CHLOROQUINE

Indications & Dose:

Prophylaxis and treatment of acute-attacks of malaria caused by susceptible strains, including P. vivax, P. malariae, P. ovale, P. falciparum (some strains); gastrointestinal, amebiasis Rheumatoid arthritis

• BY MOUTH

Adult

• Malaria suppression: PO 300 mg (base)/wk on same day of wk; treatment should begin 1-2 wk before exposure and for 4 wk after; if treatment begins after exposure, 600 mg (base) in 2 divided doses 6 hr apart

• Acute attack: PO 600 mg (base) initial dose followed by 300 mg 6-8 hr later, then 300 mg on each of 2 consecutive days (total dose 1.5 g in 3 days); IM 160-200 mg initially, repeat in 6 hr if necessary; begin oral therapy as soon as possible and continue for 3 days until 1.5 g of base has been administered

• Gastrointestinal amebiasis: IM 200-250 mg qd (HCl) up to 12 days, then substitute or resume PO administration as soon as possible; PO 600 mg.(base) qd for 2 days, then 300 mg qd for 2-3 wk

• BY MOUTH

Child

• Malaria suppression: PO 5 mg/kg/wk on same day of wk, not to exceed 300 mg (base); treatment should begin 1-2 wk before exposure and for 4 wk after; if treatment begins after exposure, 10 mg/kg (base) in 2 divided doses 6 hr apart

• Acute attack: PO 10 mg/kg (base) initial dose (do not exceed 600 mg) followed by 5 mg/kg 6-8 hr later (do not exceed 300 mg) then 5 mg/kg (do not exceed 300 mg) on each of 2 consecutive days (total dose 25 m /kg in 3 days). 

Contraindications:

Retinal field changes, porphyria 

Side Effects:

Cautions:

Precautions:

Children, blood dyscrasias, severe GI disease, neurologic disease, alcoholism, hepatic disease, G-6-PID deficiency, psoriasis, eczema, lactation 

Interaction:

Drugs

Chlorpromazine: Increased chlorpromazine concentrations

Cyclosporine: Elevates cyclosporine levels, toxicity possible

Methotrexate: Decreased methotrexate levels

Praziquantel: Decreased praziquantel absorption 

Warnings:

Adverse Effects:

Lactations:

 Excreted into breast milk; average infant consumption, considered safe; NOTE: doesn’t protect infant against malaria 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Fatigue, headache, psychosis, seizures, stimulation

CV: Asystole with syncope, ECG changes, heart block, hypotension

EENT: Blurred vision, corneal changes, corneal edema, deafness, difficulty focusing, photophobia, retinal changes, tinnitus, vertigo

GI: Anorexia, cramps, diarrhea, nausea, vomiting

HEMS: Agranulocytosis, hemolytic anemia, leukopenia, thrombocytopenia

SKIN: Eczema, exfoliative dermatitis, lichen planus-like eruptions, pigmentary changes, pruritus skin eruptions 

Patient And Carer Advice: