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'Green tea, black tea, oolong tea -- they all come from the same tea plant, Camellia sinensis. The leaves are simply processed differently, explains Weisburger. Green tea leaves are not fermented; they are withered and steamed. Black tea and oolong tea leaves undergo a crushing and fermenting process.

All teas from the camellia tea plant are rich in polyphenols, which are a type of antioxidant. These wonder nutrients scavenge for cell-damaging free radicals in the body and detoxify them, says Weisburger. "Astounding" aptly describes tea's antioxidant power, he tells WebMD. "Whether it's green or black, tea has about eight to 10 times the polyphenols found in fruits and vegetables."

Black and green both have different types of antioxidants than fruits and vegetables. Thearubigins, epicatechins, and catechins are among those listed in a USDA chart. All are considered flavonoids, a type of antioxidant. Brewed green and black teas have loads of those, the chart shows. (Herbal teas may also contain antioxidants but less is known about them, Weisburger says.)"

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It has been
demonstrated that the interaction between PQ and
NADPH underlies many aspects of PQ toxicity. The
interaction between PQ and NADPH and the autooxidation of PQ result in the formation of reactive oxygen species (ROS) which results in the oxidative alterations in erythrocytes [2-5].


Erythrocytes contain enzymes and antioxidants which protect them against the activated oxygen species: hydrogen peroxide (H2O2), superoxide (O2
.- ), and hydroxyl (.OH) radicals.

These activated oxygen species are generated within normal erythrocytes after the addition of PQ and other oxidant drugs.

There are several reports about the oxidative effect of
PQ in erythrocytes

Oxidant drugs increase oxidative stress in red blood cells by generating free radicals and decreasing the activities of antioxidant enzymes.

It has been shown that the oxidative effects of PQ have been the formation of a charge transfer complex between PQ and (NAD[P])H, and auto-oxidation of PQ leading to the oxidation of the reduced pyridine nucleotides and generation of ROS (H2O2, O2 .- , .OH) [2-4].

Thus, these observations explain the various aspects of PQ toxicity in erythrocytes.

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Posts: 945 | From U.S | Registered: Oct 2004  |  IP: Logged | 

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This is the first study describing the effects of gender, food and grapefruit juice on the pharmacokinetics of primaquine and its major plasma metabolite, carboxyprimaquine. Although gender disparity in the pharmacokinetics of numerous drugs has been identified, the differences are generally only subtle [20].

Physiological and molecular differences such as drug transporters and drug-metabolizing enzymes between genders can cause sex-related differences in the pharmacokinetics of drugs. For example, females tend to have lower body weight, a greater percentage of body fat and higher CYP3A4 activity than males.

Although the present study provided no significant evidence for sex-related differences in the pharmacokinetics of primaquine and carboxyprimaquine, the number of subjects was small, which may lead to a Type II error. Our finding, however, differed from that of Singhasivanon et al.[8], who reported healthy Thai females to have significantly higher Cmax and AUC0-∞ values of primaquine than males (252 ng ml−1vs. 139 ng ml−1 and 1900 ng ml−1 h vs. 1307 ng ml−1 h, respectively) following the first dose of a daily 15-mg regimen of primaquine.

This discordance in results between the two studies is difficult to explain, as the Cmax and AUC0-∞ of primaquine were about twofold less in the Vietnamese subjects given twice the dose than that administered to the Thai subjects. The Cmax and AUC0-∞ values of primaquine in the Vietnamese subjects, particularly in the males, were also comparable to those of Mihaly et al.[7] in healthy caucasian males administered 30 mg primaquine.

It is generally recommended that primaquine should be taken with a meal to minimize any gastrointestinal disturbances associated with the use of this drug for the treatment or prophylaxis of malaria. Since food is known to stimulate splanchnic and hepatic blood flow, delay gastric emptying, induce the release of bile acids and can cause chemical or physical drug interactions [9], the bioavailability of primaquine may be altered by the intake of food.

Our study showed a meal containing ∼ 28 g of fat significantly increased the bioavailability of primaquine by 26% and 14%, as measured by Cmax and AUC, respectively, and that the presence of food did not delay the rate of primaquine absorption. These findings suggest that the bioavailability of primaquine can be maximized by administering the drug with a meal.

However, the increase in primaquine concentrations with food was relatively modest and is unlikely to cause an increase in the incidence and severity of adverse events associated with the drug. Improved bioavailability of primaquine may be an additional reason for stressing that this drug should be taken with a meal, since higher primaquine concentrations may be beneficial in the treatment of increasingly drug-tolerant infections of vivax malaria [3].

The increased bioavailability of primaquine when coadministered with grapefruit juice indicates that gut CYP3A4 activity is involved in the drug's first-pass metabolism. Grapefruit juice-primaquine interaction was quite variable, with some individuals having no increase in primaquine concentrations and others showing up to a twofold increase (e.g. the grapefruit juice to fasting AUC0-∞ ratio ranged from 0.71 to 2.18).

This marked variability is presumably associated with the large interindividual differences in the content of mucosal CYP enzyme activity in the small intestine among individuals. Although the extent of absorption of primaquine was increased by grapefruit juice as determined by elevated maximum primaquine concentrations, the rate of absorption was not altered, with similar tmax values between the fasting and grapefruit juice phases.

Thus, grapefruit juice does not appear to accelerate gastric emptying or enhance dissolution of the primaquine tablet. The increase in oral bioavailability of primaquine by grapefruit juice would have led to more primaquine being available to be metabolized by the liver to carboxyprimaquine. This increase in parent drug would have compensated for the reduced carboxyprimaquine formation in the stomach due to gut metabolism inhibition by grapefruit juice.

Such a sequence of events would explain the lack of change in carboxyprimaquine concentrations between the fasting and grapefruit juice phases, since grapefruit juice does not inhibit liver CYP3A4 metabolism [16].

The mechanism of grapefruit juice-drug interaction is complex and as yet not fully understood [21]. In vitro studies have identified the flavonoid, naringin and the furanocoumarins, bergamottin and 6',7′-dihydroxybergamottin as probable active constituents in grapefruit juice [22, 23]. These constituents can vary considerably among types and brands of grapefruit juice [24].

However, when pure naringin was administered to humans a significant grapefruit juice interaction with the prototypical CYP3A4 substrate, felodipine, failed to materialize [25]. Recently, in human studies, bergamottin and 6′,7′-dihydroxybergamottin have been reported to be important inhibitors of CYP3A4 in both Seville orange and grapefruit juices [26]. Other possible mechanisms for grapefruit juice-drug interactions could include inhibition of intestinal P-glycoprotein-mediated efflux transport of drugs and organic anion-transporting polypeptides [21].

In conclusion, no apparent sex-related differences were found in the pharmacokinetics of primaquine and carboxyprimaquine after a single oral dose of primaquine to warrant a different dose regimen for males and females. Food increased primaquine concentrations, suggesting that primaquine should be taken with or immediately after a meal to maximize bioavailability and clinical efficacy.

Although diluted grapefruit juice increased primaquine concentrations, the marked interindividual variability demonstrated that the quantitative effects of grapefruit juice on the pharmacokinetics of primaquine are not predictable at an individual level.

Because of this unpredictability and the lack of information on the effects of full-strength grapefruit juice on the pharmacokinetics of primaquine, it would be prudent to advise people not to take primaquine with grapefruit juice or any grapefruit products.

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Posts: 945 | From U.S | Registered: Oct 2004  |  IP: Logged | 

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Originally posted by groovy2:
Hi All

I started getting the body Buzz type feeling-
by the second dose I took the Buzz was gone-

Yesterday I took 2 Primaquine -
Today I am herxing somewhat--headache -

Pamo --Make sure you read ALL of my earlier
posts-- (about 10 posts)

you Have to take Chloroquine First-


Google-- WHO Chloroquine Primaquine Malaria --

The herx that these medicines cause is
Far beyond description--

The easiest way I can discribe it is-

I thought I was going to Drop Dead
any second for 5 solid days --

You have to be a Tuff SOB to go threw this-
No wimps allowed -- Seriously --

But over all it was worth it- Scary tho -

Make Sure you have someone to watch over you-
I was flopping around like in the
Exorcists movie--

also your mind get perty scrambled so make sure you have someone there to check ALL of your dissensions--for at least 2 weeks to a month--

Have Lots of Blankets and many electric space heaters-

( my body temp dropped to 89F--
87F is supposed to kill you )

Drink as much Hot green tea as you can--

Please dont try this treatment till you
have studied up on it and know what is going to happen--

In Africa they have to pay people to do this
treatment for Malaria -

I dont think that I would want to do this treatment If I just watched my friend go threw this ether--Jay--

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Jay, Can you update us on how you are doing on this Primaquine treatment? (Sorry if I missed any subsequent posts on another thread).

This treatment sounds promising for stubborn babesia. Yet it also sounds potentially very toxic and dangerous if not properly prescribed and monitored by the MD?

What is your daily dose of Primaquine?

Why does Chloroquine have to be taken before starting Primaquine?

Thanks for the info. I hope you are doing better now!

Erica

Posts: 408 | From California | Registered: Apr 2008  |  IP: Logged | 

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Originally posted by pamoisondelune:

By the way, it CAN'T be taken with Bactrim, cephalosporins or penicillins, i think. The warning leaflet said there are very serious interactions with TRIMETHOPRIM (that's in Bactrim or Septra).

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Does anyone know if this is accurate? I know a patient taking Primaquine with many other abx, including Bactrim and Bicillin (injected penicillin formula).

Posts: 408 | From California | Registered: Apr 2008  |  IP: Logged | 

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Originally posted by Alv:
nellypointis !

I see that you have been a member since 2001.I guess you are not over this disiease yet or maybe you are here to collect information .

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Posts: 416 | From france | Registered: Oct 2001  |  IP: Logged | 

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Originally posted by Erica741:
This thread is about Babesia and Primaquine treatment.

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Posts: 416 | From france | Registered: Oct 2001  |  IP: Logged |