Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.04.2021

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52 h

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Prophylaxis and therapy of malaria, lupus erythematosus, porphyria cutanea tarda.

Notice! Before starting therapy, determine the glucose-6-phosphate dehydrogenase level. Women of childbearing age must have a negative pregnancy test before therapy and effective contraception protection must be provided during and up to 3 months after therapy! Smokers respond to the treatment significantly worse than non-smokers!

Dosage and method of use
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  • Malaria therapy:
    • Initially 800 mg p.o., then after 6, 12 and 24 hours 400 mg each. In very severe cases 5-day treatment: 2 days each 800 mg, 3 days each 400 mg.
    • Children: Initial 13 mg/kg bw. 6, 12 and 24 hours later 6.5 mg/kg bw each.
  • Malaria prophylaxis:
    • 2 times 400 mg within 1 week before travel or on 2 consecutive days at travel start, then continue 400 mg 1 time/week on the same day of the week until 4 weeks after exposure.
    • Children: Initial 2 times 6.5 mg/kg bw, then 6.5 mg/kg bw on the same day of the week.
  • Lupus erythematosus and rheumatoid arthritis: Initially 400 mg/day for 4-8 weeks, then 200 mg/day and further reduction according to findings.
  • Reticular erythematous mucinosis: 200 mg/day for 4 weeks, 100 mg/day for another 4 weeks, then further tapering.
  • Porphyria cutanea tarda: 100 mg 3 times/week.

Undesirable effects
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Pustulosis acuta generalisata. S.a.u. Chloroquine.

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Concomitant treatment with hydroxychloroquine and the following medicinal products may lead to drug interactions:

Digoxin: increased levels of digoxin possible.

Halofantrine: prolongation of the QT interval and increased risk of ventricular arrhythmias possible.

Arrhythmogenic drugs (e.g. amiodarone): increased risk of ventricular arrhythmias.

Ciclosporin: increased plasma levels of ciclosporin have been reported.

Seizure threshold-lowering agents (e.g., mefloquine) → efficacy of some anticonvulsants may be impaired with concomitant use of hydroxychloroquine, as hydroxychloroquine may lower the seizure threshold

Praziquantel: chloroquine may reduce the bioavailability of praziquantel

Agalsidase: theoretical risk of inhibition of intracellular α-galactosidase activity

Phenylbutazone: likelihood of exfoliative dermatitis increases

Hepatotoxic substances (caution with alcohol in large quantities) and MAO inhibitors.

Probenecid or indomethacin: increased risk of sensitization and retinopathy

Corticosteroids: myopathies or cardiomyopathies may be increased

Aminoglycosides: increased neuromuscular blockade possible

Pyrimethamine/sulfadoxine: risk of skin reactions significantly increased

Folic acid antagonists(methotrexate): their effect is increased

Ampicillin: absorption of ampicillin may be reduced

Neostigmine or pyridostigmine: the effect of neostigmine or pyridostigmine may be reduced

antacids: may decrease the absorption of hydroxychloroquine

cimetidine: may delay the excretion of hydroxychloroquine

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Remember! It should be taken after meals.

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  1. Jewell ML et al (2000) Patients with cutaneous lupus erythematosus who smoke are less responsive to antimalarial treatment. J Am Acad Dermatol 42: 983-987


Last updated on: 29.04.2021