Avloquin

Indications

Avloquin is prescribed for the following conditions:

• Treatment and prevention of malaria
• Prophylactic use to prevent malaria outbreaks
• Treatment of amoebic hepatitis and abscesses
• Management of discoid lupus erythematosus and systemic lupus erythematosus (SLE)
• Treatment of rheumatoid arthritis

Please follow the advice of a registered healthcare professional when using this medication.

Composition

Tablet: Each film-coated tablet contains 250 mg of Chloroquine Phosphate BP, equivalent to approximately 150 mg of Chloroquine base.
Syrup: Each 5 mL contains 80 mg of Chloroquine Phosphate BP, equivalent to approximately 50 mg of Chloroquine base.

Pharmacology

Chloroquine Phosphate is a 4-aminoquinoline compound with antimalarial and amoebicidal properties. It is effective against malaria caused by susceptible strains of Plasmodium falciparum, P. ovale, P. vivax, and P. malariae. It works as a blood schizontocide and has some gametocytocidal activity. While the exact mechanism against blood schizonts is not entirely understood, it is believed that chloroquine influences hemoglobin digestion in the parasite by increasing the pH inside parasite cells. It also interferes with nucleoprotein synthesis. Chloroquine is rapidly absorbed after oral, intramuscular, or subcutaneous administration and is about 55% bound to plasma proteins in the bloodstream.

Dosage & Administration

The dosage is typically expressed in terms of chloroquine base. As a general guideline, 300 mg of chloroquine base is roughly equivalent to 500 mg of chloroquine phosphate.

• For Malaria Treatment:
  • Adults and Children: Administer 25 mg of chloroquine base per kg body weight over a 3-day period. This can be given in several ways:
    • 10 mg/kg on day 1, followed by 5 mg/kg every 6–8 hours, then 5 mg/kg daily for the next 2 days.
    • Alternatively, 10 mg/kg on days 1 and 2, and 5 mg/kg on day 3.
    • Adult doses may also be given as 600 mg on day 1, followed by 300 mg every 6–8 hours, then 300 mg daily for the next 2 days.
• For Malaria Prophylaxis (Prevention):
  • Adults: A weekly dose of 300 mg chloroquine base is recommended for 1 week before exposure, continuing during exposure, and for at least 4 weeks afterward.
  • Children: A weekly dose of 5 mg per kg body weight is suggested.
• For Hepatic Amoebiasis:
  • Adults: Begin with 600 mg of chloroquine base daily for 2 days, then reduce to 300 mg daily for at least 2-3 weeks. Treatment is usually combined with an effective intestinal amoebicide.
• For Lupus Erythematosus:
  • Suggested dose: 150 mg of chloroquine base daily, with gradual reduction once symptoms are controlled.
• For Rheumatoid Arthritis:
  • Adults: 150 mg of chloroquine base daily, with some recommendations to treat for 10 months each year.
  • Children: 3 mg/kg body weight daily.
• For Photoallergic Reactions:
  • Adults: 150–300 mg of chloroquine base daily during periods of intense sunlight.
  • Children: 3 mg/kg body weight.
• For Porphyria Cutanea Tarda:
  • Adults: Initially, 150 mg to 600 mg of chloroquine base daily for 4–7 days, followed by 75 mg 2-3 times a week for 6–18 months.

Please follow the guidance of a registered healthcare professional for correct usage.

Drug Interactions

Avloquin may interact with medications like neostigmine, pyridostigmine, antacids, kaolin, cimetidine, ranitidine, quinine, mefloquine, amodiaquine, artemisinin, metronidazole, and ampicillin.

Contraindications

• Known or suspected chloroquine resistance in P. falciparum
• Hypersensitivity to chloroquine
• Retinal damage
• Concurrent use with hepatotoxic drugs

Side Effects

• Gastrointestinal: Nausea, vomiting, diarrhea
• Psychological: Psychotic episodes, anxiety, personality changes
• Visual: Blurred vision, difficulty focusing, keratopathy, retinopathy
• Hematological: Aplastic anemia, agranulocytosis, thrombocytopenia, neutropenia
• Other: Hair loss, hair pigmentation changes, bluish-black pigmentation of mucous membranes, photosensitivity, tinnitus, hearing reduction, nerve deafness, myopathy

Pregnancy & Lactation

Chloroquine should be used during pregnancy only when necessary for the treatment or prevention of malaria, with physician approval. As chloroquine may cause severe reactions in nursing infants, consider whether to stop breastfeeding or discontinue the medication based on its importance to the mother.

Precautions & Warnings

• Prior eye examination is recommended before starting long-term treatment, with regular monitoring for potential visual disturbances.
• Visual disturbances may impair the ability to operate vehicles or machinery.
• Caution is required when administering to patients with liver or kidney issues, a history of epilepsy, or conditions like porphyria and psoriasis.
• Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency should be closely monitored for hemolytic anemia during chloroquine treatment.

Therapeutic Class

Antimalarial Drugs

Storage Conditions

Store below 30°C, away from light and moisture. Keep out of reach of children.