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Chloroquine Phosphate
Chloroquine Phosphate is an antimalarial and anti-inflammatory medication primarily used to treat and prevent malaria. It is also used for certain autoimmune conditions like rheumatoid arthritis and lupus erythematosus. Chloroquine works by inhibiting the growth of the malaria parasite in red blood cells. Due to the development of resistant strains of malaria, its use has become more limited in certain regions.
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Frequently Asked Questions
How long does it take for Chloroquine to start working?
Chloroquine usually starts working within 1-2 days for malaria treatment, though it may take longer for its full effects to be felt in conditions like rheumatoid arthritis or lupus.
Can I drink alcohol while taking Chloroquine?
There are no specific interactions between chloroquine and alcohol, but alcohol can increase the risk of liver damage and worsen side effects like nausea and dizziness. It's best to limit alcohol consumption.
Do I need regular eye exams if I'm taking Chloroquine long-term?
Yes, patients on long-term chloroquine therapy should have regular eye exams (every 6-12 months) to monitor for retinal toxicity, which can cause vision problems.
Is Chloroquine safe during pregnancy?
Chloroquine is generally considered safe during pregnancy for malaria prevention and treatment, but always consult your healthcare provider for personalized advice.
What should I do if I miss a dose of Chloroquine?
For malaria prevention, take the missed dose as soon as you remember, then continue your regular schedule. For daily use, skip the missed dose if it’s almost time for your next one. Do not double the dose.
Can Chloroquine be used for COVID-19?
Chloroquine was initially explored for COVID-19 treatment, but it is not recommended for this purpose due to the lack of proven benefit and the risk of serious side effects like heart arrhythmias.
Does Chloroquine cause vision problems?
Yes, long-term use of chloroquine can cause retinal toxicity, leading to vision problems. Regular eye check-ups are essential for those on chronic chloroquine therapy.
Can I stop taking Chloroquine once I feel better?
No, it is important to complete the full course of chloroquine for malaria treatment or prevention to avoid complications and resistance development. Always follow your healthcare provider’s instructions.
Can Chloroquine cause hearing loss?
Yes, chloroquine has been associated with ototoxicity (hearing loss) in some cases, particularly with prolonged use or high doses. Contact your healthcare provider if you experience ringing in the ears or hearing changes.
Comprehensive Drug Guide
How Does Chloroquine Phosphate Work?
Chloroquine interferes with the growth of the Plasmodium parasite in red blood cells by increasing the pH within parasite cells and disrupting vital processes. It is also thought to inhibit certain immune pathways, making it useful in treating autoimmune diseases like lupus and rheumatoid arthritis.
Common Dosages
- Malaria Treatment (Adults):
- Initial Dose: 1000 mg (600 mg base) as a single dose.
- Second Dose: 500 mg (300 mg base) 6-8 hours later.
- Maintenance Dose: 500 mg (300 mg base) once daily for the next two days.
- Malaria Prevention (Adults):
- 500 mg (300 mg base) once weekly, starting 1-2 weeks before travel and continuing for 4 weeks after returning from a malaria-endemic area.
- Rheumatoid Arthritis and Lupus (Adults):
- 250 mg to 500 mg daily, based on patient response and tolerability
Typical Dosing
- Administration: Chloroquine Phosphate is taken orally with food to reduce stomach upset. For malaria prevention, it should be started 1 to 2 weeks before travel and continued for 4 weeks after returning.
- Frequency: For malaria, it is taken as a one-time treatment or weekly for prevention. For rheumatoid arthritis or lupus, it is taken daily.
- Duration of Use: Short-term for malaria, but potentially long-term for autoimmune conditions under medical supervision.
Typical Dosing
FDA Approved Indications
- Malaria: Treatment and prevention of malaria caused by susceptible strains of Plasmodium (mainly P. vivax, P. malariae, and P. ovale).
- Rheumatoid Arthritis: As a second-line treatment for inflammation and joint pain.
- Lupus Erythematosus: To reduce flare-ups and inflammation.
Who Shouldn't Take Chloroquine Phosphate?
- Hypersensitivity to chloroquine or any of its components.
- Retinal or visual field changes, as chloroquine can cause serious eye damage.
- Psoriasis or Porphyria, as it may worsen these conditions.
Advice From The Pharmacist
- Take it with food to reduce gastrointestinal upset.
- Be aware that long-term use may cause eye damage, and regular eye exams are recommended.
- Avoid taking antacids or kaolin within 4 hours before or after taking chloroquine, as these can interfere with absorption.
- Be sure to complete the full course for malaria treatment or prevention to avoid resistance and complications.
- Inform their doctor if they experience any changes in vision, hearing issues, or muscle weakness, as these may be signs of serious side effects.
- Drink plenty of water and maintain good hydration while taking this medication to prevent kidney issues.
Side Effects of Chloroquine Phosphate
Common Side Effects
- Nausea or vomiting
- Diarrhea
- Abdominal pain
- Headache
- Dizziness or blurred vision
Uncommon/Severe Side Effects
- Retinal Toxicity: Eye damage that may lead to vision loss if not monitored.
- Hearing Loss: Ringing in the ears or difficulty hearing.
- Muscle Weakness: Especially with long-term use.
- Psychiatric Effects: Confusion, mood swings, or hallucinations.
Risks and Warnings of Chloroquine Phosphate
- Retinal Toxicity: Long-term use can cause irreversible retinal damage, leading to vision problems. Regular eye exams are required for patients on chronic chloroquine therapy.
- Cardiotoxicity: Rare cases of fatal heart arrhythmias have been reported, especially with high doses.
- Hearing Damage: Chloroquine can cause hearing loss in some patients, particularly with long-term use.
- Resistant Strains of Malaria: Chloroquine is not effective against certain strains of P. falciparum in regions where resistance has developed. Check local resistance patterns before using for malaria prevention.
Interactions with Chloroquine Phosphate
Common Drug Interactions
- Antacids: These can reduce the absorption of chloroquine, making it less effective. Take antacids at least 4 hours apart from chloroquine.
- Other Antimalarials: May increase the risk of heart rhythm problems when combined with other antimalarial drugs like quinine.
- Cimetidine: May increase the levels of chloroquine in the blood, increasing the risk of side effects.
- Digoxin: Chloroquine can increase digoxin levels, leading to toxicity.
- Drugs Affecting Heart Rhythm: Such as amiodarone or other drugs that prolong the QT interval, which increases the risk of arrhythmias.
Alternatives to Chloroquine Phosphate
- Other Antimalarials: Such as hydroxychloroquine, atovaquone-proguanil, or mefloquine, depending on local resistance patterns.
- Methotrexate: An alternative disease-modifying drug for rheumatoid arthritis.
- Biologics (e.g., adalimumab, etanercept): For more severe autoimmune conditions like lupus or rheumatoid arthritis.
