Dosing & Uses
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) for chloroquine June 15, 2020
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
The NIH COVID-19 Treatment Guidelines recommend against the use of chloroquine or hydroxychloroquine and/or azithromycin for the treatment of COVID-19 in hospitalized patients and in nonhospitalized patients
For more information, see the FDA news release: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine
Additional Medscape COVID-19 references are available
- Coronavirus Disease 2019 (COVID-19) (link https://emedicine.medscape.com/article/2500114-overview)
- Novel Coronavirus Resource Center (link https://www.medscape.com/resource/coronavirus)
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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 (85)
- 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.
- amisulpride
chloroquine and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- amlodipine
chloroquine will increase the level or effect of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- anagrelide
chloroquine and anagrelide both increase QTc interval. 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.
aripiprazole and chloroquine both increase QTc interval. Avoid or Use Alternate Drug. - arsenic trioxide
chloroquine increases toxicity of arsenic trioxide by QTc interval. Avoid or Use Alternate Drug.
- atomoxetine
atomoxetine and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- bedaquiline
chloroquine increases toxicity of bedaquiline by QTc interval. Avoid or Use Alternate Drug.
- buprenorphine
chloroquine and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- ceritinib
ceritinib and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
ceritinib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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.
- desflurane
desflurane and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- 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.
- donepezil
donepezil and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- doxepin
doxepin and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- dronedarone
chloroquine increases toxicity of dronedarone by QTc interval. Avoid or Use Alternate Drug.
- efavirenz
efavirenz and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- eliglustat
chloroquine and eliglustat both increase 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. - fingolimod
fingolimod and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- gilteritinib
chloroquine and gilteritinib both increase QTc interval. Avoid or Use Alternate Drug.
- 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.
- granisetron
chloroquine and granisetron both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxyzine
chloroquine and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- 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 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.
- isoflurane
chloroquine and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- itraconazole
itraconazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
chloroquine and itraconazole both increase QTc interval. 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.
chloroquine and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug. - lefamulin
chloroquine and lefamulin both increase QTc interval. Avoid or Use Alternate Drug.
- levalbuterol
chloroquine and levalbuterol both increase QTc interval. Avoid or Use Alternate Drug.
- lithium
chloroquine and lithium both increase QTc interval. Avoid or Use Alternate Drug.
- 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.
- loperamide
chloroquine and loperamide both increase QTc interval. Avoid or Use Alternate Drug.
- 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.
- midostaurin
chloroquine and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mirtazapine
chloroquine and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.
- olodaterol inhaled
chloroquine and olodaterol inhaled both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
chloroquine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- ozanimod
chloroquine and ozanimod both increase 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.
- ponesimod
chloroquine and ponesimod 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.
- primaquine
chloroquine and primaquine both increase QTc interval. 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.
- salmeterol
chloroquine and salmeterol 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.
- selpercatinib
chloroquine and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.
- sevoflurane
chloroquine and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
chloroquine and siponimod both increase QTc interval. 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.
- trazodone
chloroquine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- triclabendazole
chloroquine and triclabendazole both increase QTc interval. 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.
- voclosporin
chloroquine and voclosporin both increase 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 (144)
- 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.
- albuterol
albuterol and chloroquine both increase QTc interval. Use Caution/Monitor.
- 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.
- asenapine transdermal
asenapine transdermal and chloroquine both increase 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. - belzutifan
belzutifan will decrease the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.
- 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. - deutetrabenazine
chloroquine increases toxicity of deutetrabenazine by QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- 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.
- gadobenate
chloroquine and gadobenate both increase QTc interval. Use Caution/Monitor.
- 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 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.
- lenacapavir
lenacapavir will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
- 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.
- omaveloxolone
omaveloxolone will decrease the level or effect of chloroquine by Other (see comment). Use Caution/Monitor. Omaveloxolone may reduce systemic exposure of sensitive CYP2C8 substrates. Check prescribing information of substrate if dosage modification is needed.
- 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.
- valbenazine
valbenazine and chloroquine both increase QTc interval. Use Caution/Monitor.
- 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 (102)
- acetazolamide
acetazolamide will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- alfuzosin
chloroquine and alfuzosin both increase QTc interval. Minor/Significance Unknown.
- anastrozole
anastrozole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. - cyclophosphamide
cyclophosphamide will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- degarelix
chloroquine increases toxicity of degarelix 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
chloroquine decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. 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, 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.
- larotrectinib
larotrectinib will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- levoketoconazole
levoketoconazole will increase the level or effect of chloroquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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.
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
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 to prevent life-threatening complications
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
Administer with caution in patients with preexisting auditory damage; discontinue therapy immediately in case of any defects in hearing; observe patient closely
Caution with hepatic disease, alcoholism, and coadministration with other hepatotoxic drugs
May provoke seizures in patients with history of epilepsy
Chloroquine does not treat hypnozoite liver stage forms of Plasmodium and will therefore not prevent relapses of malaria due to P. vivax or P. ovale; additional treatment with an anti-malarial agent active against these forms, such as an 8-aminoquinoline, required for treatment of infections with P. vivax and P. ovale
Chloroquine-resistant malaria
- This drug is not effective against resistant strains of Plasmodium species; chloroquine resistance is widespread in P. falciparum and is reported in P. vivax
- Before using chloroquine for prophylaxis, it should be ascertained whether chloroquine is appropriate for use in the region to be visited by the traveler. Information regarding the geographic areas where resistance to chloroquine occurs, is available at the Centers for Disease Control and Prevention (www.cdc.gov\malaria)
- Patients infected with a resistant strain of plasmodia as shown by the fact that normally adequate doses have failed to prevent or cure clinical malaria or parasitemia should be treated with another form of antimalarial therapy
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
- Risk of QT interval prolongation increases with concomitant administration of chloroquine with QT interval prolonging agents
-
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
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.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
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 |  | |
| chloroquine oral - | 500 mg tablet |  | |
| chloroquine oral - | 250 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
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 this medication has been prescribed because your doctor 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 liver disease (such as severe stomach/abdominal pain, yellowing eyes/skin, dark urine), signs of kidney problems (such as change in the amount of 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: fever, swollen lymph nodes, 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/kidney function, 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 May 2022. Copyright(c) 2023 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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