Chloroquine Overview

A detailed overview of Chloroquine will clear out the indications to the drug use, its potential for COVID-19 treatment, safety, contraindications, and possible side effects.

Chloroquine coronavirus. An Old Drug with a New Potential

Chloroquine is a drug intended to treat some types of malaria and amebiasis. It can also be used in patients suffering from certain autoimmune diseases, like lupus and rheumatoid arthritis. However, as of 2020, this preparation is being studied for its potential to cure COVID-19.

How Chloroquine Works

The efficiency of Chloroquine in individuals with chloroquine-sensitive forms of malaria is explained by the ability of the medication to inhibit the vital functions of the parasite cells. It interferes with the normal membrane function thus leading to cell autodigestion.

The use of this preparation in the experimental treatment of patients infected with novel coronavirus is explained by the antiviral properties of Chloroquine. It affects the viral cell pH, which doesn’t allow the virus to release its RNA into the cell, and thus replicate.

How to Take the Drug

Chloroquine is a very serious medication with a whole list of warnings and contraindications. What’s more, the drug can be the reason for numerous adverse reactions, which can get extremely dangerous if it is taken without the doctor’s prescription. Therefore, the first step to a safe intake of Chloroquine is a consultation with a medical specialist. Only if your doctor considers that the potential benefits prevail the possible risks, he/she can give out a prescription for it.

The dosing regimen of the drug depends on the disease treated. In case the medication is used for the prophylaxis of malaria, the scheme of intake gets totally different from the one used to cure this illness. For example, when using Chloroquine as a prophylactic measure, take 500 mg tablet once a week, the same day of the week. It is strongly advised to start the intake two weeks prior to the possible exposure to the parasite.

The therapeutic dose of the medication for the treatment of malaria depends on the patient’s weight. The therapy lasts for only 3 days with different doses of the medication taken each day.

When treating amebiasis, the common dose is 1 g Chloroquine for two days (single daily dose intake). The dose should be halved on the third day of the therapy and remain the same for the rest of two or three weeks of treatment.

The Potential of Chloroquine for COVID-19

Trying to find a cure for the novel coronavirus, the World Health Organization, as well as the US CDC, allowed using some of the already existing drugs as an off-label treatment for this illness. Chloroquine became one of those that have shown positive results in patients with confirmed COVID-19.

Because of the lack of knowledge regarding the effect of the drug on the virus and the absence of common recommendations for its use in this category of patients, it’s up to the medical specialists to decide what dose of Chloroquine to prescribe.

Clinical studies on the efficiency and safety of Chloroquine for COVID-19 treatment are already on the way. They started in January and the first results give hope for the better.

When Chloroquine is not Advised

One of the cases, when Chloroquine can do more harm than benefit, is its use in patients who are hypersensitive or allergic to chloroquine or 4-aminoquinolines. It is strictly contraindicated to prescribe this drug to the patients with the mentioned issues.

The medication can also provoke rapid worsening of certain health conditions, including:

Therefore, its use in individuals with these health problems is not recommended.

Warnings for the Drug Use

Being a prescription-only drug, Chloroquine may cause more serious side effects in patients with certain health conditions. To reduce the risks, special caution and close monitoring are needed when prescribing Chloroquine to those suffering from:

There exist certain risks for the fetus and breastfed babies if their mothers take Chloroquine. It is recommended to avoid prescribing this medication in these patients. However, if the potential benefits for the mother prevail the possible risks for the baby, this medication can be applied.

The drug can increase your skin sensitivity to the sun. Thus, you should use all the possible protective measures, including sunscreen, hats, and clothes covering the body areas that can be exposed to the sun to avoid sunburns.

What Adverse Reactions to Chloroquine Are Possible

The most commonly experienced side effects of the drug are associated with the gastrointestinal tract. They are the following:

Headaches are also not rare in patients taking Chloroquine. In most cases, these reactions are light-to-moderate in nature and go away on their own. Still, you should inform your attending doctor about them to keep the situation under control.

Unfortunately, the reactions we’ve mentioned above are only a few of all the possible conditions you may develop. Among the severe adverse effects to Chloroquine there are:

The list can be continued but you’d better discuss it with your healthcare provider. Any of the listed reactions is a reason to call 911 or go to the nearest clinic.

One of the factors determining the severity of adverse reactions you may experience is your general health condition. Also, the intake of certain medications or shortage of some nutrients (magnesium or potassium) can trigger more severe adverse reactions than in other patients taking Chloroquine. Therefore, informing your doctor about all the drugs and herbal products you use is crucial.

Mortality 40%
The experts predict new economical crisis
Millions of people are isolated
One virus carrier infects 1.4-2.5 of people

What has been found out?

Advanced laboratories around the world are working on a drug search. Already managed to decipher the genome of the virus and develop a vaccine, but it still has to pass a series of tests. Scientists tested the effects of existing antiviral agents on 2019-nCoV. There have been found 30 drugs of traditional and alternative medicine, which have a necessary antiviral effect. Among them, there are both, exotic agents that are rarely found and quite popular antiviral drugs.

The recent researches proved that Chloroquine (Generic Aralen) blocks viral entry into the host cell, lopinavir/ritonavir (Generic Kaletra) blocks viral replication.

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Aralen Aralen

Generic Aralen

Active Ingredient : Chloroquine Phosphate
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Generic Aralen is an anti-malaria medicine that works by interfering with the growth of parasites in the red blood cells of the human body. This medicine is also used to treat amebiasis (infection caused by amoebae. And on the 4th of February 2020, the lab researches showed that the drug was also effective in stopping the COVID-2019 virus from spreading in human cells.

Chloroquine Phosphate tablet

What is this medicine?

CHLOROQUINE is an anti-malaria medicine that works by interfering with the growth of parasites in the red blood cells of the human body. This medicine is also used to treat amebiasis (infection caused by amoebae. And on the 4th of February 2020, the lab researches showed that the drug was also effective in stopping the COVID-2019 virus from spreading in human cells.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • eye disease, vision problems
  • glucose 6-phosphate dehydrogenase (G6PD) deficiency
  • hearing problems
  • liver disease
  • psoriasis
  • history of seizures
  • an unusual or allergic reaction to chloroquine, hydroxychloroquine, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. To prevent malaria, take this medicine on the same day each week starting 2 weeks before entering the endemic area and continue for 8 weeks after leaving. Take your doses at regular intervals. Do not take your medicine more often than directed. Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for selected conditions, precautions do apply. Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:
  • arsenic trioxide
  • chlorpromazine
  • cisapride
  • droperidol
  • medicines for depression, anxiety, or psychotic disturbances
  • medicines for irregular heartbeats, rhythm
  • methadone
  • pentamidine
  • ranolazine
  • some antibiotics like erythromycin, levofloxacin
This medicine may also interact with the following:
  • ampicillin
  • antacids
  • cimetidine
  • cyclosporine
  • kaolin
This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or health care professional if your symptoms do not start to get better in a few days. If you are taking this medicine for a long time, visit your doctor or health care professional for regular checks. If you notice any changes in your vision see your eye doctor for an eye exam. If you get a fever during or after you start taking this medicine, do not treat yourself. Contact your doctor or health care professional immediately. You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. While in areas where malaria is common, you should take steps to prevent being bit by mosquitos. This includes staying in air-conditioned or well-screened rooms to reduce human-mosquito contact, sleep under mosquito netting, preferably one with pyrethrum-containing insecticide, wear long-sleeved shirts or blouses and long trousers to protect arms and legs, apply mosquito repellents containing DEET to uncovered areas of skin, and use a pyrethrum-containing flying insect spray to kill mosquitos. This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths. Avoid products with antacids and kaolin for 4 hours before and after taking a dose of this medicine.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • changes in vision
  • hallucinations
  • hearing loss or ringing
  • feeling faint, lightheaded
  • fever or infection
  • muscle weakness
  • numbness, tingling
  • seizures
  • unusual bleeding or bruising
  • unusually weak or tired
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
  • bleaching of body hair
  • blue-black color to the skin, nails
  • diarrhea
  • hair loss
  • headache
  • loss of appetite
  • nausea, vomiting
  • stomach cramps
This list may not describe all possible side effects.

Where should I keep my medicine?

Keep out of the reach of children. In children, this medicine can cause overdose with small doses. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.
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Express tests for coronavirus work according to the following principle: it is not the virus that is identified, but the presence of antibodies to virus in human.

One step Covid-19 test kit

In order for the test to show the presence of antibodies in human blood, there must be a certain concentration of them. It is not achieved immediately: the body must produce antibodies for several days. That is why the express test can certainly confirm the presence of coronavirus in the human body later than the molecular test. Due to this, the risk of false negative results of such a test is quite high. A person may already be a carrier of the virus, but there will not be enough antibodies in his body for the express test to work. It must be mentioned that the molecular test does not give a 100% guarantee of virus detection as well - but it is much more reliable than the express test.
Hydroxychloroquine Hydroxychloroquine

Generic Hydroxychloroquine

Active Ingredient : Hydroxychloroquine
Dosage: 200mg
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Hydroxychloroquine is used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia. Hydroxychloroquine is also used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus. In 2020, after clinical trials, hydroxychloroquine (the main active ingredient) was found to be more potent than chloroquine to inhibit SARS-CoV-2 (COVID-19 disease) in vitro.

Hydroxychloroquine tablet

What is this medicine?

HYDROXYCHLOROQUINE is used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia. Hydroxychloroquine is also used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus. Hydroxychloroquine may also be used for purposes not listed in this medication guide.

What should my health care professional know before I take this medicine?

You should not use Hydroxychloroquine if you are allergic to hydroxychloroquine, or if you have a history of vision changes or damage to your retina caused by an anti-malaria medication. Hydroxychloroquine should not be used for long-term treatment in children. To make sure Hydroxychloroquine is safe for you, tell your doctor if you have any of these conditions:
  • psoriasis;
  • porphyria;
  • liver disease;
  • alcoholism; or
  • glucose-6-phosphate dehydrogenase (G-6-PD) deficiency.
It is not known whether Hydroxychloroquine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Malaria is more likely to cause death in a pregnant woman. If you are pregnant, talk with your doctor about the risks of traveling to areas where malaria is common. It is not known whether hydroxychloroquine passes into breast milk or if it could harm a nursing baby. Do not use Hydroxychloroquine without telling your doctor if you are breast-feeding a baby.

How should I take this medicine?

Take Hydroxychloroquine exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Take Hydroxychloroquine with a meal or a glass of milk, unless your doctor tells you otherwise. Hydroxychloroquine is sometimes given only once per week. Choose the same day each week to take this medication if you are on a weekly dosing schedule. To prevent malaria: Start taking the medicine 2 weeks before entering an area where malaria is common. Continue taking Hydroxychloroquine regularly during your stay and for at least 8 weeks after you leave the area. To treat malaria: Your doctor may recommend a single dose of Hydroxychloroquine, or a high starting dose followed by a smaller dose during the last 2 days of treatment. Follow your doctor's instructions. Take Hydroxychloroquine for the full prescribed length of time for malaria. Your symptoms may improve before the infection is completely cleared. In addition to taking Hydroxychloroquine, use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria. Contact your doctor as soon as possible if you have been exposed to malaria, or if you have fever or other symptoms of illness during or after a stay in an area where malaria is common. When treating lupus or arthritis, Hydroxychloroquine is usually given daily for several weeks or months. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 6 months of treatment. While using Hydroxychloroquine, you may need frequent blood tests at your doctor's office. No medication is 100% effective in treating or preventing all types of malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Hydroxychloroquine can harm your liver. This effect is increased when you also use other medicines harmful to the liver. You may need dose adjustments or special tests if you have recently used:
  • acetaminophen (Tylenol);
  • an antibiotic, antifungal medicine, sulfa drug, or tuberculosis medicine;
  • birth control pills or hormone replacement therapy;
  • blood pressure medication;
  • cancer medications;
  • cholesterol-lowering medications such as Crestor, Lipitor, Pravachol, Simcor, Vytorin, Zocor;
  • gout or arthritis medications (including gold injections);
  • HIV/AIDS medications;
  • medicines to treat psychiatric disorders;
  • an NSAID such as Advil, Aleve, Arthrotec, Cataflam, Celebrex, Indocin, Motrin, Naprosyn, Treximet, Voltaren; or
  • seizure medications.
This list is not complete and other drugs may interact with Hydroxychloroquine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

What side effects may I notice from taking this medicine?

Some people taking this medication over long periods of time or at high doses have developed irreversible damage to the retina of the eye. Stop taking Hydroxychloroquine and call your doctor at once if you have trouble focusing, if you see light streaks or flashes in your vision, or if you notice any swelling or color changes in your eyes. Get emergency medical help if you have any of these signs of an allergic reaction to Hydroxychloroquine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:
  • muscle weakness, twitching, or uncontrolled movement;
  • loss of balance or coordination;
  • blurred vision, light sensitivity, seeing halos around lights;
  • pale skin, easy bruising or bleeding;
  • confusion, unusual thoughts or behavior; or
  • seizure (convulsions).
Less serious Hydroxychloroquine side effects may include:
  • headache, ringing in your ears, spinning sensation;
  • nausea, vomiting, stomach pain;
  • loss of appetite, weight loss;
  • mood changes, feeling nervous or irritable;
  • skin rash or itching; or
  • hair loss.
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