Chloroquine
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From MedlinePlus, U.S. National Library of Medicine
Dosing in kidney impairment
Central Nervous System Effects Acute extrapyramidal disorders may occur with chloroquine (see PRECAUTIONS , ADVERSE REACTIONS and OVERDOSAGE ). These adverse reactions usually resolve after treatment discontinuation and/or symptomatic treatment. Renal Toxicity Proteinuria with or without a moderate reduction in glomerular filteration rate have been reported with the use of chloroquine.
Renal biopsy showed phospholipidosis without immune deposits, inflammation, and/or increased cellularity. Physcians should consider phospholipidosis as a possible cause of renal injury in patients with underlying connective tissue disorders who are reciving chloroquine. Discontinue chloroquine if renal toxicity is suspected or demonstrated by tissue biopsy.
Drug interactions
Check chloroquine against a medication listLabel text (4 paragraphs)
Drug Interactions Antacids and kaolin: Antacids and kaolin can reduce absorption of chloroquine; an interval of at least4 hours between intake of these agents and chloroquine should be observed. Cimetidine: Cimetidine can inhibit the metabolism of chloroquine, increasing its plasma level. Concomitant use of cimetidine should be avoided. Insulin and other antidiabetic drugs: As chloroquine may enhance the effects of a hypoglycemic treatment, a decrease in doses of insulin or other antidiabetic drugs may be required.
Arrhythmogenic drugs: There may be an increased risk of inducing ventricular arrhythmias if chloroquine is used concomitantly with other arrhythmogenic drugs, such as amiodarone or moxifloxacin. Ampicillin: In a study of healthy volunteers, chloroquine significantly reduced the bioavailability of ampicillin. An interval of at least two hours between intake of ampicillin and chloroquine should be observed. Cyclosporine: After introduction of chloroquine (oral form), a sudden increase in serum cyclosporine level has been reported. Therefore, close monitoring of serum cyclosporine level is recommended and, if necessary, chloroquine should be discontinued.
Mefloquine: Co-administration of chloroquine and mefloquine may increase the risk of convulsions. 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.
Tamoxifen: Concomitant use of chloroquine with drugs known to induce retinal toxicity such as tamoxifen is not recommended (see WARNINGS ).
Contraindications
Use of chloroquine phosphate tablets for indications other than acute malaria is contraindicated in the presence of retinal or visual field changes of any etiology. Use of chloroquine phosphate tablets is contraindicated in patients with known hypersensitivity to 4-aminoquinoline compounds.
Pregnancy and lactation
Pregnancy
Pregnancy See WARNINGS, Usage in Pregnancy.
Lactation
Nursing Mothers 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 was investigated in eleven lactating mothers following a single oral dose of chloroquine (600 mg base). The maximum daily dose of the drug that the infant can receive from breastfeeding was about 0.7% of the maternal start dose of the drug in malaria chemotherapy.
Separate chemoprophylaxis for the infant is required (see DOSAGE AND ADMINISTRATION ).
For breastfeeding, also see LactMed (National Library of Medicine), which summarizes milk levels and infant effects.
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