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Hydroxychloroquine
From WikEM
Contents
Administration
- Type: Antimalarial, anti-inflammatory
- Dosage Forms:
- Routes of Administration: Oral
- Common Trade Names: Plaquenil
Adult Dosing
Malaria
Most malaria-endemic areas have high rates of chloroquine resistance. Per the CDC, chloroquine-sensitive areas include: Central America west of the Panama Canal, Haiti, the Dominican Republic, and most of the Middle East. See [CDC malaria information by country] for details
- Malaria treatment: 800 mg PO, then 400 mg PO at 6, 24, and 48 hours after initial dose
- Malaria prophylaxis: 400 mg PO weekly beginning 1 to 2 weeks prior to travel to malarious area through 4 weeks after departure
Other indications
- Lupus: 200-400mg PO 1-2 times per day
- Rheumatoid Arthritis: 200-600mg PO daily
Pediatric Dosing
- Malaria treatment: 12.9 mg/kg (max 800mg) PO, then 6.45 mg/kg PO at 6, 24, and 48 hours after initial dose
- Malaria prophylaxis: 6.45 mg/kg PO weekly beginning 1 to 2 weeks prior to travel to malarious area through 4 weeks after departure
Special Populations
- Pregnancy Rating: D
- Lactation risk: Infant risk minimal
- Renal dosing:
- Hepatic dosing:
Contraindications
- Allergy to class/drug
- Retinal or visual field changes from prior 4-aminoquinoline compound
- Prolonged use in children
Adverse Reactions
Serious
- Torsades de pointes
- Agranulocytosis, leukopenia, thrombocytopenia, aplastic anemia
- Fulminant hepatic failure
- Myopathy
- Seizure
- Retinopathy
- Hearing loss
- Angioedema
Common
- Corneal disorder
Pharmacology
- Half-life: 7-50 days
- Metabolism: Hepatic
- Excretion: Mostly renal
Mechanism of Action
- Precise mechanism unknown
