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Krintafel

DrugKrintafel (tafenoquine) [GlaxoSmithKline LLC]

September 2019

Therapeutic area - Malaria

Approval criteria

  • Patient is at least 16 years or older AND
  • Patient has diagnosis of Plasmodium vivax malaria AND
  • Patient is receiving appropriate antimalarial therapy for acute P. vivax infection, for which it is susceptible (Krintafel is NOT indicated for the treatment of acute P. vivax malaria) AND
  • Krintafel will be used for the radical cure (prevention of relapse) of P. vivax AND
  • Patient does not have glucose-6-phosphate dehydrogenase (G6PD) deficiency (confirmed by testing) AND
  • Pregnancy status has been determined and, if pregnant, fetus does not have G6PD deficiency AND
  • If patient is breastfeeding, recipient child does not have G6PD deficiency AND
  • Patient does not have known hypersensitivity reactions to tafenoquine, other 8-aminoquinolines, or any component of Krintafel AND
  • Krintafel will be administered on the first or second day of antimalarial treatment for acute P. vivax infection AND
  • Patient has tried and failed primaquine for radical cure (prevention of relapse) of P. vivax

Denial criteria

  • G6PD deficiency or unknown G6PD status
  • Breastfeeding woman if infant is found to be G6PD deficient or if G6PD status is unknown

Quantity limits

  • 2 tablets
  • An additional 2 tablets may be approved if patient vomited initial dose of 300 mg within 1 hour of administration (may be readministered once only)
  • No renewal will be approved

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411

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