Life-threatening features include arrhythmias which can have a very rapid onset and convulsions which can be intractable. Benefit of use in prophylaxis and treatment in malaria outweighs risk. For rheumatoid disease, it is not necessary to withdraw an antimalarial drug during pregnancy if the disease is well controlled. Present in breast milk and breast-feeding should be avoided when used to treat rheumatic disease. Amount in milk probably too small to be harmful when used for malaria.

Only partially excreted by the kidneys and reduction of the dose is not required for prophylaxis of malaria except in severe impairment. Manufacturers recommend regular ophthalmological examination but the evidence of practical value is unsatisfactory. Warn travellers going to malarious areas about importance of avoiding mosquito bites, importance of taking prophylaxis regularly, and importance of immediate visit to doctor if ill within 1 year and especially within 3 months of return.

Drugs for malaria prophylaxis are not prescribable in NHS primary care; health authorities may investigate circumstances under which antimalarials are prescribed. Tablet , Oral solution.

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Other drugs classified as antimalarials. Initially by mouth using syrup For Child 4—5 weeks body-weight up to 4. For Child 6 weeks—5 months body-weight 4. For Child 3—4 years body-weight 15— For Child 5—7 years body-weight Doses expressed as chloroquine base. Acute porphyrias ; diabetes may lower blood glucose ; elderly in adults ; G6PD deficiency ; long-term therapy regular ophthalmic examination recommended by manufacturers ; may aggravate myasthenia gravis ; may exacerbate psoriasis ; neurological disorders, especially epilepsy may lower seizure threshold —avoid for prophylaxis of malaria if history of epilepsy ; severe gastro-intestinal disorders Cautions, further information Screening for retinopathy In adults A review group convened by the Royal College of Ophthalmologists has updated guidelines on screening for chloroquine and hydroxychloroquine retinopathy Hydroxychloroquine and Chloroquine Retinopathy: Recommendations on Screening Screening recommendations for chloroquine: All patients planning to be on long-term treatment should receive a baseline examination including fundus photography and spectral domain optical coherence tomography within months of treatment initiation; Annual screening is recommended in all patients who have taken chloroquine for greater than 1 year.

Individual interactants: Chloroquine. Rare or very rare Cardiomyopathy ; hallucination ; hepatitis.

Frequency not known Abdominal pain ; agranulocytosis ; alopecia ; anxiety ; atrioventricular block ; bone marrow disorders ; confusion ; corneal deposits ; depression ; diarrhoea ; eye disorders ; gastrointestinal disorder ; headache ; hearing impairment ; hypoglycaemia ; hypotension ; insomnia ; interstitial lung disease ; movement disorders ; myopathy ; nausea ; neuromyopathy ; neutropenia ; personality change ; photosensitivity reaction ; psychotic disorder ; QT interval prolongation ; seizure ; severe cutaneous adverse reactions SCARs ; skin reactions ; thrombocytopenia ; tinnitus ; tongue protrusion ; vision disorders ; vomiting.

Side-effects, further information Side-effects which occur at doses used in the prophylaxis or treatment of malaria are generally not serious. One small study reported that hydroxychloroquine alone or in combination with azithromycin reduced detection of SARS-CoV-2 RNA in upper respiratory tract specimens compared with a non-randomized control group but did not assess clinical benefit [ 7 ].

Hydroxychloroquine and azithromycin are associated with QT prolongation and caution is advised when considering these drugs in patients with chronic medical conditions e. Hydroxychloroquine is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis of SARS-CoV-2 infection, and treatment of patients with mild, moderate, and severe COVID In the United States, several clinical trials of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection are planned or will be enrolling soon.

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Lopinavir-ritonavir did not show promise for treatment of hospitalized COVID patients with pneumonia in a recent clinical trial in China [ 8 ]. This trial was underpowered, and lopinavir-ritonavir is under investigation in a World Health Organization study.

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Several other drugs are under investigation in clinical trials or are being considered for clinical trials of prophylaxis or treatment of COVID in the United States and worldwide. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation. Minus Related Pages. Remdesivir Remdesivir is an investigational intravenous drug with broad antiviral activity that inhibits viral replication through premature termination of RNA transcription and has in-vitro activity against SARS-CoV-2 and in-vitro and in-vivo activity against related betacoronaviruses [ ].

Chloroquine and hydroxychloroquine: what to know about the potential coronavirus drugs

The manufacturer is currently transitioning the provision of emergency access to remdesivir from individual compassionate use requests to an expanded access program. The expanded access program for the United States is under rapid development. Other Drugs Lopinavir-ritonavir did not show promise for treatment of hospitalized COVID patients with pneumonia in a recent clinical trial in China [ 8 ].

COVID-19 Update 8: Zinc and chloroquine for the treatment of COVID-19?

Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus nCoV in vitro. Cell Res. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun.



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Broad-spectrum antiviral GS inhibits both epidemic and zoonotic coronaviruses. Sci Transl Med. Int J Antimicrob Agents. Clin Infect Dis.