquin phosphate 15 mg base<\/strong> (Sanofi India). Je to jedin\u00fd \u0161iroce dostupn\u00fd l\u00e9k schopn\u00fd radik\u00e1ln\u00ed l\u00e9\u010dby P. vivax a P. ovale recidivuj\u00edc\u00ed mal\u00e1rie<\/strong> \u2014 zab\u00edj\u00ed dormantn\u00ed hypnozoity<\/em> jatern\u00ed st\u00e1dium, kter\u00e9 ostatn\u00ed antimalarika neovliv\u0148uj\u00ed. Standardn\u00ed re\u017eim: 30 mg base\/den po dobu 14 dn\u016f<\/strong> po 3denn\u00edm cyklu chlorochinu, kter\u00fd vy\u010dist\u00ed krevn\u00ed st\u00e1dium. Tak\u00e9 se pou\u017e\u00edv\u00e1 pro P. falciparum<\/em> vy\u010di\u0161t\u011bn\u00ed gametocyt\u016f (jednor\u00e1zov\u00e1 d\u00e1vka 0,25 mg\/kg, blokuj\u00edc\u00ed p\u0159enos) a jako mo\u017enost pro Pneumocystis jirovecii<\/em> z\u00e1pal plic u pacient\u016f alergick\u00fdch na sulfonamidy (s klindamycinem). Povinn\u00e9 testov\u00e1n\u00ed G6PD p\u0159ed pou\u017eit\u00edm<\/strong> \u2014 primachin zp\u016fsobuje t\u011b\u017ekou hemolytickou an\u00e9mii u pacient\u016f s deficitem G6PD. U\u017e\u00edvejte s j\u00eddlem ke sn\u00ed\u017een\u00ed gastrointestin\u00e1ln\u00edch pot\u00ed\u017e\u00ed.<\/p>\n<\/div>\n

\ud83c\udfed V\u00fdrobce certifikovan\u00fd WHO-GMP<\/strong>  \u00b7  \ud83d\udce6 Diskr\u00e9tn\u00ed balen\u00ed<\/strong>  \u00b7  \ud83c\udf0d Doprava do cel\u00e9ho sv\u011bta<\/strong>  \u00b7  \u2b50 1,400+ recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a><\/strong><\/div>\n

\ud83d\udee1\ufe0f Ka\u017ed\u00e1 objedn\u00e1vka je kryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, za\u0161leme zdarma n\u00e1hradn\u00ed z\u00e1silku prost\u0159ednictv\u00edm kur\u00fdrn\u00ed slu\u017eby EMS nebo ITPS.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Primachin je z\u00edsk\u00e1v\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP a expedov\u00e1n po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm balen\u00ed. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a> a podporov\u00e1na na\u0161\u00ed 1,400+ recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>. . Celosv\u011btov\u00e1 doprava bez p\u0159edpisov\u00e9 dokumentace.<\/p>\n

O Primachinu<\/h2>\n

Primachin je tableta obsahuj\u00edc\u00ed 15 mg primachin fosf\u00e1tu (b\u00e1ze) vyr\u00e1b\u011bn\u00e1 spole\u010dnost\u00ed Sanofi India za podm\u00ednek certifikovan\u00fdch WHO-GMP. Primachin je 8-aminochinolin poprv\u00e9 vyvinut\u00fd americkou arm\u00e1dou b\u011bhem druh\u00e9 sv\u011btov\u00e9 v\u00e1lky. Je na seznamu z\u00e1kladn\u00edch l\u00e9k\u016f WHO a z\u016fst\u00e1v\u00e1 jedin\u00fdm \u0161iroce dostupn\u00fdm l\u00e9kem, kter\u00fd zab\u00edj\u00ed dormantn\u00ed hypnozoitn\u00ed jatern\u00ed st\u00e1dium P. vivax<\/em> a P. ovale<\/em> \u2014 bez l\u00e9\u010dby primachinem mohou tito parazit\u00e9 relapsovat t\u00fddny a\u017e m\u011bs\u00edce po l\u00e9\u010db\u011b krevn\u00edho st\u00e1dia.<\/p>\n

Jak primachin funguje<\/h2>\n

P\u0159esn\u00fd molekul\u00e1rn\u00ed c\u00edl primachinu nen\u00ed zcela charakterizov\u00e1n \u2014 vedouc\u00ed hypot\u00e9za je, \u017ee jeden z jeho metabolit\u016f generovan\u00fdch CYP2D6 vytv\u00e1\u0159\u00ed reaktivn\u00ed kysl\u00edkov\u00e9 species a voln\u00e9 radik\u00e1ly, kter\u00e9 po\u0161kozuj\u00ed mitochondri\u00e1ln\u00ed membr\u00e1nu parazita v jatern\u00edm st\u00e1diu hypnozoitu. Stejn\u00e1 oxida\u010dn\u00ed chemie je to, co po\u0161kozuje \u010derven\u00e9 krvinky s deficitem G6PD (kde redukovan\u00fd glutathion nem\u016f\u017ee regenerovat, aby neutralizoval oxida\u010dn\u00ed stres) \u2014 co\u017e vysv\u011btluje paralelu mezi antiparazit\u00e1rn\u00ed aktivitou primachinu a jeho hemolytickou toxicitou.<\/p>\n

Primachin m\u00e1 slabou aktivitu na parazity v krevn\u00edm st\u00e1diu \u2014 kombinujte jej s chlorochinem (v oblastech citliv\u00fdch na chlorochin u vivax\/ovale) nebo s artemisininovou kombinovanou terapi\u00ed k nejprve vy\u010di\u0161t\u011bn\u00ed krevn\u00edho st\u00e1dia. Samotn\u00fd primachin NEN\u00cd l\u00e9\u010dbou akutn\u00ed symptomatick\u00e9 mal\u00e1rie.<\/p>\n

Indikace a d\u00e1vkov\u00e1n\u00ed<\/h2>\n
\n\n\n\n\n\n\n\n\n\n\n
Indikace<\/th>\nD\u00e1vkov\u00e1n\u00ed (v mg b\u00e1ze)<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
Radik\u00e1ln\u00ed l\u00e9\u010dba P. vivax \/ P. ovale (norm\u00e1ln\u00ed G6PD)<\/td>\n30 mg base\/den po dobu 14 dn\u016f<\/td>\nPo l\u00e9\u010db\u011b krevn\u00edho st\u00e1dia chlorochinem (nebo ACT). Dodr\u017eov\u00e1n\u00ed v\u0161ech 14 dn\u016f je nezbytn\u00e9 \u2014 p\u0159ed\u010dasn\u00e9 ukon\u010den\u00ed je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou relapsu.<\/td>\n<\/tr>\n
P. vivax u tropick\u00fdch\/oce\u00e1nsk\u00fdch kmen\u016f (Chesson-like, n\u00e1chyln\u011bj\u0161\u00ed k relapsu)<\/td>\n30 mg b\u00e1ze\/den po 14 dn\u00ed, n\u011bkdy prodlou\u017eeno na 21 dn\u00ed dle uv\u00e1\u017een\u00ed specialisty<\/td>\nVy\u0161\u0161\u00ed kumulativn\u00ed d\u00e1vka pro kmeny rezistentn\u00ed na chlorochin nebo bohat\u00e9 na hypnozoity.<\/td>\n<\/tr>\n
Radik\u00e1ln\u00ed l\u00e9\u010dba P. vivax (st\u0159edn\u00ed G6PD)<\/td>\n0,75 mg\/kg jednou t\u00fddn\u011b \u00d7 8 t\u00fddn\u016f<\/td>\nPod dohledem specialisty. Vy\u017eaduje hematologick\u00e9 sledov\u00e1n\u00ed.<\/td>\n<\/tr>\n
Odstran\u011bn\u00ed gametocyt\u016f P. falciparum (blokov\u00e1n\u00ed p\u0159enosu, n\u00edzk\u00e1 dle WHO)<\/td>\n0,25 mg\/kg jednor\u00e1zov\u00e1 d\u00e1vka s ACT<\/td>\nI u pacient\u016f s deficitem G6PD je riziko hemol\u00fdzy p\u0159i t\u00e9to jednor\u00e1zov\u00e9 d\u00e1vce n\u00edzk\u00e9.<\/td>\n<\/tr>\n
Pneumocystis jirovecii pneumonie (PJP) \u2014 alternativa k TMP-SMX p\u0159i alergii na sulfonamidy<\/td>\n30 mg b\u00e1ze\/den s klindamycinem 600 mg peror\u00e1ln\u011b 3\u00d7 denn\u011b po dobu 21 dn\u00ed<\/td>\nSpecializovan\u00fd kontext HIV \/ imunokompromitovan\u00e9ho hostitele.<\/td>\n<\/tr>\n
Radik\u00e1ln\u00ed l\u00e9\u010dba vivaxu u d\u011bt\u00ed (\u2265 6 m\u011bs\u00edc\u016f, norm\u00e1ln\u00ed G6PD)<\/td>\n0,5 mg\/kg\/den po dobu 14 dn\u00ed (max. 30 mg\/den)<\/td>\nM\u016f\u017ee b\u00fdt nutn\u00e9 rozd\u011blen\u00ed tablet.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
G6PD \u010derven\u00fd r\u00e1me\u010dek \u2014 povinn\u00e9 p\u0159ed pou\u017eit\u00edm.<\/strong> Primachin zp\u016fsobuje t\u011b\u017ekou akutn\u00ed hemolytickou an\u00e9mii u pacient\u016f s deficitem G6PD. P\u0159ed p\u0159edeps\u00e1n\u00edm vy\u0161et\u0159ete stav G6PD<\/strong>. Standardn\u00ed fluorescen\u010dn\u00ed spot test nebo kvantitativn\u00ed test je p\u0159ijateln\u00fd. T\u011b\u017ek\u00fd deficit G6PD (< 30 % aktivity)<\/strong> \u2014 primachin kontraindikov\u00e1n; pou\u017eijte tafenoquin (jin\u00fd 8-aminochinolin, jednor\u00e1zov\u00e1 d\u00e1vka, tak\u00e9 omezen\u00fd pro G6PD) nebo alternativn\u00ed strategii. St\u0159edn\u00ed deficit G6PD (heterozygotn\u00ed \u017eeny 30\u201370 %)<\/strong> \u2014 rozhodnut\u00ed p\u0159\u00edpad od p\u0159\u00edpadu; n\u011bkter\u00e9 autority pou\u017e\u00edvaj\u00ed upraven\u00fd t\u00fddenn\u00ed re\u017eim (0,75 mg\/kg jednou t\u00fddn\u011b \u00d7 8 t\u00fddn\u016f) pod hematologick\u00fdm dohledem. T\u011b\u017ek\u00e1 hemol\u00fdza se projevuje tmavou\/barvou koly mo\u010di, \u017eloutenkou, bledost\u00ed, \u00fanavou, du\u0161nost\u00ed \u2014 okam\u017eit\u011b p\u0159eru\u0161te pod\u00e1v\u00e1n\u00ed l\u00e9ku a vyhledejte l\u00e9ka\u0159sk\u00e9 vy\u0161et\u0159en\u00ed. Prevalence G6PD je 5\u201310 % v mnoha africk\u00fdch, st\u0159edomo\u0159sk\u00fdch, indick\u00fdch, bl\u00edzkov\u00fdchodn\u00edch a jihov\u00fdchodn\u00edch asijsk\u00fdch populac\u00edch a v\u00fdrazn\u011b vy\u0161\u0161\u00ed v n\u011bkter\u00fdch subpopulac\u00edch (a\u017e 25 % u sardinsk\u00fdch nebo kurdsk\u00fdch mu\u017e\u016f).<\/div>\n

Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n