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Chloroquine
Chloroquine for prophylaxis and treatment of malaria

Use
Chloroquine can be used for prophylaxis in areas with no resistance to chloroquine. 

Dose
The usual dose for adults of chloroquine is 2 tablets once a week starting one week before departure and continuing 4 weeks after leaving the area with malaria. It is important that the dose is taken at the same day of the week.

Chloroquine or hydroxychloroquine tablets of 250 mg each.
  • Adults > 90 kg body weight: 3 tablets per week
  • Adults 45 – 90 kg: 2 tablets per week
  • Children 30 – 44 kg: 1,5 tablets per week
  • Children 20 – 29 kg: 1 tablet per week
  • Children 10 – 19 kg: 0,5 tablet per week
  • Children < 10 kg 0.25 tablet per week

    Pregnancy
    Chloroquine can be used during pregnancy. It has been used for over 50 years with very few reports on adverse events and is considered safe during pregnancy.
    Malaria infection during pregnancy is a risk for mother and child. Pregnant mothers travelling to areas with malaria should ensure they use efficient prophylaxis or postpone their travel until after delivery.

    Lactation
    Lactating women can use chloroquine, but the small amounts of chloroquine passing into the child do not provide any protection of the child.

    Side effects
    Nausea, vomiting, loss of hair, itching and rash are seen in rare cases. Blurred vision is seen, most often in the first 8 to 16 hours after intake of the tablets and is always temporary. If blurred vision is a problem the tablets can be taken in the evening. serious side effects are rare but involuntary movements, hearing impairment, anaemia seizures and acute psychosis has all been described.
    Chloroquine increases the sensitivity to sunlight, and photo allergic reactions may occur.

    Who can not use chloroquine
    Chloroquine can be used with care in people with previous psychiatric illness and epilepsy.
    The dose should be reduced in patients with reduced kidney function. People with psoriasis may experience an exacerbation of the disease and should be warned to stop chloroquine as soon as they experience an increased activity in the disease.

    Interactions with other drugs
    Inform your doctor if you use other drugs, also drugs which do not need a prescription. Drugs containing cimethidine may increase the blood levels of chloroquine and should be avoided.

    Note
    No antimalarial drug provides 100% protection even if used strictly according to the recommendations. Malaria drugs reduce the risk of infection with around 80% to 95% depending of your destination and living conditions.
    Prevention of mosquito bites is therefore still important even if you take malaria drugs regularly.

    The UK HPA recommendations
    Guidelines malaria prevention in travellers from the United Kingdom 2008

    Edited 27. December 2008