Chloroquine to prevent malaria

Chloroquine tablets 250mg are used for malaria prophylaxis (prevention) and to treat malaria. Chloroquine is only effective where malaria is not chloroquine resistant. Chloroquine and all other anti-malaria tablets (Mefloquine, doxycycline, proguanil chloroquine and proguanil, and malarone) are available on prescription at the Dr Fox website. In the UK chloroquine tablets are usually supplied under the brand name Avloclor.

Dosage

Chloroquine is also used in combination with proguanil (paludrine) for malaria prevention. When this combination is used the chloroquine tablets are taken once weekly and the proguanil daily.
How to order
For malaria prevention in adults the chloroquine dose is two 250mg tablets taken once a week on the same day. Start one week before exposure and continue for 4 weeks after leaving the malaria area. The dose of chloroquine for children depends on age and weight. For full details see the Summary of Product Characteristics for Chloroquine.

Finding the right malaria tablet

The best malaria prophylaxis for each country recommended by the NHS can be found from its Fit for Travel website. The recommended prevention depends on the pattern of malaria resistance. In much of sub-Saharan Africa malaria is chloroquine resistant. In chloroquine resistant areas alternative malaria prophylaxis is required. Alernatives to chloroquine include malarone (atovaquone/proguanil), mefloquine (lariam), doxycycline and proguanil.

Side effects of chloroquine and cautions

Chloroquine should be used with caution in people with a diagnosis of live or kidney diseases or where there is a history of epilepsy or fits. Long-term high dose chloroquine therapy can lead to eye damage and possibly cardiomyopathy, both unlikely at the doses taken for malaria prevention. Starting chloroquine tablets can precipitate attacks of psoriasis. People with glucose-6-phosphate dehydrogenase deficiency (an enzyme disorder of the blood) should not take Chloroquine.

Interactions

There are possible interactions between chloroquine and the following prescription medicines: antacids that can reduce absorption, amiodarone, ciclosporin, mefloquine, digoxin and some ulcer healing drugs. For details see the chloroquine side effects and interactions see  the patient information leaflet.

Pregnancy

Manufacturers recommend against use of chloroquine in pregnancy. However pregnant women are at greater risk of becoming seriously sick with malaria and should therefore avoid travel to malaria areas or take effective prophylaxis. In practice chloroquine has been used widely in pregnant women.

Miscellaneous

Malaria is a serious and potentially life threatening condition. Effective malaria prophylaxis is essential. Anti-malaria tablets should be taken regularly at the same time each day or each week. No malaria tablet provides 100% protection. It is important to avoid mosquito bites and to seek urgent medical help if symptoms of malaria develop between 1 week and 1 year after possible exposure.

Each 250mg tablet of chloroquine phosphate is equivalent to 155mg of chloroquine base. Apart from malaria prophylaxis chloroquine is also used to treat amoebic dysentery, lupus erythematosus, rheumatoid arthritis. Short courses of high dose chloroquine are used to treat malaria.

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