chloroquine (Rx)

Brand and Other Names:Chloroquine phosphate
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 500mg
  • NOTE: Chloroquine phosphate 16.6 mg is equivalent to 10 mg chloroquine base

Malaria

Prophylaxis

  • Indicated for prophylaxis of malaria in geographic areas where resistance to chloroquine is not present
  • 500 mg (300-mg base) weekly on the same day each week; begin 1-2 weeks before travel, during travel, and for 4 weeks after leaving endemic area (CDC 2018 [link https://www.cdc.gov/malaria/travelers/drugs.html])

Treatment

  • Indicated for acute attacks of malaria due to P. vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum
  • Acute attack
    • 1 g (600-mg base) PO, THEN
    • 500 mg (300 mg-base) PO after 6-8 hr THEN
    • 500 mg (300 mg-base) PO at 24 hr and 48 hr after initial dose
    • Total dose of 2500 mg (1500 mg-base) in 3 days

Amebiasis, Extraintestinal

1 g (600 mg base) PO qDay for 2 days, THEN

500 mg (300 mg base) qDay for 14-21 days

Coronavirus Disease 2019 (COVID-19) (Off-label)

Data available as of June 15, 2020

FDA revoked the emergency use authorization (EUA) that chloroquine donated to the Strategic National Stockpile to be used to treat certain hospitalized patients with COVID-19 when a clinical trial was unavailable, or participation in a clinical trial was not feasible

Based on its ongoing analysis of the EUA and emerging scientific data, the FDA determined that chloroquine is unlikely to be effective in treating COVID-19 for the authorized uses in the EUA; additionally, in light of ongoing serious cardiac adverse events and other potential serious side effects, the known and potential benefits of chloroquine no longer outweigh the known and potential risks for the EUA

While additional clinical trials may continue to evaluate potential benefit, the FDA determined the EUA was no longer appropriate

For more information, see the FDA news release: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine

Additional Medscape COVID-19 references are available

Porphyria Cutanea Tarda (Off-label)

125-250 mg (75-150 mg base) PO twice weekly

Glioblastoma (Orphan)

Orphan designation for treatment of glioblastoma multiforme

Sponsor

  • DualTpharma B.V.; Boschstraat 111-D01; 6211 A W Maastricht; Netherlands

Dosage Modifications

Hepatic impairment

  • Chloroquine phosphate tablets may concentrate in the liver; use with caution in patients with hepatic disease or alcoholism or in conjunction with known hepatotoxic drugs

Dosing Considerations

Limitations of use

  • Do not use for the treatment of complicated malaria (high-grade parasitemia and/or complications [eg, cerebral malaria, acute renal failure])
  • Do not use for malaria prophylaxis in areas where chloroquine resistance occurs
  • Concomitant use with an 8-aminoquinoline drug is necessary for treatment of hypnozoite liver stage forms of P.vivax and P.ovale

Dosage Forms & Strengths

tablet

  • 500mg
  • NOTE: Chloroquine phosphate 16.6 mg is equivalent to 10 mg chloroquine base

Malaria

Prophylaxis

  • Indicated for prophylaxis of malaria in geographic areas where resistance to chloroquine is not present
  • 5 mg/kg PO q1Week, not to exceed 500 mg (300-mg base), on the same day each week; begin 1-2 weeks before travel, during travel, and for 4 weeks after leaving endemic area (CDC 2018 [link https://www.cdc.gov/malaria/travelers/drugs.html])

Treatment

  • Indicated for acute attacks of malaria due to P. vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum for adults, infants, and children
  • Acute attack
    • Note: Dosing is based chloroquine base; chloroquine phosphate 16.6 mg is equivalent to 10 mg chloroquine base
    • First dose: 10 mg base/kg (not to exceed 600-mg base/dose)
    • Second dose: (6 hr after first dose) 5 mg base/kg (not to exceed 300 mg base/dose)
    • Third dose: (24 hr after first dose): 5 mg base/kg (not to exceed 300 mg base/dose)
    • Fourth dose (36 hr after first dose): 5 mg base/kg (not to exceed 300 mg base/dose)
    • Total dose of 25mg base/kg

Dosage Modifications

Hepatic impairment

  • Chloroquine phosphate tablets may concentrate in the liver; use with caution in patients with hepatic disease or alcoholism or in conjunction with known hepatotoxic drugs

Dosing Considerations

Limitations of use

  • Do not use for the treatment of complicated malaria (high-grade parasitemia and/or complications [eg, cerebral malaria, acute renal failure])
  • Do not use for malaria prophylaxis in areas where chloroquine resistance occurs
  • Concomitant use with an 8-aminoquinoline drug is necessary for treatment of hypnozoite liver stage forms of P.vivax and P.ovale
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Interactions

Interaction Checker

and chloroquine

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            Contraindicated (11)

            • agalsidase alfa

              chloroquine decreases effects of agalsidase alfa by pharmacodynamic antagonism. Contraindicated.

            • agalsidase beta

              chloroquine decreases effects of agalsidase beta by pharmacodynamic antagonism. Contraindicated.

            • artemether

              artemether increases toxicity of chloroquine by QTc interval. Contraindicated.

            • artemether/lumefantrine

              artemether/lumefantrine increases toxicity of chloroquine by QTc interval. Contraindicated.

            • clarithromycin

              chloroquine increases toxicity of clarithromycin by QTc interval. Contraindicated.

            • eliglustat

              chloroquine increases levels of eliglustat by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors.

            • lefamulin

              lefamulin will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.

            • pazopanib

              chloroquine increases toxicity of pazopanib by QTc interval. Contraindicated.

            • quinidine

              quinidine will increase the level or effect of chloroquine by Other (see comment). Contraindicated. Quinidine is contraindicated in patients receiving drugs that both prolong the QT interval and are metabolized by CYP2D6, such as chloroquine

            • saquinavir

              chloroquine increases toxicity of saquinavir by QTc interval. Contraindicated.

            • voriconazole

              chloroquine increases toxicity of voriconazole by QTc interval. Contraindicated.

            Serious - Use Alternative (49)

            • abametapir

              abametapir will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

            • amiodarone

              chloroquine increases toxicity of amiodarone by QTc interval. Avoid or Use Alternate Drug.

            • amlodipine

              chloroquine will increase the level or effect of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • apalutamide

              apalutamide will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

            • aripiprazole

              chloroquine will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • arsenic trioxide

              chloroquine increases toxicity of arsenic trioxide by QTc interval. Avoid or Use Alternate Drug.

            • bedaquiline

              chloroquine increases toxicity of bedaquiline by QTc interval. Avoid or Use Alternate Drug.

            • chlorpromazine

              chloroquine increases toxicity of chlorpromazine by QTc interval. Avoid or Use Alternate Drug.

            • cimetidine

              cimetidine increases levels of chloroquine by decreasing metabolism. Avoid or Use Alternate Drug.

            • cisapride

              chloroquine increases toxicity of cisapride by QTc interval. Avoid or Use Alternate Drug.

            • clarithromycin

              clarithromycin will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • conivaptan

              conivaptan will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • dacomitinib

              dacomitinib will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.

            • dapsone topical

              chloroquine, dapsone topical. unspecified interaction mechanism. Avoid or Use Alternate Drug. Avoid coadministration of dapsone topical with oral dapsone or antimalarial medications because of the potential for hemolytic reactions.

            • disopyramide

              chloroquine increases toxicity of disopyramide by QTc interval. Avoid or Use Alternate Drug.

            • dofetilide

              chloroquine increases toxicity of dofetilide by QTc interval. Avoid or Use Alternate Drug.

            • dronedarone

              chloroquine increases toxicity of dronedarone by QTc interval. Avoid or Use Alternate Drug.

            • entrectinib

              chloroquine and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

            • eribulin

              eribulin and chloroquine both increase QTc interval. Avoid or Use Alternate Drug. Potential for enhanced QTc-prolonging effects; if concurrent use is necessary then ECG monitoring is recommended.

            • fexinidazole

              fexinidazole and chloroquine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels and/or prolong QT interval.

              fexinidazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

            • givosiran

              givosiran will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.

            • glasdegib

              chloroquine and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

            • idelalisib

              idelalisib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

            • influenza virus vaccine quadrivalent, adjuvanted

              chloroquine decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

            • influenza virus vaccine trivalent, adjuvanted

              chloroquine decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

            • inotuzumab

              inotuzumab and chloroquine both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

            • itraconazole

              itraconazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • ivosidenib

              ivosidenib will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

            • lonafarnib

              lonafarnib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

            • lopinavir

              lopinavir will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • lumefantrine

              chloroquine increases toxicity of lumefantrine by QTc interval. Avoid or Use Alternate Drug.

            • mefloquine

              chloroquine, mefloquine. Mechanism: unknown. Contraindicated. Risk of convulsions.

            • methadone

              chloroquine increases toxicity of methadone by QTc interval. Avoid or Use Alternate Drug.

            • panobinostat

              chloroquine and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

            • pimozide

              pimozide increases toxicity of chloroquine by QTc interval. Avoid or Use Alternate Drug.

              chloroquine increases toxicity of pimozide by QTc interval. Contraindicated.

            • pitolisant

              chloroquine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

            • posaconazole

              posaconazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • procainamide

              chloroquine increases toxicity of procainamide by QTc interval. Avoid or Use Alternate Drug.

            • quinidine

              chloroquine increases toxicity of quinidine by QTc interval. Avoid or Use Alternate Drug.

            • quinine

              chloroquine increases toxicity of quinine by QTc interval. Avoid or Use Alternate Drug.

            • remdesivir

              chloroquine decreases effects of remdesivir by unspecified interaction mechanism. Avoid or Use Alternate Drug. Coadministration not recommended owing to antagonistic effect on remdesivir?s intracellular metabolic activation and antiviral activity.

            • ribociclib

              ribociclib and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.

            • saquinavir

              saquinavir will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • thioridazine

              chloroquine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • tucatinib

              tucatinib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

            • vandetanib

              chloroquine increases toxicity of vandetanib by QTc interval. Avoid or Use Alternate Drug.

            • voriconazole

              voriconazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • voxelotor

              voxelotor will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

            • ziprasidone

              chloroquine increases toxicity of ziprasidone by QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (137)

            • abiraterone

              abiraterone increases levels of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.

            • aluminum hydroxide

              aluminum hydroxide will decrease the level or effect of chloroquine by cation binding in GI tract. Use Caution/Monitor. Separate doses by at least 4 hr

              aluminum hydroxide will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely.

            • amitriptyline

              chloroquine increases toxicity of amitriptyline by QTc interval. Use Caution/Monitor.

            • amoxapine

              chloroquine increases toxicity of amoxapine by QTc interval. Use Caution/Monitor.

            • ampicillin

              chloroquine decreases levels of ampicillin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate doses by at least 2 hr.

            • apomorphine

              chloroquine increases toxicity of apomorphine by QTc interval. Use Caution/Monitor.

            • arformoterol

              chloroquine increases toxicity of arformoterol by QTc interval. Use Caution/Monitor.

            • asenapine

              chloroquine increases toxicity of asenapine by QTc interval. Use Caution/Monitor.

            • aspirin/citric acid/sodium bicarbonate

              aspirin/citric acid/sodium bicarbonate will decrease the level or effect of chloroquine by cation binding in GI tract. Use Caution/Monitor. Separate doses by at least 4 hr

            • atomoxetine

              chloroquine will increase the level or effect of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • azithromycin

              azithromycin increases toxicity of chloroquine by QTc interval. Modify Therapy/Monitor Closely.

              chloroquine increases toxicity of azithromycin by QTc interval. Use Caution/Monitor.

            • benzhydrocodone/acetaminophen

              chloroquine will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone [benzhydrocodone is prodrug of hydrocodone]) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

            • brexpiprazole

              chloroquine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.

            • bupivacaine implant

              chloroquine, bupivacaine implant. Either increases effects of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.

            • bupropion

              bupropion will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • calcium carbonate

              calcium carbonate will decrease the level or effect of chloroquine by cation binding in GI tract. Use Caution/Monitor. Separate doses by at least 4 hr

            • carbamazepine

              carbamazepine will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • carvedilol

              chloroquine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • cholera vaccine

              chloroquine decreases effects of cholera vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Immune responses to cholera vaccine may be diminished when it is coadministered with chloroquine. Administer cholera vaccine at least 10 days before beginning antimalarial prophylaxis with chloroquine.

            • ciprofloxacin

              chloroquine and ciprofloxacin both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.

            • citalopram

              chloroquine increases toxicity of citalopram by QTc interval. Use Caution/Monitor.

            • clobazam

              clobazam will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.

            • clofazimine

              chloroquine increases toxicity of clofazimine by QTc interval. Modify Therapy/Monitor Closely.

            • clomipramine

              chloroquine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              chloroquine increases toxicity of clomipramine by QTc interval. Use Caution/Monitor.

            • clozapine

              chloroquine increases toxicity of clozapine by QTc interval. Use Caution/Monitor.

            • codeine

              chloroquine will increase the level or effect of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Prevents conversion of codeine to its active metabolite morphine.

            • crizotinib

              crizotinib increases levels of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

              chloroquine increases toxicity of crizotinib by QTc interval. Use Caution/Monitor.

            • crofelemer

              crofelemer increases levels of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

            • cyclosporine

              chloroquine increases levels of cyclosporine by decreasing metabolism. Use Caution/Monitor.

            • dabrafenib

              dabrafenib will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

            • dasatinib

              chloroquine increases toxicity of dasatinib by QTc interval. Use Caution/Monitor.

            • desipramine

              chloroquine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              chloroquine increases toxicity of desipramine by QTc interval. Use Caution/Monitor.

            • dolasetron

              chloroquine increases toxicity of dolasetron by QTc interval. Use Caution/Monitor.

            • doxepin

              chloroquine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • droperidol

              chloroquine increases toxicity of droperidol by QTc interval. Use Caution/Monitor.

            • duvelisib

              duvelisib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of

            • efavirenz

              efavirenz will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • elagolix

              elagolix will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

            • eliglustat

              eliglustat increases levels of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

              elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

            • encorafenib

              encorafenib, chloroquine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

              chloroquine increases toxicity of encorafenib by QTc interval. Use Caution/Monitor.

            • enzalutamide

              enzalutamide will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

            • erythromycin base

              chloroquine increases toxicity of erythromycin base by QTc interval. Use Caution/Monitor.

            • erythromycin ethylsuccinate

              chloroquine increases toxicity of erythromycin ethylsuccinate by QTc interval. Use Caution/Monitor.

            • erythromycin lactobionate

              chloroquine increases toxicity of erythromycin lactobionate by QTc interval. Use Caution/Monitor.

            • erythromycin stearate

              chloroquine increases toxicity of erythromycin stearate by QTc interval. Use Caution/Monitor.

            • escitalopram

              chloroquine increases toxicity of escitalopram by QTc interval. Use Caution/Monitor.

            • fedratinib

              fedratinib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

              fedratinib will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.

            • flecainide

              chloroquine will increase the level or effect of flecainide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              chloroquine increases toxicity of flecainide by QTc interval. Use Caution/Monitor.

            • fluconazole

              chloroquine increases toxicity of fluconazole by QTc interval. Use Caution/Monitor.

            • fostemsavir

              chloroquine and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

            • gemifloxacin

              chloroquine increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor.

            • gemtuzumab

              chloroquine and gemtuzumab both increase QTc interval. Use Caution/Monitor.

            • goserelin

              goserelin increases toxicity of chloroquine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • haemophilus influenzae type b vaccine

              chloroquine decreases effects of haemophilus influenzae type b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored.

            • haloperidol

              chloroquine will increase the level or effect of haloperidol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              chloroquine increases toxicity of haloperidol by QTc interval. Use Caution/Monitor.

            • histrelin

              histrelin increases toxicity of chloroquine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • hydrocodone

              chloroquine will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

            • hydromorphone

              chloroquine will increase the level or effect of hydromorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • iloperidone

              chloroquine will increase the level or effect of iloperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              iloperidone increases levels of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

            • imipramine

              chloroquine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • influenza virus vaccine quadrivalent, recombinant

              chloroquine decreases effects of influenza virus vaccine quadrivalent, recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immune response to vaccine may be decreased in immunocompromised individuals.

            • influenza virus vaccine trivalent, recombinant

              chloroquine decreases effects of influenza virus vaccine trivalent, recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immune response to vaccine may be decreased in immunocompromised individuals.

            • inotuzumab

              chloroquine increases toxicity of inotuzumab by QTc interval. Use Caution/Monitor.

            • isradipine

              chloroquine increases toxicity of isradipine by QTc interval. Use Caution/Monitor.

            • istradefylline

              istradefylline will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

            • lanthanum carbonate

              lanthanum carbonate decreases levels of chloroquine by cation binding in GI tract. Use Caution/Monitor. Administer chlorquine at least 2 hr before or after lanthanum.

            • lenvatinib

              chloroquine and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

            • leuprolide

              leuprolide increases toxicity of chloroquine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • levofloxacin

              chloroquine increases toxicity of levofloxacin by QTc interval. Use Caution/Monitor.

            • lofepramine

              chloroquine will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • lofexidine

              chloroquine increases toxicity of lofexidine by QTc interval. Use Caution/Monitor.

            • lopinavir

              chloroquine increases toxicity of lopinavir by QTc interval. Use Caution/Monitor.

            • lorcaserin

              lorcaserin will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • lorlatinib

              lorlatinib will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

            • magaldrate

              magaldrate will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate doses by at least 4 hr

            • magnesium hydroxide

              magnesium hydroxide will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate doses by at least 4 hr

            • magnesium oxide

              magnesium oxide will decrease the level or effect of chloroquine by cation binding in GI tract. Use Caution/Monitor. Separate doses by at least 4 hr

            • meningococcal group B vaccine

              chloroquine decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.

            • methamphetamine

              chloroquine will increase the level or effect of methamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • metoprolol

              chloroquine will increase the level or effect of metoprolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • mexiletine

              chloroquine will increase the level or effect of mexiletine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • mifepristone

              mifepristone will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

            • mirabegron

              mirabegron will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • mitotane

              mitotane decreases levels of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

            • morphine

              chloroquine will increase the level or effect of morphine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • moxifloxacin

              chloroquine increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor.

            • nebivolol

              chloroquine will increase the level or effect of nebivolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • nilotinib

              chloroquine increases toxicity of nilotinib by QTc interval. Use Caution/Monitor.

            • nortriptyline

              chloroquine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              chloroquine increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor.

            • ofatumumab SC

              ofatumumab SC, chloroquine. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.

            • olanzapine

              chloroquine increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.

            • olaparib

              chloroquine and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.

            • oliceridine

              chloroquine will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.

            • ondansetron

              chloroquine increases toxicity of ondansetron by QTc interval. Use Caution/Monitor.

            • osilodrostat

              osilodrostat and chloroquine both increase QTc interval. Use Caution/Monitor.

              chloroquine and osilodrostat both increase QTc interval. Use Caution/Monitor.

            • osimertinib

              chloroquine increases toxicity of osimertinib by QTc interval. Use Caution/Monitor.

            • oxaliplatin

              oxaliplatin will increase the level or effect of chloroquine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

            • oxycodone

              chloroquine will increase the level or effect of oxycodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • oxymorphone

              chloroquine will increase the level or effect of oxymorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • paliperidone

              chloroquine increases toxicity of paliperidone by QTc interval. Use Caution/Monitor.

            • phenobarbital

              phenobarbital will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • phenytoin

              phenytoin will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • potassium bicarbonate

              potassium bicarbonate will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate doses by at least 4 hr

            • primidone

              primidone will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • propafenone

              chloroquine will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              chloroquine increases toxicity of propafenone by QTc interval. Use Caution/Monitor.

            • propranolol

              chloroquine will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • quetiapine

              chloroquine increases toxicity of quetiapine by QTc interval. Use Caution/Monitor.

            • ranolazine

              chloroquine increases toxicity of ranolazine by QTc interval. Use Caution/Monitor.

            • ribociclib

              chloroquine increases toxicity of ribociclib by QTc interval. Use Caution/Monitor.

              ribociclib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifampin

              rifampin will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • risperidone

              chloroquine increases toxicity of risperidone by QTc interval. Use Caution/Monitor.

            • rolapitant

              rolapitant will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.

            • romidepsin

              chloroquine increases toxicity of romidepsin by QTc interval. Use Caution/Monitor.

            • rucaparib

              rucaparib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

            • saquinavir

              saquinavir, chloroquine. Either increases toxicity of the other by QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. Increased risk of QT prolongation and cardiac arrhythmias.

            • sipuleucel-T

              chloroquine decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

            • sodium bicarbonate

              sodium bicarbonate will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate doses by at least 4 hr

            • sotalol

              chloroquine and sotalol both increase QTc interval. Use Caution/Monitor.

            • stiripentol

              stiripentol, chloroquine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

            • tacrolimus

              chloroquine increases toxicity of tacrolimus by QTc interval. Use Caution/Monitor.

            • tamoxifen

              chloroquine decreases effects of tamoxifen by decreasing metabolism. Use Caution/Monitor. Inhibition of CYP2D6 metabolism to tamoxifen's active metabolite, endoxifen.

            • tamsulosin

              chloroquine increases levels of tamsulosin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • tazemetostat

              tazemetostat will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tecovirimat

              tecovirimat will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

            • terbinafine

              terbinafine will increase the level or effect of chloroquine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.

            • tetracaine

              tetracaine, chloroquine. Other (see comment). Use Caution/Monitor. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered.

            • thioridazine

              chloroquine increases toxicity of thioridazine by QTc interval. Use Caution/Monitor.

            • timolol

              chloroquine will increase the level or effect of timolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • tobramycin inhaled

              tobramycin inhaled and chloroquine both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

            • toremifene

              chloroquine increases toxicity of toremifene by QTc interval. Use Caution/Monitor.

            • tramadol

              chloroquine decreases effects of tramadol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Decreased conversion of tramadol to active metabolite.

              chloroquine decreases effects of tramadol by decreasing metabolism. Use Caution/Monitor. Decreased conversion of tramadol to active metabolite.

            • treosulfan

              treosulfan decreases effects of chloroquine by Mechanism: unspecified interaction mechanism. Use Caution/Monitor.

            • triptorelin

              triptorelin increases toxicity of chloroquine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • vemurafenib

              chloroquine increases toxicity of vemurafenib by QTc interval. Use Caution/Monitor.

            • vilanterol/fluticasone furoate inhaled

              chloroquine increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Use Caution/Monitor.

            • zoster vaccine recombinant

              chloroquine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

            Minor (98)

            • alfuzosin

              chloroquine increases toxicity of alfuzosin by QTc interval. Minor/Significance Unknown.

            • anthrax vaccine

              chloroquine decreases effects of anthrax vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • aripiprazole

              chloroquine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • artemether/lumefantrine

              chloroquine increases toxicity of artemether/lumefantrine by QTc interval. Minor/Significance Unknown.

            • BCG vaccine live

              chloroquine decreases effects of BCG vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • chlorpromazine

              chloroquine will increase the level or effect of chlorpromazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of chlorpromazine by decreasing metabolism. Minor/Significance Unknown.

            • degarelix

              chloroquine increases toxicity of degarelix by QTc interval. Minor/Significance Unknown.

            • deutetrabenazine

              chloroquine increases toxicity of deutetrabenazine by QTc interval. Minor/Significance Unknown.

            • dexfenfluramine

              chloroquine will increase the level or effect of dexfenfluramine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • dextroamphetamine

              chloroquine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • dextromethorphan

              chloroquine will increase the level or effect of dextromethorphan by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • diphtheria & tetanus toxoids/ acellular pertussis vaccine

              chloroquine decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine

              chloroquine decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • donepezil

              chloroquine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • duloxetine

              chloroquine will increase the level or effect of duloxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • encainide

              chloroquine will increase the level or effect of encainide by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • eribulin

              chloroquine increases toxicity of eribulin by QTc interval. Minor/Significance Unknown.

            • ezogabine

              chloroquine increases toxicity of ezogabine by QTc interval. Minor/Significance Unknown.

            • fesoterodine

              chloroquine will increase the level or effect of fesoterodine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • fluoxetine

              chloroquine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases toxicity of fluoxetine by QTc interval. Minor/Significance Unknown.

            • fluphenazine

              chloroquine will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of fluphenazine by decreasing metabolism. Minor/Significance Unknown.

              chloroquine increases toxicity of fluphenazine by QTc interval. Minor/Significance Unknown.

            • formoterol

              chloroquine increases toxicity of formoterol by QTc interval. Minor/Significance Unknown.

            • foscarnet

              chloroquine increases toxicity of foscarnet by QTc interval. Minor/Significance Unknown.

            • galantamine

              chloroquine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • hepatitis A vaccine inactivated

              chloroquine decreases effects of hepatitis A vaccine inactivated by pharmacodynamic antagonism. Minor/Significance Unknown.

            • hepatitis a/b vaccine

              chloroquine decreases effects of hepatitis a/b vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • hepatitis a/typhoid vaccine

              chloroquine decreases effects of hepatitis a/typhoid vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • hepatitis b vaccine

              chloroquine decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • human papillomavirus vaccine, nonavalent

              chloroquine decreases effects of human papillomavirus vaccine, nonavalent by pharmacodynamic antagonism. Minor/Significance Unknown. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.

            • human papillomavirus vaccine, quadrivalent

              chloroquine decreases effects of human papillomavirus vaccine, quadrivalent by pharmacodynamic antagonism. Minor/Significance Unknown. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.

            • hydroxychloroquine sulfate

              chloroquine increases toxicity of hydroxychloroquine sulfate by QTc interval. Minor/Significance Unknown.

            • ibutilide

              chloroquine increases toxicity of ibutilide by QTc interval. Minor/Significance Unknown.

            • iloperidone

              chloroquine increases toxicity of iloperidone by QTc interval. Minor/Significance Unknown.

            • indacaterol, inhaled

              chloroquine increases toxicity of indacaterol, inhaled by QTc interval. Minor/Significance Unknown.

            • indapamide

              chloroquine increases toxicity of indapamide by QTc interval. Minor/Significance Unknown.

            • influenza virus vaccine quadrivalent

              chloroquine decreases effects of influenza virus vaccine quadrivalent by pharmacodynamic antagonism. Minor/Significance Unknown.

            • influenza virus vaccine quadrivalent, cell-cultured

              chloroquine decreases effects of influenza virus vaccine quadrivalent, cell-cultured by pharmacodynamic antagonism. Minor/Significance Unknown.

            • influenza virus vaccine quadrivalent, intranasal

              chloroquine decreases effects of influenza virus vaccine quadrivalent, intranasal by pharmacodynamic antagonism. Minor/Significance Unknown.

            • influenza virus vaccine trivalent

              chloroquine decreases effects of influenza virus vaccine trivalent by pharmacodynamic antagonism. Minor/Significance Unknown.

            • Japanese encephalitis virus vaccine

              chloroquine decreases effects of Japanese encephalitis virus vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • lapatinib

              chloroquine increases toxicity of lapatinib by QTc interval. Minor/Significance Unknown.

            • loratadine

              chloroquine will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • maprotiline

              chloroquine increases toxicity of maprotiline by QTc interval. Minor/Significance Unknown.

            • measles (rubeola) vaccine

              chloroquine decreases effects of measles (rubeola) vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • measles mumps and rubella vaccine, live

              chloroquine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • measles, mumps, rubella and varicella vaccine, live

              chloroquine decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • mefloquine

              chloroquine increases toxicity of mefloquine by QTc interval. Minor/Significance Unknown.

            • meningococcal A C Y and W-135 polysaccharide vaccine combined

              chloroquine decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by pharmacodynamic antagonism. Minor/Significance Unknown.

            • mifepristone

              chloroquine increases toxicity of mifepristone by QTc interval. Minor/Significance Unknown.

            • octreotide

              chloroquine increases toxicity of octreotide by QTc interval. Minor/Significance Unknown.

            • ofloxacin

              chloroquine increases toxicity of ofloxacin by QTc interval. Minor/Significance Unknown.

            • oxycodone

              chloroquine decreases effects of oxycodone by decreasing metabolism. Minor/Significance Unknown. Decreased conversion of oxycodone to active metabolite morphine.

            • paroxetine

              chloroquine will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • pasireotide

              chloroquine increases toxicity of pasireotide by QTc interval. Minor/Significance Unknown.

            • pentamidine

              chloroquine increases toxicity of pentamidine by QTc interval. Minor/Significance Unknown.

            • perhexiline

              chloroquine will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • perphenazine

              chloroquine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of perphenazine by decreasing metabolism. Minor/Significance Unknown.

              chloroquine increases toxicity of perphenazine by QTc interval. Minor/Significance Unknown.

            • pimavanserin

              chloroquine increases toxicity of pimavanserin by QTc interval. Minor/Significance Unknown.

            • pneumococcal vaccine 13-valent

              chloroquine decreases effects of pneumococcal vaccine 13-valent by pharmacodynamic antagonism. Minor/Significance Unknown.

            • pneumococcal vaccine heptavalent

              chloroquine decreases effects of pneumococcal vaccine heptavalent by pharmacodynamic antagonism. Minor/Significance Unknown.

            • pneumococcal vaccine polyvalent

              chloroquine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Minor/Significance Unknown.

            • posaconazole

              chloroquine increases toxicity of posaconazole by QTc interval. Minor/Significance Unknown.

            • praziquantel

              chloroquine decreases levels of praziquantel by unspecified interaction mechanism. Minor/Significance Unknown.

            • primaquine

              primaquine, chloroquine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hemolysis in G6PD deficient pts.

            • prochlorperazine

              chloroquine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of prochlorperazine by decreasing metabolism. Minor/Significance Unknown.

            • promazine

              chloroquine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of promazine by decreasing metabolism. Minor/Significance Unknown.

            • promethazine

              chloroquine will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of promethazine by decreasing metabolism. Minor/Significance Unknown.

            • protriptyline

              chloroquine increases toxicity of protriptyline by QTc interval. Minor/Significance Unknown.

            • rabies vaccine

              chloroquine decreases effects of rabies vaccine by pharmacodynamic antagonism. Minor/Significance Unknown. Immunosuppressants may interfere with development of active immunity.

            • rabies vaccine chick embryo cell derived

              chloroquine decreases effects of rabies vaccine chick embryo cell derived by pharmacodynamic antagonism. Minor/Significance Unknown.

            • rilpivirine

              chloroquine increases toxicity of rilpivirine by QTc interval. Minor/Significance Unknown.

            • risperidone

              chloroquine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • rotavirus oral vaccine, live

              chloroquine decreases effects of rotavirus oral vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • rubella vaccine

              chloroquine decreases effects of rubella vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • sertraline

              chloroquine increases toxicity of sertraline by QTc interval. Minor/Significance Unknown.

            • smallpox (vaccinia) vaccine, live

              chloroquine decreases effects of smallpox (vaccinia) vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • solifenacin

              chloroquine increases toxicity of solifenacin by QTc interval. Minor/Significance Unknown.

            • sorafenib

              chloroquine increases toxicity of sorafenib by QTc interval. Minor/Significance Unknown.

            • sunitinib

              chloroquine increases toxicity of sunitinib by QTc interval. Minor/Significance Unknown.

            • tacrolimus

              chloroquine increases levels of tacrolimus by decreasing metabolism. Minor/Significance Unknown.

            • telavancin

              chloroquine increases toxicity of telavancin by QTc interval. Minor/Significance Unknown.

            • tetanus toxoid adsorbed or fluid

              chloroquine decreases effects of tetanus toxoid adsorbed or fluid by pharmacodynamic antagonism. Minor/Significance Unknown.

            • tetrabenazine

              chloroquine increases toxicity of tetrabenazine by QTc interval. Minor/Significance Unknown.

            • thioridazine

              chloroquine increases levels of thioridazine by decreasing metabolism. Minor/Significance Unknown.

            • thiothixene

              chloroquine increases toxicity of thiothixene by QTc interval. Minor/Significance Unknown.

            • tick borne encephalitis vaccine

              chloroquine decreases effects of tick borne encephalitis vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • tolterodine

              chloroquine will increase the level or effect of tolterodine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • travelers diarrhea and cholera vaccine inactivated

              chloroquine decreases effects of travelers diarrhea and cholera vaccine inactivated by pharmacodynamic antagonism. Minor/Significance Unknown.

            • trifluoperazine

              chloroquine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of trifluoperazine by decreasing metabolism. Minor/Significance Unknown.

            • trimipramine

              chloroquine increases toxicity of trimipramine by QTc interval. Minor/Significance Unknown.

            • tropisetron

              chloroquine will increase the level or effect of tropisetron by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • typhoid polysaccharide vaccine

              chloroquine decreases effects of typhoid polysaccharide vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • typhoid vaccine live

              chloroquine decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • vardenafil

              chloroquine increases toxicity of vardenafil by QTc interval. Minor/Significance Unknown.

            • varicella virus vaccine live

              chloroquine decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • vorinostat

              chloroquine increases toxicity of vorinostat by QTc interval. Minor/Significance Unknown.

            • yellow fever vaccine

              chloroquine decreases effects of yellow fever vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • zoster vaccine live

              chloroquine decreases effects of zoster vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown.

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            Adverse Effects

            Frequency Not Defined

            Ocular disorders: Maculopathy, macular degeneration, visual disturbances, nyctalopia, scotomatous vision with field defects of paracentral, pericentral ring types, typically temporal scotomas (eg, difficulty in reading with words tending to disappear, seeing half an object, misty vision, and fog before the eyes), reversible corneal opacities

            Immune system disorders: Urticaria, anaphylactic reaction (eg, angioedema)

            Ear and labyrinth disorders: Nerve type deafness, tinnitus, reduced hearing in patients with preexisting auditory damage

            Musculoskeletal and connective tissue-disorders: Sensorimotor disorders, skeletal muscle myopathy or neuromyopathy, depression of tendon reflexes, abnormal nerve conduction

            Gastrointestinal disorders: Hepatitis, increased liver enzymes, anorexia, nausea, vomiting, diarrhea, abdominal cramps

            Skin and subcutaneous tissue disorders: Erythema multiforme, Stevens Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, pleomorphic skin eruptions, skin and mucosal pigment changes, lichen planus-like eruptions, pruritus, drug rash with eosinophilia and systemic symptoms (DRESS syndrome), photosensitivity, hair loss

            Blood and lymphatic system disorders: Pancytopenia, aplastic anemia, reversible agranulocytosis, thrombocytopenia, neutropenia, hemolytic anemia in G6PD deficient patients

            Nervous system disorders: Convulsions, mild and transient headache, polyneuropathy, acute extrapyramidal disorders (eg, dystonia, dyskinesia, tongue protrusion, torticollis)

            Neuropsychiatric disorders: Psychosis, delirium, anxiety, agitation, insomnia, confusion, hallucinations, personality changes, depression, suicidal behavior

            Cardiac disorders: Hypotension, ECG changes (particularly, inversion or depression of the T-wave with widening of the QRS complex), cardiomyopathy, cardiac arrhythmias, conduction disorders (eg, bundle branch block / atrioventricular [AV] block, QT interval prolongation, torsade de pointes, ventricular tachycardia, ventricular fibrillation)

            Metabolic and nutritional disorders: Hypoglycemia

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            Warnings

            Contraindications

            Hypersensitivity to chloroquine, 4-aminoquinolones

            Psoriasis, porphyria, retinal or visual field changes

            Cautions

            Acute extrapyramidal disorders may occur; reactions usually resolve after treatment discontinuation and/or symptomatic treatment

            Not effective in most areas; CDC recommends mefloquine or atovaquone/proguanil - check CDC traveler information for specific recommendations for region

            May cause hemolysis in glucose-6 phosphate dehydrogenase (G-6-PD) deficiency; blood monitoring may be needed as hemolytic anemia may occur, in particular in association with other drugs that cause hemolysis

            Experimental data showed a potential risk of inducing gene mutations; there are insufficient data in humans to rule out an increased risk of cancer in patients receiving long-term treatment

            Cases of cardiomyopathy resulting in cardiac failure, in some cases with fatal outcome, have been reported in patients treated during long term therapy at high doses with chloroquine; monitor for signs and symptoms of cardiomyopathy and discontinue chloroquine if cardiomyopathy develops

            May cause conduction disorders (eg, bundle branch block / AV heart block) are diagnosed; if cardiotoxicity is suspected, prompt discontinuation of chloroquine may prevent life-threatening complications

            Monitor knee and ankle reflexes in patients on long-term therapy to detect any evidence of muscular weakness; if weakness occurs, discontinue therapy

            A number of fatalities have been reported following the accidental ingestion of chloroquine; advise to keep medication out of the reach of children because they are especially sensitive to the 4-aminoquinoline compounds

            Use in patients with psoriasis may precipitate a severe attack of psoriasis; may be exacerbated condition when used in patients with porphyria; do not use in these conditions unless the benefit to the patient outweighs the potential risks

            Shown to cause severe hypoglycemia including loss of consciousness that could be life-threatening in patients treated with or without antidiabetic medications; patients should be warned about risk of hypoglycemia and associated clinical signs and symptoms; patients presenting with clinical symptoms suggestive of hypoglycemia during treatment with chloroquine should have blood glucose level checked and treatment reviewed as necessary

            Caution with history of auditory damage

            Caution with hepatic disease, alcoholism, and coadministration with other hepatotoxic drugs

            May provoke seizures in patients with history of epilepsy

            QT prolongation

            • QT interval prolongation, torsade de pointes, and ventricular arrhythmias have been reported
            • The risk increases with higher doses chloroquine; fatal cases have been reported
            • Use with caution in patients with cardiac disease, a history of ventricular arrhythmias, uncorrected hypokalemia and/or hypomagnesemia, or bradycardia (<50 bpm)

            Retinopathy

            • Irreversible retinal damage observed
            • Significant risk factors for retinal damage include daily doses of chloroquine phosphate >2.3 mg/kg of actual body weight, durations of use >5 years, subnormal glomerular filtration, and concurrent macular disease
            • Perform baseline ophthalmological examination within the first year of starting chloroquine phosphate tablets
            • Baseline exam should include: best corrected distance visual acuity (BCVA), an automated threshold visual field (VF) of the central 10 degrees (with retesting if an abnormality is noted), and spectral domain optical coherence tomography (SD-OCT)
            • Exams (including BCVA, VF and SD-OCT) should be monitored annually in individuals with significant risk factors and may be deferred up to 5 years for individuals without risk factors
            • In patients of Asian descent, it is recommended that visual field testing be performed in the central 24 degrees instead of the central 10 degrees
            • Discontinue if ocular toxicity is suspected and closely monitor; retinal changes (and visual disturbances) may progress even after cessation of therapy

            Drug interaction overview

            • Plasma concentrations of chloroquine and desethylchloroquine (major metabolite of chloroquine) were negatively associated with log antibody titers; the recommended dose of chloroquine for malaria prophylaxis can reduce the antibody response to primary immunization with intradermal human diploid-cell rabies vaccine
            • Concomitant use of chloroquine with drugs known to induce retinal toxicity such as tamoxifen is not recommended
            • Effects of other drugs on chloroquine
              • Antacids and kaolin can reduce absorption of chloroquine; observe for at least 4 hr between intake of these agents and chloroquine
              • Cimetidine can inhibit the metabolism of chloroquine, increasing its plasma level; avoid use
            • Chloroquine effects on other drugs
              • As chloroquine may enhance the effects of a hypoglycemic treatment, a decrease in doses of insulin or other antidiabetic drugs may be required.
              • Chloroquine significantly reduced the bioavailability of ampicillin; monitor at least 2 hr between intake of ampicillin and chloroquine
              • After introduction of chloroquine (oral form), a sudden increase in serum cyclosporine level has been reported; closely monitor of serum cyclosporine level and if necessary, discontinue chloroquine
              • May increase risk of inducing ventricular arrhythmias if chloroquine is used concomitantly with other arrhythmogenic drugs (eg, amiodarone, moxifloxacin)
              • In a single-dose interaction study, chloroquine has been reported to reduce the bioavailability of praziquantel
              • Coadministration of chloroquine and mefloquine may increase the risk of convulsions
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            Pregnancy & Lactation

            Pregnancy

            In humans, at recommended doses for prophylaxis and treatment of malaria, observational studies as well as a meta-analysis, including a small number of prospective studies with chloroquine exposure during pregnancy, have shown no increase in the rate of birth defects or spontaneous abortions

            Avoid use during pregnancy except in prophylaxis or treatment of malaria when benefit outweighs potential risk to fetus

            Animal data

            • In animal studies, embryofetal developmental toxicity was shown at doses ranging from 250-1500 mg/kg body weight; approximately 3-16x the maximum recommended therapeutic dose based on a body surface area comparison
            • Preclinical data showed a potential risk of genotoxicity in some test systems

            Lactation

            Owing to the potential for serious adverse reactions in nursing infants from chloroquine, a decision should be made whether to discontinue nursing or chloroquine, taking into account the potential clinical benefit of the drug to the mother

            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); 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

            Separate prophylaxis for the infant is required

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Active against erythrocytic forms of Plasmodium vivax & P. malariae and most strains of Plasmodium falciparum

            Precise mechanism not known

            Absorption

            Bioavailability: ~89%

            Peak plasma time: 1-2 hr

            Distribution

            Distributed widely in body tissues (eg, eyes, heart, kidneys, liver, lungs) where retention prolonged; crosses placenta; enters breast milk

            Metabolism

            Partially in liver

            Elimination

            Half-life: 3-5 days

            Excretion: urine (~70% as unchanged drug); acidification of urine increases elimination

            Small amounts may be present in urine months following discontinuation of therapy

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            chloroquine oral
            -
            250 mg tablet
            chloroquine oral
            -
            500 mg tablet
            chloroquine oral
            -
            500 mg tablet
            chloroquine oral
            -
            250 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            chloroquine oral

            CHLOROQUINE - ORAL

            (KLOR-oh-kwin)

            COMMON BRAND NAME(S): Aralen

            USES: Chloroquine is used to prevent or treat malaria caused by mosquito bites. Chloroquine belongs to a class of drugs known as antimalarials.The United States Centers for Disease Control provide updated guidelines and travel recommendations for the prevention and treatment of malaria in different parts of the world. Discuss the most recent information with your doctor before traveling to areas where malaria occurs.Chloroquine is also used to treat infection caused by a different type of parasite (ameba).Chloroquine is not recommended for coronavirus infection, also known as COVID-19, unless you are enrolled in a study. Talk to your doctor about the risks and benefits.

            HOW TO USE: Take this medication by mouth, usually with food to prevent stomach upset, exactly as directed by your doctor. The dosage and length of treatment are based on your medical condition and response to treatment. In children, dosage is also based on weight.To prevent malaria, take chloroquine as directed by your doctor, usually once a week on the same day each week. Mark a calendar to help you remember. This drug is usually started 1 to 2 weeks before entering the malarious area. Continue to take it weekly while in the area and for 4 to 8 weeks after leaving the area, or as directed by your doctor.To treat malaria or an ameba infection, follow your doctor's instructions.If you are also taking a certain drug for diarrhea (kaolin) or taking antacids (such as magnesium/aluminum hydroxide), take chloroquine at least 4 hours before or after these products. These products may bind with chloroquine, preventing your body from fully absorbing it.Use this medication regularly in order to get the most benefit from it. Take this medication exactly as prescribed. Do not stop taking it without talking with your doctor. It is important to continue taking this for the length of time prescribed. Stopping prevention or treatment too soon may lead to infection or a return of the infection.Tell your doctor if your condition lasts or gets worse. Chloroquine may not prevent malaria in all cases. If you experience fever or other symptoms of illness, get medical help right away (especially while in the malarious area and for 2 months after returning from the area). You may need a different medication. Avoid exposure to mosquitoes. (See also Notes section.)

            SIDE EFFECTS: Nausea, vomiting, abdominal cramps, headache, and diarrhea may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: slow heartbeat, symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), mental/mood changes (such as anxiety, depression, rare thoughts of suicide, hallucinations), hearing changes (such as ringing in the ears, hearing loss), easy bruising/bleeding, signs of infection (such as sore throat that doesn't go away, fever), signs of liver disease (such as severe stomach/abdominal pain, yellowing eyes/skin, dark urine), muscle weakness, unwanted/uncontrolled movements (including tongue/face twitching), hair loss, hair/skin color changes.This medication may cause low blood sugar (hypoglycemia). Tell your doctor right away if you develop symptoms of low blood sugar, such as sudden sweating, shaking, hunger, blurred vision, dizziness, or tingling hands/feet. If you have diabetes, be sure to check your blood sugars regularly. Your doctor may need to adjust your diabetes medication.Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, fast/irregular heartbeat, seizures.This medication may cause serious eye/vision problems. The risk for these side effects is increased with long-term use of this medication and with taking this medication in high doses. Get medical help right away if you have any symptoms of serious eye problems, including: sensitivity to light, vision changes (such as light flashes/streaks, blurred vision, difficulty reading, missing areas of vision).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking chloroquine, tell your doctor or pharmacist if you are allergic to it; or to hydroxychloroquine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: a certain enzyme problem (glucose-6-phosphate dehydrogenase deficiency-G6PD), vision/eye problems, hearing problems, kidney disease, liver disease, regular alcohol use/abuse, skin problems (such as psoriasis), a certain blood disorder (porphyria), seizures.If you have diabetes, this product may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of low blood sugar (see Side Effects section). Your doctor may need to adjust your diabetes medication, exercise program, or diet.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Chloroquine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using chloroquine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using chloroquine safely.Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: mefloquine, penicillamine, remdesivir.Many drugs besides chloroquine may affect the heart rhythm (QT prolongation). Some examples are amiodarone, azithromycin, disopyramide, dronedarone, pimozide, quinidine, among others.Certain vaccines (rabies vaccine, cholera vaccine) may not work as well if given while you are taking chloroquine. Ask your doctor for more details.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/irregular heartbeat, fainting, slow/shallow breathing, unwanted/uncontrolled movements (including tongue/face twitching), seizures.

            NOTES: Do not share this medication with others.Lab and/or medical tests (such as eye exams, reflex tests, liver tests, EKG, complete blood counts) should be done if you are taking chloroquine for a long time. Keep all medical and lab appointments. Consult your doctor for more details.When traveling in an area at risk for malaria, use protective clothing, insect repellent, and bed nets. Remain indoors or in well-screened areas when possible. If you are taking this medication to prevent or treat malaria, use it for your current travel or condition only. Do not use it later to prevent or treat another infection unless your doctor tells you to.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised July 2020. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.