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chloroquine [chloroquine phosphate] (Aralen, Atabrine, Artrichin, Nivaquine, Cisplaquin, Quingamine, Avoclor, Chingaminum)

Tradename: Aralen, Atabrine. (chloroquine phosphate). Indications: 1) prophylaxis for malaria 2) treatment of uncomplicated, mild to moderate malaria 3) extraintestinal amebiasis 4) rheumatoid arthritis Contrandications: - appears to have activity against SARS CoV2 (COVID-19) in vitro [4] but is associated with higher in hospital mortality, QT prolongation & ventricular arrhythmias in patients with COVID-19 - FDA rescinded emergency use authorization of chloroquine to treat COVID-19 patients [7] Dosage: 1) malarial prophylaxis: a) 8 mg/kg up to 500 mg PO weekly b) 300 mg weekly [2] c) from 1 week before exposure to 4 weeks post exposure 2) malarial treatment: a) adults: 1] loading dose: 1000 mg chloroquine phosphate, 600 mg (base) 2] 500 mg chloroquine phosphate, 300 mg (base) after 6 hours 3] 500 mg chloroquine phosphate. 300 mg (base) QD for 2 days b) children 1] loading dose: 10 mg/kg up to 600 mg (base) 2] 5 mg/kg up to 300 mg after 6 hours 3] 5 mg/kg up to 300 mg QD for 2 days 3) rheumatoid arthritis: 250 mg (150 mg base) mg PO QD 4) extraintestinal amebiasis a) adults: 1] loading dose: 1000 mg chloroquine phosphate, 600 mg (base) 2] 500 mg chloroquine phosphate, 300 mg (base) PO QD for 2-3 weeks b) children: 10 mg/kg (base) up to 300 mg PO QD for 2-3 weeks 5) 500 mg choroquine phosphate (300 mg base) - EC90 value of chloroquine against SARS CoV2 is 6.90 uM, achievable with oral dose of 500 mg chloroquine phosphate (300 mg base) [4], but contraindicated for treatment of COVID-19 Tabs: chloroquine phosphate 250 chloroquine phosphate (150 mg base) & 500 mg (300 mg base). Monitor: 1) ophthalmologic examination recommended prior to therapy & every 6 months with continued therapy 2) liver function tests (LFTs) Adverse effects: 1) not common (1-10%) - nausea/vomiting, dizziness, diarrhea 2) uncommon (< 1%) - hypotension, fatigue, personality changes, headache, pruritus, anorexia, stomatitis, blood dyscrasia, retinopathy, blurred vision,lightening of hair 3) EKG changes (QT prolongation) - ventricular arrhythmias in 4.3% of patients hospitalized for COVID-19 vs 0.3% of controls [6] Drug interactions: 1) cimetidine, kaolin, magnesium trisalicylate, 2) rabies vaccine

Interactions

drug interactions drug adverse effects of antimalarials

Related

amebiasis chloroquine/hydroxychloroquine for COVID-19 malaria

General

amebicide antimalarial quinoline; leucoline; chinoleine; 1-benazazine; benzo[b]pyridine

Properties

MISC-INFO: elimination route LIVER KIDNEY pregnancy-category - safety in lactation -

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. Deprecated Reference
  4. Wang M, Cao R, Zhang L et al Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020 Mar;30(3):269-271. PMID: 32020029 Free PMC Article
  5. Prescriber's Digital Referenc Chloroquine phosphate - Drug Summary https://www.pdr.net/drug-summary/Chloroquine-Phosphate-chloroquine-phosphate-3418
  6. Mehra MR, Desai SS, Ruschitzka F, Patel AN Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. Lancet. May 22, 2020 PMID: 32450107 Free PMC article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext * authors associated with Surgisphere implicated in false data *
  7. FDA News Release June 15, 2020 Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-chloroquine-and