Adult Dosing
Malaria prophylaxis
- 500 mg PO qwk if started 1-2 week prior to exposure
- 500 mg PO q6 hrs x2 if started after the exposure; continue above for 8 weeks after the last exposure in endemic area
Acute attacks of malaria
- 1 gm PO x1, then 500 mg PO x1 after 6 hrs followed by 500 mg PO daily x2 days for a total dose of 2,500 mg in 3 days
Extraintestinal amebiasis
- 1 g PO daily x 2 day followed by 500 mg PO qd x2-3wk
Malaria [Non FDA-Approved]
- 600 mg, PO stat; then 300 mg at 8 hrs, 24 hrs and 48 hrs after initial dose
Pediatric Dosing
Malaria prophylaxis
Note: 500 mg phosphate = 300 mg base
- 5 mg base/kg PO qwk if started 1-2 week prior to exposure and continue for 8 wks after last exposure in endemic area
- If started after exposure, a loading dose of 5 mg/kg base PO q6 hrs x2, then as above
- Max: 300 mg base/dose
Acute attacks of malaria
- 10 mg base/kg PO x1, then 5 mg base/kg PO x1 after 6 hrs followed by 5 mg base/kg PO daily x2 days
- Max: 600 mg base/loading dose; 300 mg base/dose
Extraintestinal amebiasis
- 10 mg base/kg PO daily x2-3wk
- Max: 600 mg base/loading dose; 300 mg base/dose
Malaria [Non FDA-Approved]
- 10mg/kg, PO stat; then 5mg/kg at 8 hrs, 24hrs and 48hrs after initial dose
Note: 500 mg phosphate = 300 mg base
[Outline]
Renal Dose Adjustment (Based on CrCl)
- <10 mL/min: 50% dose reduction recommended
Hepatic Dose Adjustment
- Several hepatic impairment: Caution advised as 30-50% of dose is modified by liver
- Indicated for treatment of malaria and extraintestinal amebiasis [US Black Box Warning]
- Ascertain whether chloroquine is appropriate for use in the region to be visited by the traveler, before using chloroquine for prophylaxis. Do not administer to treat P. falciparum infections acquired in areas of chloroquine resistance or malaria occurring in patients where chloroquine prophylaxis has failed
- Normally adequate doses have failed to prevent or cure clinical malaria or parasitemia in patients infected with a resistant strain of plasmodia. In such patients treat with another form of antimalarial therapy
- For chronic use perform baseline and periodic opthalmic examinations as irreversible retinal damage has been observed in some patients with chronic use
- Discontinue therapy immediately if abnormality in the visual acuity, visual field, or retinal macular areas or any visual symptoms occur
- Long term therapy may lead to evidences of muscular weakness. Such patients should be questioned and examined periodically, including testing knee and ankle reflexes
- Use with caution in conditions such as psoriasis or porphyria as therapy may exacerbate these conditions. Do not administer unless in the judgment of the physician the benefit to the patient outweighs the potential risks
- During prolonged therapy perform complete blood cell counts periodically. Suspend therapy if any severe blood disorder appears which is not attributable to the disease under treatment
- Administer cautiously in patients having G6PD (glucose6 phosphate dehydrogenase) deficiency
- Administer with caution in patients with preexisting auditory damage. In case of any defects in hearing, ,chloroquine should be immediately discontinued, and the patient closely observed
- Monitor patients with hepatic disease or alcoholism, or taking other hepatotoxic medications for evidence of worsening liver function such as bleeding
- Apprise patients with hx of epilepsy about the risk of chloroquine provoking seizures
Cautions: Use cautiously in
- Blood dyscrasias
- Renal and hepatic impairment
- Hearing impairment
- Alcoholism
- G6PD deficiency
- Liver disease
- Psoriasis
- Patients receiving hepatotoxic drugs
- Epilepsy
- Porphyria
- Bone marrow depression
- Lactation
Pregnancy Category:C
Breastfeeding: Probably safe. Poorly excreted in breast milk; the amount of drug is not sufficient to harm the infant; if given once weekly. Breastfeeding infants should receive the recommended dosages for malaria prophylaxis. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 21 December 2010).This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776)Manufacturer advises continuation or discontinuation of therapy, taking into account the potential clinical benefit of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Aralen 500 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
25 mg = $190
75 mg = $545.96
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
