The blood concentrations of chloroquine and desethylchloroquine the major metabolite of chloroquine, which also has antimalarial properties were negatively associated with log antibody titers. Chloroquine taken in the dose recommended for malaria prophylaxis can reduce the antibody response to primary immunization with intradermal human diploid-cell rabies vaccine. Praziquantel: In a single-dose interaction study, chloroquine has been reported to reduce the bioavailability of praziquantel. Because of the potential for serious adverse reactions in nursing infants from chloroquine, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the potential clinical benefit of the drug to the mother.
The excretion of chloroquine and the major metabolite, desethylchloroquine, in breast milk wasinvestigated in eleven lactating mothers following a single oral dose of chloroquine mg base. The maximum daily dose of the drug that the infant can receive from breastfeeding was about 0. Clinical studies of chloroquine phosphate did not include sufficient numbers of subjects aged 65and over to determine whether they respond differently from younger subjects.
However, this drugis known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug maybe greater in patients with impaired renal function. Because elderly patients are more likely to havedecreased renal function, care should be taken in dose selection and it may be useful to monitorrenal function.
The following adverse reactions have been identified during post-approval use of chloroquine or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Ocular disorders: Maculopathy and macular degenration have been reported and may be irreversible see WARNINGS , irreversible retinal damage in patients receiving long-term or high-dosage 4-aminoquinoline therapy; visual disturbances blurring of vision and difficulty of focusing or accommodation ; nyctalopia; scotomatous vision with field defects of paracentral, pericentral ring types, and typically temporal scotomas, e.
Reversible corneal opacities have also been reported. Immune system disorders: Urticaria, anaphylactic reaction including angioedema. Ear and labyrinth disorders: Nerve type deafness; tinnitus, reduced hearing in patients with preexisting auditory damage. Musculoskeletal and connective tissue-disorders: Sensorimotor disorders, skeletal muscle myopathy or neuromyopathy leading to progressive weakness and atrophy of proximal muscle groups, depression of tendon reflexes and abnormal nerve conduction.
Gastrointestinal disorders: Hepatitis, increased liver enzymes, anorexia, nausea, vomiting, diarrhea, abdominal cramps. Skin and subcutaneous tissue disorders: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis. Pleomorphic skin eruptions, skin and mucosal pigmentary changes; lichen planus-like eruptions, pruritus,; drug rash with eosinophilia and systemic symptoms DRESS syndrome ; photosensitivity and hair loss and bleaching of hair pigment.
Blood and lymphatic system disorders: Pancytopenia, aplastic anemia, reversible agranulocytosis, thrombocytopenia and neutropenia. Neuropsychiatric disorders: Neuropsychiatric changes including psychosis, delirium, anxiety, agitation, insomnia, confusion, hallucinations, personality changes, depression, and suicidal behavior. Cardiac disorders: Hypotension, electrocardiographic changes particularly, inversion or depression of the T-wave with widening of the QRS complex , and cardiomyopathy which may result in cardiac failure and in some cases a fatal outcome.
Signs and Symptoms: Chloroquine is very rapidly and completely absorbed after ingestion. Toxic doses of chloroquine can be fatal. As little as 1 g may be fatal in children. Toxic symptoms can occur within minutes. The symptoms of overdosage may include nausea, vomiting, headache, drowsiness, visual disturbances, cardiovascular collapse, convulsions, hypokalemia, rhythm and conduction disorders including QT prolongation, torsades de pointes, ventricular tachycardia and ventricular fibrillation, followed by sudden potentially fatal respiratory and cardiac arrest. Immediate medical attention is required, as these effects may appear shortly after the overdose.
Treatment: Treatment is symptomatic and must be prompt with immediate evacuation of the stomach by emesis or gastric lavage followed by treatment with activated charcoal. Chloroquine overdose is a life-threatening emergency and should be managed with cardio-respiratory and hemodynamic support, monitoring of potassium along with management of arrhythmias and convulsions, as necessary.
A patient who survives the acute phase and is asymptomatic should be closely observed until all clinical features of toxicity resolve.
The dosage of chloroquine phosphate is often expressed in terms of equivalent chloroquine base. Each mg tablet of chloroquine phosphate contains the equivalent of mg chloroquine base. In infants and children the dosage is preferably calculated by body weight. Pediatric Dose: The dosage for prophylaxis is 5 mg calculated as base, per kg of body weight, administered once per week on exactly the same day of each week. The pediatric dose should never exceed the adult dose regardless of weight. If circumstances permit, suppressive therapy should begin two weeks prior to exposure.
The suppressive therapy should be continued for eight weeks after leaving the endemic area. This represents a total dose of 2. The dosage for adults of low body weight and for infants and children should be determined as follows: First dose: 10 mg base per kg but not exceeding a single dose of mg base. Second dose: 6 hours after first dose 5 mg base per kg but not exceeding a single dose of mg base. Third dose: 24 hours after first dose 5 mg base per kg. Fourth dose: 36 hours after first dose 5 mg base per kg. Extraintestinal Amebiasis: Adults Dosage: 1 g salt mg base daily for two days, followed by mg mg base daily for at least two to three weeks.
Treatment is usually combined with an effective intestinal amebicide. Tablets containing mg chloroquine phosphate USP, equivalent to mg of chloroquine base. Chloroquine phosphate tablets are white to off-white colour round, bi-convex tablets, debossed with 'CN ' on one side and score line on the other side. Protect from light and moisture. Manufactured for: Rising Pharmaceuticals Inc. The reduction of ampicillin bioavailability produced by chloroquine might be attnbuted to slowing of gastric emptying and enhancement of gut motility induced by the chloroquine.
US firm making coronavirus 'treatment' doubled the price in January
Most users should sign in with their email address. If you originally registered with a username please use that to sign in. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.
Sign In or Create an Account. Kangwon National University, Samcheok Campus. Sign In. Advanced Search.
Search Menu. Article Navigation. Close mobile search navigation Article Navigation.
Volume Reduced ampicillin bioavailability following oral coadministration with chloroquine Hassan M. Oxford Academic. Retrieved 11 November Bibcode : Natur. April The Journal of Neuroscience. Parasitology Research.
June The Journal of Experimental Medicine. Archived PDF from the original on 22 September Bibcode : Sci Experimental Parasitology. The Lancet. Infectious Diseases. Journal of Virology. PloS One. PLoS Pathogens. PLOS Genetics. Archived from the original on 25 August Retrieved 2 February Universitas Scientiarum : 1. Archived PDF from the original on 22 February Retrieved 22 February — via scielo. Centers for Disease Control. Archived from the original on 28 August National Institutes of Health. Archived from the original on 6 April Retrieved 14 March Cell Research, 30, — Archived from the original on 6 February Retrieved 6 February Archived from the original on 17 March Retrieved 18 March Archived from the original on 18 March Retrieved 19 March March Clinical Infectious Diseases.
Archived from the original on 19 March NBC News. Banner Health Press release. Biochemical and Biophysical Research Communications.
Amid coronavirus, a drugmaker rescinds its chloroquine price hike - STAT
Int J Antimicrob Agents : Annals of Internal Medicine. Adding chloroquine to conventional chemotherapy and radiotherapy for glioblastoma multiforme". Antiparasitics — antiprotozoal agents — Chromalveolate antiparasitics P Balantidiasis : tetracycline. Blastocystosis : metronidazole. Sodium aurothiomalate Sodium aurothiosulfate Auranofin Aurothioglucose Aurotioprol.