II. Indications
-
Malaria Prophylaxis
- Areas without Chloroquine resistance
- Discoid Lupus (off label)
- NOT indicated in COVID-19 outside of clinical trials as of May 2020
- Low efficacy in trials to date and risk of serious reactions (including QTc Prolongation)
- https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2
III. Safety
- Safe in all trimesters of pregnancy (but Chloroquine does cross the placenta)
- Safe for children of all ages
IV. Dose: Malaria Prophylaxis
- Protocol
- Start 1-2 weeks before travel
- Continue through 4 weeks after return
- Adult: 300 mg base (500 mg salt) PO once weekly
- Child: Dose: 5 mg/kg base (8.3 mg/kg salt) up to 300 mg base orally once weekly
V. Dose: Malaria Treatment
- Adults
- Load: 1000 mg salt (600 mg base) orally at start
- Maintenance: 500 mg salt (300 mg base) orally at 6 hours, 24 hours and 48 hours after initial dose
- Child
- Load: 16.7 mg/kg salt (10 mg/kg base) orally at start
- Maintenance: 8.3 mg/kg salt (5 mg/kg base) orally at 6 hours, 24 hours and 48 hours after initial dose
VI. Technique
- Taking with food decreases gastric irritation
VII. Adverse Effects
- Cardiovascular
- Dermatologic
- Hair, skin and Nail Discoloration
- Erythema Multiforme
- Endocrine
- Ear
- Eye
- Blurred Vision
- Corneal disorders
- Retinopathy (more common than with Hydroxychloroquine)
- Gastrointestinal
- Hematologic
- Neurologic
- Confusion or Delirium
- Hallucination
- Psychosis
- Insomnia
- Extrapyramidal Side Effects
- Depressed mood and Suicidality
VIII. Efficacy
- Most world regions exhibit high Chloroquine resistance in Plasmodium Falciparum
- Limit use to only nonsevere infections from non-Chloroquine resistance regions
IX. References
- (2020) LexiComp, Chloroquine, accessed 5/6/2020
- Shahbodaghi (2022) Am Fam Physician 106(3): 270-8 [PubMed]