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Arakoda
Arakoda (tafenoquine) is an antimalarial medication used for the prevention of malaria in adults. It is a quinoline derivative and works by targeting the Plasmodium parasites that cause malaria, both during their blood stage and their dormant liver stage. Arakoda is especially useful for travelers visiting malaria-endemic areas, providing weekly dosing convenience compared to other daily antimalarial medications.
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Frequently Asked Questions
How long does Arakoda protect against malaria?
Arakoda provides protection during your stay in malaria-endemic areas and continues to protect you with a terminal dose taken after leaving the area.
Do I need to take Arakoda with food?
Yes, it is recommended to take Arakoda with food to minimize stomach upset.
Can I take Arakoda if I have G6PD deficiency?
No, Arakoda is contraindicated in individuals with G6PD deficiency due to the risk of severe hemolysis.
What should I do if I miss a dose of Arakoda?
If you miss a dose, take it as soon as you remember. If it is close to the time of your next scheduled dose, skip the missed dose and resume your normal dosing schedule. Do not double up doses.
Is Arakoda safe for children?
Arakoda is currently only approved for use in adults, and its safety and effectiveness in children have not been established.
Comprehensive Drug Guide
How Does Arakoda Work?
Arakoda works by targeting the Plasmodium parasites at both the blood and liver stages of their lifecycle. It is believed to interfere with the parasites’ redox processes, ultimately killing the parasites in the liver before they can reach the bloodstream and cause active infection.
Common Dosages
- Tablets: 100 mg of tafenoquine
Typical Dosing
- Initial dose: Take 200 mg (two 100 mg tablets) once daily for three days prior to traveling to a malaria-endemic area.
- Maintenance dose: Take 200 mg once weekly starting seven days after the last loading dose while staying in the malaria-endemic area.
- Terminal dose: Take 200 mg as a single dose after leaving the malaria-endemic area to complete the prophylactic treatment.
Typical Dosing
FDA Approved Indications
- Prevention of malaria caused by Plasmodium falciparum and Plasmodium vivax in adults.
Who Shouldn't Take Arakoda?
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency, as it can cause severe hemolytic anemia.
- Known hypersensitivity to tafenoquine or any other components of the formulation.
- Patients with a history of psychosis or other psychiatric conditions, as tafenoquine has been associated with psychiatric side effects.
Advice From The Pharmacist
- Before starting Arakoda, you must undergo a G6PD deficiency test, as this medication can cause severe hemolysis in individuals with this condition.
- It’s important to take Arakoda with food to reduce stomach upset.
- Continue taking Arakoda as directed for the duration of your stay in a malaria-endemic area and take the terminal dose to ensure complete protection.
- Use additional mosquito protection methods, such as repellents and nets, as Arakoda does not prevent mosquito bites, only the malaria infection itself.
Side Effects of Arakoda
Common Side Effects
- Headache
- Dizziness
- Stomach pain
- Nausea
Uncommon/Severe Side Effects
- Hemolytic anemia in individuals with G6PD deficiency
- Psychiatric effects, such as anxiety, insomnia, or hallucinations
Risks and Warnings of Arakoda
- G6PD deficiency: Arakoda can cause severe hemolytic anemia in individuals with G6PD deficiency. Patients must be screened for this condition before starting the medication.
- Psychiatric risks: Arakoda has been associated with psychiatric side effects, such as depression, psychosis, or hallucinations. Caution is advised in individuals with a history of psychiatric disorders.
- Pregnancy: Arakoda should not be used during pregnancy or breastfeeding due to the risk of hemolysis in the infant.
Interactions with Arakoda
Common Drug Interactions
- Other antimalarial drugs: Using Arakoda with other antimalarial drugs, especially those that affect the liver or blood, may increase the risk of side effects.
- Medications that cause hemolysis: Drugs that also have the potential to cause hemolysis should be used cautiously with Arakoda, especially in individuals with borderline G6PD activity.
Alternatives to Arakoda
- Malarone (atovaquone/proguanil): A daily antimalarial that is also used for malaria prevention.
- Doxycycline: Another daily oral antimalarial option, particularly useful in areas with chloroquine-resistant malaria.
- Chloroquine: A weekly antimalarial used for areas with chloroquine-sensitive malaria.
