Drug General Information (ID: DDILRFZUDQ)
Drug Name			Primaquine		Drug Info		Nitrous acid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antimalarial Agents				Antidotes
Structure

Mechanism of Primaquine-Nitrous acid Interaction (Severity Level: Major)
Increased risk of methemoglobinemia Click to Show/Hide Mechanism Graph
Drug Name		Primaquine				Nitrous acid
Mechanism		Methemoglobinemia				Methemoglobinemia
Key Mechanism Factor 1
		Factor Name		Methemoglobinemia
		Factor Description		Methemoglobinemia is a condition in which higher than normal levels of methemoglobin are found in the blood. Methemoglobinemia is a potentially life-threatening condition in which the oxygen-carrying capacity of circulating hemoglobin is reduced due to the conversion of some or all of the four iron species from the reduced ferrous (Fe2+) state to the oxidized iron (Fe3+) state.
Mechanism Description		Increased risk of methemoglobinemia by the combination of Primaquine and Nitrous acid

Recommended Action
Management		Sodium nitrite should be used with caution in the presence of other methemoglobin-inducing drugs. Patients should be closely monitored to ensure adequate perfusion and oxygenation during treatment with sodium nitrite. Methemoglobin levels should be monitored and oxygen administered whenever possible.

References
1	Coleman MD, Coleman NA "Drug-induced methaemoglobinaemia: treatment issues." Drug Saf 14 (1996): 394-405. [PMID: 8828017]
2	Product Information. Sodium Nitrite (sodium nitrite). Hope Pharmaceuticals, Scottsdale, AZ.
3	Rehman HU "Methemoglobinemia." West J Med 175 (2001): 193-6. [PMID: 11527852]