Krintafel
Drug - Krintafel (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