Infectious Disease Book



Aka: Chloroquine, Aralen
  1. Indications
    1. Malaria Prophylaxis
      1. Areas without Chloroquine resistance
    2. Discoid Lupus (off label)
    3. NOT indicated in COVID-19 outside of clinical trials as of May 2020
      1. Low efficacy in trials to date and risk of serious reactions (including QTc Prolongation)
  2. Safety
    1. Safe in all trimesters of pregnancy (but Chloroquine does cross the placenta)
    2. Safe for children of all ages
  3. Dose: Malaria Prophylaxis
    1. Protocol
      1. Start 1-2 weeks before travel
      2. Continue through 4 weeks after return
    2. Adult: 300 mg base (500 mg salt) PO once weekly
    3. Child: Dose: 5 mg/kg base (8.3 mg/kg salt) up to 300 mg base orally once weekly
  4. Dose: Malaria Treatment
    1. Adults
      1. Load: 1000 mg salt (600 mg base) orally at start
      2. Maintenance: 500 mg salt (300 mg base) orally at 6 hours, 24 hours and 48 hours after initial dose
    2. Child
      1. Load: 16.7 mg/kg salt (10 mg/kg base) orally at start
      2. Maintenance: 8.3 mg/kg salt (5 mg/kg base) orally at 6 hours, 24 hours and 48 hours after initial dose
  5. Technique
    1. Taking with food decreases gastric irritation
  6. Adverse Effects
    1. Cardiovascular
      1. AV Block
      2. QTc Prolongation
        1. Risk of Ventricular Tachycardia including Drug-Induced Torsades de Pointes
    2. Dermatologic
      1. Hair, skin and Nail Discoloration
      2. Erythema Multiforme
    3. Endocrine
      1. Hypoglycemia
    4. Ear
      1. Tinnitus
      2. Hearing Loss
    5. Eye
      1. Blurred Vision
      2. Corneal disorders
      3. Retinopathy (more common than with Hydroxychloroquine)
    6. Gastrointestinal
      1. Nausea and Vomiting
      2. Diarrhea
      3. Abdominal Pain
    7. Hematologic
      1. Agranulocytosis
      2. Neutropenia
      3. Pancytopenia
      4. Thrombocytopenia
    8. Neurologic
      1. Confusion or Delirium
      2. Hallucination
      3. Psychosis
      4. Insomnia
      5. Extrapyramidal Side Effects
      6. Depressed mood and Suicidality
  7. Efficacy
    1. Most world regions exhibit high Chloroquine resistance in Plasmodium Falciparum
    2. Limit use to only nonsevere infections from non-Chloroquine resistance regions
  8. References
    1. (2020) LexiComp, Chloroquine, accessed 5/6/2020
    2. Shahbodaghi (2022) Am Fam Physician 106(3): 270-8 [PubMed]
Medication Costs
chloroquine (on 8/17/2016 at Medicaid.Gov Pharmacy Drug pricing)
CHLOROQUINE PH 500 MG TABLET Generic $11.13 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Chloroquine (C0008269)

Definition (NCI) A 4-aminoquinoline with antimalarial, anti-inflammatory, and potential chemosensitization and radiosensitization activities. Although the mechanism is not well understood, chloroquine is shown to inhibit the parasitic enzyme heme polymerase that converts the toxic heme into non-toxic hemazoin, thereby resulting in the accumulation of toxic heme within the parasite. This agent may also interfere with the biosynthesis of nucleic acids. Chloroquine's potential chemosensitizing and radiosensitizing activities in cancer may be related to its inhibition of autophagy, a cellular mechanism involving lysosomal degradation that minimizes the production of reactive oxygen species (ROS) related to tumor reoxygenation and tumor exposure to chemotherapeutic agents and radiation.
Definition (MSH) The prototypical antimalarial agent with a mechanism that is not well understood. It has also been used to treat rheumatoid arthritis, systemic lupus erythematosus, and in the systemic therapy of amebic liver abscesses.
Definition (CSP) antiamebic and antimalarial; chloroquine phosphate is also listed by USP as a suppressant of lupus erythematosus.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D002738
SnomedCT 330034001, 324890009, 14728000, 373468005
LNC LP16070-2, MTHU014870
English Chingamin, Chlorochin, Chloroquine, Khingamin, chloroquine, 1,4-Pentanediamine, N4-(7-chloro-4-quinolinyl)-N1,N1-diethyl-, Chloroquine [anti-malarial], Chloroquine [musculo-skeletal], chloroquine (medication), Chloroquine [Chemical/Ingredient], chloroquine products, Chloroquine [musculo-skeletal] (product), Chloroquine [anti-malarial] (product), CHLOROQUINE, Chloroquine (product), Chloroquine (substance), Chloroquine [anti-malarial] (substance), Chloroquine [musculo-skeletal] (substance)
Swedish Klorokin
Czech chlorochin, chloroquin
Finnish Klorokiini
Japanese リン酸クロロキン, クロロキン
Polish Arechina, Resochina, Chlorochina
Spanish cloroquina [antipalúdico] (producto), cloroquina [uso musculoesquelético] (producto), cloroquina [antipalúdico], cloroquina [uso musculoesquelético], cloroquina (producto), cloroquina (sustancia), cloroquina, Cloroquina
Croatian Klorokin
French Chloroquine
German Chlorochin
Italian Clorochina
Portuguese Cloroquina
Derived from the NIH UMLS (Unified Medical Language System)

Aralen Phosphate (C0718643)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Aralen Phosphate
Derived from the NIH UMLS (Unified Medical Language System)

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