Chloroquine 80 mg/5 ml Syrup

Antimalarial and anti-inflammatory for:

• Treatment of malaria caused by chloroquine-sensitive Plasmodium vivax, P. ovale, P. malariae (and sensitive P. falciparum — rare in Bangladesh)
• Malaria prevention in areas without chloroquine resistance
• Amoebic liver abscess (with other drugs)
• Rheumatoid arthritis and lupus (hydroxychloroquine is usually preferred)

Doses are expressed as chloroquine base (250 mg chloroquine phosphate ≈ 150 mg base).

Malaria treatment (adults and children), total 25 mg base/kg over 3 days:

• Day 1: 10 mg base/kg (adults 600 mg base), then 5 mg/kg 6–8 hours later (or 10 mg/kg on day 1)
• Day 2: 10 mg/kg (or 5 mg/kg); Day 3: 5 mg/kg
• For P. vivax/ovale, followed by primaquine to prevent relapse (after G6PD testing).

Prevention: 300 mg base once weekly, starting 1 week before travel and continuing 4 weeks after.

Rheumatoid arthritis: 150 mg base daily (specialist).

• Take with food to reduce stomach upset.

• Allergy to 4-aminoquinolines
• Pre-existing retinal or visual field changes (for long-term use)
• Use with QT-prolonging drugs (e.g. amiodarone, moxifloxacin, halofantrine) — caution/avoid

Common: nausea, vomiting, stomach upset, headache, diarrhoea, itching (common in Africans and Asians), blurred vision (temporary).

Less common: dizziness, rash, hair bleaching, mood changes, insomnia.

Rare but serious: retinopathy with long-term use (irreversible vision loss), QT prolongation and arrhythmias, low blood sugar, seizures, psychosis, blood disorders, haemolysis in G6PD deficiency, muscle and heart muscle damage.

• Very toxic in overdose — keep away from children (even a few tablets can be fatal).
• Long-term use: eye examination before starting and regularly.
• Epilepsy, psoriasis, porphyria, G6PD deficiency, liver/kidney disease, heart rhythm problems: caution.
• Diabetes: watch for low sugar.

May be used in pregnancy for malaria treatment and prevention (benefit outweighs risk). Compatible with breastfeeding (does not protect the infant from malaria).

• QT-prolonging drugs (amiodarone, macrolides, quinolones, antipsychotics, mefloquine) — arrhythmias
• Antacids, kaolin (take 4 hours apart)
• Ciclosporin, digoxin (levels rise)
• Praziquantel (reduced effect), ampicillin (reduced absorption)
• Antidiabetic drugs (hypoglycaemia)
• Rabies vaccine (intradermal — reduced response)

Rapidly life-threatening: headache, drowsiness, visual disturbance, vomiting, low blood pressure, cardiac arrhythmias, seizures, cardiac arrest within hours. Emergency hospital care.

Store below 30°C, protected from light, in a child-resistant container.