References: [1] [2] [3]. References: [4] [5] [6].
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We list the most important adverse effects. The selection is not exhaustive. References: [4] [5] [7] [8]. Clinical science Chloroquine and hydroxychloroquine are drugs derived from the quinoline molecule.
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Visual disturbances : in cases of long-term use, regular ophthalmological exams are recommended Irreversible retinopathy : key fundoscopic feature is Bull's eye maculopathy Reversible corneal opacity Blurred vision Photophobia Gastrointestinal: e. Treatment and prophylaxis of malaria due to Plasmodium malariae , P. You are viewing BNF. With oral use in adults. In active rheumatoid arthritis and systemic and discoid lupus erythematosus, to avoid excessive dosage in obese patients, the daily maximum dose should be calculated on the basis of ideal body weight.
Chloroquine doses for the treatment and prophylaxis of malaria in BNF publications may differ from those in product literature. Acute porphyrias ; diabetes may lower blood glucose ; elderly in adults ; G6PD deficiency ; long-term therapy regular ophthalmic examination recommended by manufacturers ; may aggravate myasthenia gravis ; may exacerbate psoriasis ; neurological disorders, especially epilepsy may lower seizure threshold —avoid for prophylaxis of malaria if history of epilepsy ; severe gastro-intestinal disorders.
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A review group convened by the Royal College of Ophthalmologists has updated guidelines on screening for chloroquine and hydroxychloroquine retinopathy Hydroxychloroquine and Chloroquine Retinopathy: Recommendations on Screening Chloroquine appears to be more retinotoxic than hydroxychloroquine. Cardiomyopathy ; hallucination ; hepatitis. Abdominal pain ; agranulocytosis ; alopecia ; anxiety ; atrioventricular block ; bone marrow disorders ; confusion ; corneal deposits ; depression ; diarrhoea ; eye disorders ; gastrointestinal disorder ; headache ; hearing impairment ; hypoglycaemia ; hypotension ; insomnia ; interstitial lung disease ; movement disorders ; myopathy ; nausea ; neuromyopathy ; neutropenia ; personality change ; photosensitivity reaction ; psychotic disorder ; QT interval prolongation ; seizure ; severe cutaneous adverse reactions SCARs ; skin reactions ; thrombocytopenia ; tinnitus ; tongue protrusion ; vision disorders ; vomiting.
Side-effects which occur at doses used in the prophylaxis or treatment of malaria are generally not serious.
Chloroquine is very toxic in overdosage; overdosage is extremely hazardous and difficult to treat. Urgent advice from the National Poisons Information Service is essential. Life-threatening features include arrhythmias which can have a very rapid onset and convulsions which can be intractable.
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Benefit of use in prophylaxis and treatment in malaria outweighs risk. For rheumatoid disease, it is not necessary to withdraw an antimalarial drug during pregnancy if the disease is well controlled. Present in breast milk and breast-feeding should be avoided when used to treat rheumatic disease.
Amount in milk probably too small to be harmful when used for malaria. Only partially excreted by the kidneys and reduction of the dose is not required for prophylaxis of malaria except in severe impairment.
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Manufacturers recommend regular ophthalmological examination but the evidence of practical value is unsatisfactory. Warn travellers going to malarious areas about importance of avoiding mosquito bites, importance of taking prophylaxis regularly, and importance of immediate visit to doctor if ill within 1 year and especially within 3 months of return.
Drugs for malaria prophylaxis are not prescribable in NHS primary care; health authorities may investigate circumstances under which antimalarials are prescribed.
Tablet , Oral solution.