Bibliographic information
GuidelineWHO guidelines for malaria, 13 August 2025
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
Tafenoquine is recommended as an alternative to primaquine (3.5 mg/kg total dose) for preventing relapses of P. vivax in patients ≥ 2years of age, who have ≥ 70% glucose-6-phosphate dehydrogenase (G6PD) activity and who receive chloroquine treatment.
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
Remarks
- These recommendations pertain only to South America.
- Quantitative or semi-quantitative determination of G6PD activity must be done before tafenoquine administration.
- Tafenoquine is not recommended in pregnant and lactating women.
- Tafenoquine is not recommended in patients receiving artemisinin-based combination therapies for the treatment of P. vivax.
- Controlled deployment and /or further research is encouraged outside of South America, to generate evidence of the efficacy and safety of tafenoquine compared to primaquine as an anti-relapse treatment.
- No data is available comparing tafenoquine with primaquine given at a total dose of 7.0 mg/kg.
Practical info
- Quantitative or semi-quantitative G6PD testing MUST be done prior to tafenoquine administration.
- Dose: ◦ Adults, adolescents and children weighing more than 35 kg: the administration of a single 300 mg dose (two 150 mg tafenoquine tablets) is recommended on Day 1 or Day 2 of the 3-day course of chloroquine ◦ Children ≥ 2 years of age and weighing >10 kg to ≤ 35 kg: (see Table)
- Tafenoquine is NOT recommended for pregnant or lactating women.