CDC Offers Guidance on Tafenoquine for Malaria Chemoprophylaxis

By Kelly Young

Edited by William E. Chavey, MD, MS

The CDC has published new guidance on using tafenoquine for malaria prophylaxis and antirelapse therapy.

In MMWR, the agency says that adults aged 18 and older may take tafenoquine (Arakoda, 100-mg tablets), a long-acting 8-aminoquinoline drug approved in 2018, to prevent malaria. Travelers should take 200 mg a day for the 3 days before their trip, 200 mg per week during the trip, and one 200-mg dose in the week after they return.

For people aged 16 years and older, tafenoquine (Krintafel, 150 mg) may be taken for presumptive antirelapse therapy for Plasmodium vivax and off-label for P. ovale. Clinicians should aim to overlap the single 300-mg antirelapse dose with blood-stage treatment or the last dose of prophylaxis.

Patients with G6PD deficiency should not take tafenoquine because of increased risk for hemolytic anemia. The drug is also contraindicated in pregnancy.