Krintafel

Krintafel is the brand name for tafenoquine, an antimalarial drug in the 8-aminoquinoline class. It is used for the radical cure of Plasmodium vivax malaria, working to eradicate liver-stage hypnozoites in addition to treating the blood-stage infection when used with chloroquine. The medication is administered as a single-dose regimen in combination with chloroquine to prevent malaria relapse, and it is not intended for routine malaria prophylaxis.

Mechanism and pharmacology

Tafenoquine has activity against liver-stage parasites in addition to blood-stage Plasmodium species. Its exact mechanism is not fully understood, but the drug’s long half-life supports a single-dose approach for radical cure. It is typically given after an initial course of treatment to clear blood-stage parasites.

Indications, usage, and restrictions

In the United States, Krintafel is approved for radical cure of Plasmodium vivax malaria in adults and adolescents aged 16 years and older who have a confirmed P. vivax infection and are treated with chloroquine for blood-stage parasitemia. It is not used as a standalone prophylactic and is not indicated for species other than P. vivax. Prior to administration, patients should be tested for glucose-6-phosphate dehydrogenase (G6PD) deficiency due to the risk of hemolytic anemia in G6PD-deficient individuals. Krintafel is contraindicated in individuals with G6PD deficiency and in certain patients who are pregnant or breastfeeding, or who cannot undergo G6PD testing.

Safety and side effects

Common adverse effects include gastrointestinal upset, headache, and dizziness. Serious risks include hemolysis in G6PD-deficient patients and, less commonly, methemoglobinemia. As with all antimalarials, clinicians monitor for adverse reactions and potential drug interactions, and consider patient-specific factors such as liver function and concomitant medications.