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Chloroquine Oral, Intramuscular

KLOR-oh-kwin

Commonly used brand name(s):

In the U.S.

  • Aralen Phosphate

Available Dosage Forms:

  • Solution
  • Tablet

Therapeutic Class: Antimalarial

Chemical Class: Aminoquinoline

Uses For chloroquine

Chloroquine is a medicine used to prevent and treat malaria, a red blood cell infection transmitted by the bite of a mosquito, and to treat some conditions such as liver disease caused by protozoa (tiny one-celled animals).

Malaria transmission occurs in large areas of Central and South America, Hispaniola, sub-Saharan Africa, the Indian subcontinent, Southeast Asia, the Middle East, and Oceania. Country-specific information on malaria can be obtained from the Centers for Disease Control and Prevention (CDC), or from the CDC's web site at http://www.cdc.gov/travel/yellowbk.

chloroquine may be given alone or with one or more other medicines. It may also be used for other conditions as determined by your doctor.

Chloroquine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, chloroquine is used in certain patients with the following medical conditions:

  • Arthritis in children
  • High levels of calcium in the blood associated with sarcoidosis
  • Rheumatoid arthritis
  • Systemic lupus erythematosus (lupus; SLE)
  • Various skin disorders

For patients taking chloroquine for arthritis or lupus :

  • chloroquine must be taken regularly as ordered by your doctor in order for it to help you. It may take up to several weeks before you begin to feel better. It may take up to 6 months before you feel the full benefit of chloroquine.
  • If your symptoms of arthritis do not improve within a few weeks or months, or if they become worse, check with your doctor.

Before Using chloroquine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For chloroquine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to chloroquine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Children are especially sensitive to the effects of chloroquine. This may increase the chance of side effects during treatment. Overdose is especially dangerous in children. Taking as little as 1 tablet (300-mg strength) has resulted in the death of a small child. Children should avoid traveling to areas where there is a chance of getting malaria, unless they can take antimalarial medicines that are more effective than chloroquine.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of chloroquine in the elderly with use in other age groups.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using chloroquine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Aurothioglucose
  • Bepridil
  • Cisapride
  • Levomethadyl
  • Mesoridazine
  • Pimozide
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using chloroquine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Ajmaline
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Aprindine
  • Arsenic Trioxide
  • Astemizole
  • Azimilide
  • Bretylium
  • Chloral Hydrate
  • Chlorpromazine
  • Cimetidine
  • Clarithromycin
  • Desipramine
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Doxepin
  • Droperidol
  • Enflurane
  • Erythromycin
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Foscarnet
  • Gemifloxacin
  • Halofantrine
  • Haloperidol
  • Halothane
  • Hydroquinidine
  • Ibutilide
  • Imipramine
  • Isoflurane
  • Isradipine
  • Lidoflazine
  • Mefloquine
  • Nortriptyline
  • Octreotide
  • Pentamidine
  • Pirmenol
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Rabies Vaccine
  • Risperidone
  • Sematilide
  • Sertindole
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sultopride
  • Tedisamil
  • Telithromycin
  • Trifluoperazine
  • Trimethoprim
  • Trimipramine
  • Vasopressin
  • Zolmitriptan
  • Zotepine

Using chloroquine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ciprofloxacin
  • Cyclosporine
  • Kaolin
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Oxide
  • Magnesium Trisilicate
  • Praziquantel
  • Proguanil

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of chloroquine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood disease (severe)—Chloroquine may cause blood disorders
  • Eye or vision problems—Chloroquine, especially in high doses, may cause serious side effects affecting the eyes
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency—Chloroquine may cause serious side effects affecting the blood in patients with this deficiency
  • Liver disease—May decrease the removal of chloroquine from the blood, increasing the chance of side effects
  • Nerve or brain disease (severe), including convulsions (seizures)—Chloroquine may cause muscle weakness and, at high doses, seizures
  • Porphyria—Chloroquine may cause episodes of porphyria to occur more frequently
  • Psoriasis—Chloroquine may bring on severe attacks of psoriasis
  • Stomach or intestinal disease (severe)—Chloroquine may cause stomach or intestinal irritation

Proper Use of chloroquine

Take chloroquine with meals or milk to lessen stomach upset, unless otherwise directed by your doctor.

Keep chloroquine out of the reach of children. Children are especially sensitive to the effects of chloroquine and overdose is especially dangerous in children. Taking as little as 1 tablet (300-mg strength) has resulted in the death of a small child.

It is very important that you take chloroquine only as directed. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of serious side effects.

If you are taking chloroquine to help keep you from getting malaria, keep taking it for the full time of treatment. If you already have malaria, you should still keep taking chloroquine for the full time of treatment even if you begin to feel better after a few days. This will help to clear up your infection completely. If you stop taking chloroquine too soon, your symptoms may return.

Chloroquine works best when you take it on a regular schedule. For example, if you are to take it once a week to prevent malaria, it is best to take it on the same day each week. Or if you are to take two doses a day, one dose may be taken with breakfast and the other with the evening meal. Make sure that you do not miss any doses. If you have any questions about this, check with your health care professional.

For patients taking chloroquine to prevent malaria :

  • Your doctor may want you to start taking chloroquine 1 to 2 weeks before you travel to an area where there is a chance of getting malaria. This will help you to see how you react to the medicine. Also, it will allow time for your doctor to change to another medicine if you have a reaction to chloroquine.
  • Also, you should keep taking chloroquine while you are in the area and for 4 weeks after you leave the area. No medicine will protect you completely from malaria. However, to protect you as completely as possible, it is important to keep taking chloroquine for the full time your doctor ordered. Also, if fever develops during your travels or within 2 months after you leave the area, check with your doctor immediately .

Dosing

The dose of chloroquine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of chloroquine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For prevention of malaria:
      • Adults—500 milligrams (mg) once every seven days.
      • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 8.3 mg per kilogram (kg) (3.7 mg per pound) of body weight once every seven days.
    • For treatment of malaria:
      • Adults—Start with 1 gram. Then, 500 mg six to eight hours after the first dose, and 500 mg once a day on the second and third days of treatment.
      • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 41.7 mg per kg (18.9 mg per pound) of body weight divided up over three days. This dose is given as follows: Start with 16.7 mg per kg (7.5 mg per pound) of body weight, then 8.3 mg per kg (3.7 mg per pound) of body weight six hours, twenty-four hours, and forty-eight hours after the first dose.
    • For treatment of liver disease caused by protozoa:
      • Adults—At first, start with 250 mg four times a day for two days. Then 250 mg two times a day for at least two to three weeks.
      • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 10 mg per kg (4.5 mg per pound) of body weight a day for three weeks.
  • For injection dosage form:
    • For treatment of malaria:
      • Adults—200 to 250 mg injected into a muscle. This dose may be repeated in six hours if needed.
      • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 4.4 mg per kg (2 mg per pound) of body weight injected into a muscle or under the skin. This dose may be repeated in six hours if needed. Chloroquine may also be injected slowly into a vein. If the medicine is given in this way, the dose must be determined by your doctor.
    • For treatment of liver disease caused by protozoa:
      • Adults—200 to 250 mg a day injected into a muscle for ten to twelve days.
      • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 7.5 mg per kg (3.4 mg per pound) of body weight a day for ten to twelve days.

Missed Dose

If you miss a dose of chloroquine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using chloroquine

If you will be taking chloroquine for a long time, it is very important that your doctor check you at regular visits for any blood problems or muscle weakness that may be caused by chloroquine. In addition, check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

If your symptoms do not improve within a few days or if they become worse, check with your doctor.

Make sure you know how you react to chloroquine before you drive, use machines, or do anything else that could be dangerous if you are not able to see well.

Chloroquine may cause blurred vision, difficulty in reading, or other change in vision. It may also cause some people to become lightheaded.

If these reactions are especially bothersome, check with your doctor.

Malaria is spread by mosquitoes. If you are living in, or will be traveling to, an area where there is a chance of getting malaria, the following mosquito-control measures will help to prevent infection:

  • Avoid going out between dusk and dawn because it is at these times when mosquitoes most commonly bite.
  • If possible, sleep in a screened or air-conditioned room or under mosquito netting, preferably netting coated or soaked with pyrethrum, to avoid being bitten by malaria-carrying mosquitoes.
  • Remain in air-conditioned or well-screened rooms to reduce contact with mosquitoes
  • Wear long-sleeved shirts or blouses and long trousers to protect your arms and legs, especially from dusk through dawn when mosquitoes are out.
  • Apply mosquito repellent, preferably one containing DEET, to uncovered areas of the skin from dusk through dawn when mosquitoes are out.
  • Use mosquito coils or sprays to kill mosquitoes in living and sleeping quarters during evening and night-time hours.

chloroquine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. When chloroquine is used for short periods of time, side effects usually are rare. However, when it is used for a long time and/or in high doses, side effects are more likely to occur and may be serious.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Blurred vision
  • change in vision
  • eye pain
  • loss of vision
Rare
  • Black, tarry stools
  • blood in urine or stools
  • convulsions (seizures)
  • cough or hoarseness
  • feeling faint or lightheaded
  • fever or chills
  • increased muscle weakness
  • lower back or side pain
  • mood or other mental changes
  • painful or difficult urination
  • pinpoint red spots on skin
  • ringing or buzzing in ears or any loss of hearing
  • sore throat
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Symptoms of overdose
  • Drowsiness
  • headache
  • increased excitability

Note: The side effects in the Less Common category above may also occur or get worse after you stop taking chloroquine.

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Diarrhea
  • difficulty in seeing to read
  • headache
  • itching (more common in black patients)
  • loss of appetite
  • nausea or vomiting
  • stomach cramps or pain
Less common
  • Bleaching of hair or increased hair loss
  • blue-black discoloration of skin, fingernails, or inside of mouth
  • skin rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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