Chloroquine: the anti-malaria drug that’s tackling the coronavirus

Introduction

In 1934, scientist Hans Andersag discovered chloroquine. It is ranked as one of the most important medicines prescribed by Doctors.

Chloroquine is widely known as CHLOROQUINE PHOSPHATE which is used to treat amebiasis (a parasitic infection of the intestine caused by amoebae) and malaria (a disease caused by a mosquito-bite caused by a parasite). Other than this it is used to treat lupus erythematosus and rheumatoid arthritis. Recent studies have been carried out on Chloroquine to treat COVID-19.

This anti-malarial medicine is available under the brand name Aralen and is sold under a doctor or physician’s prescription.

The function of chloroquine is that it interferes with the parasitic growth in the RBC’s of the human body.

Availability

Chloroquine is available in liquid, tablets and injectable form. When available in tablets occurs in two different sizes.

• 150 mg base
• 300 mg base

Dosages

A physician would prescribe the doses depending upon the following:

• The medical condition of the patient
• Age of the patient                                                                     
• Weight of the patient
• Patient’s response to the drug.

How should chloroquine be used?

This anti-malarial drug can be taken with food so that food poisoning can be avoided.  Chloroquine injections are given by the doctor or physician at his clinic or hospital. But often people can inject the medicine by themselves at home. always read the label of the prescription properly. The quantity of chloroquine must be accurate as per the prescription.

To treat malaria by taking the drug orally it is recommended to take it once a week on the same day of each week.

It is advisable to take the first dose before traveling to a place where malaria is common. After that, it must be taken for the entire duration when staying at such a place until eight weeks after returning home.

The first dose of chloroquine is given on the spot when malaria is diagnosed in adults. After the first dose, half the dose is taken every 6-8 hours. This is followed for 2 days.

For treating malaria in infants, the dose is given depending on the weight of the child.

If chloroquine is used to treat Amebiasis orally, it is prescribed to be taken one dose every two days. After the first dose, the dose is reduced to half and is continued for 2-3 weeks.

It is not safe to double the dose if a previous dose is missed. You can take your missed dose if there is still time for your next dose but if it is time for the scheduled dose, so you may leave the missed one!

What side effects can chloroquine cause?

If a physician advise a patient to take chloroquine as he must be sure that the drug will be beneficial. According to research, people are highly unlikely to show any serious or alarming side effects.

But still, there are some side effects, which include:

• Nausea
• Vomiting
• Headache
• Blurred vision
• Cramps at the abdomen
• Diarrhea
• Problem in hearing
• Muscle weakness
• Irregular heart rate
• Drowsiness
• Breathing problems
• Convulsions
• Skin rashes
• Hair loss

If these side effects are experienced after taking chloroquine, a doctor, physician or pharmacist should be consulted immediately to minimize these effects.

Warning: irreversible retina damage may occur when chloroquine is taken in large quantities and for a longer duration of time!

Other drugs that can affect chloroquine

Use of the following drugs should be ceased prior to taking chloroquine as they are known to cause interference:

Heart rhythm may be affected if chloroquine is used alongside the following:

• Amiodarone, 
• Dofetilide,
• Macrolide antibiotics
• Mefloquine, 
• Pimozide,
• Procainamide, 
• Quinidine,
• Sotalol

Chloroquine overdoses

If an overdose is taken, the following symptoms may occur:

• Blurred vision (very common symptom)
• Dizziness
• Fainting
• Drowsiness
• Mood swings
• Headache
• Seizures
• Unconsciousness
• Shallow breathing
• Difficulty in breathing

In such cases, a doctor should be consulted immediately.

Medical uses

Treatment of malaria

Chloroquine has been used commonly in the prevention and treatment of malaria,. It is not recommended to be used in Plasmodium falciparum due to resistance to it.

Chloroquine is also helpful to be used in mass drug administrations. And it is prescribed to treat malaria with the help of other anti-malarial drugs.

Amebiasis treatment

To treat amoebic liver abscess, it is preferred to use chloroquine with the other combinations if there is no progress with metronidazole or nitroimidazole.

Rheumatic disease

It is used to treat some of the autoimmune disorders that include rheumatoid arthritis and lupus erythematosus.

Other uses

Chloroquine is also used to treat discoid lupus erythematosus, pemphigus, lichen planus,  polymyositis, scleroderma, sarcoidosis, and porphyria cutnea tarda.

Use during pregnancy

It is safe for pregnant women to use chloroquine, according to the CDC (Centers for Disease Control and Prevention), however it is considered that may impact a baby during breastfeeding. For this reason, a doctor should be consulted on its use prior to breastfeeding.

New research on chloroquine for the treatment of COVID-19

Other than the above diseases, recently a Chinese study has been published in BioScience Trends that showed the connection between chloroquine treating the rapidly spreading disease COVID-19.  

Research showed that pneumonia diagnosed in COVID-19 can be treated by chloroquine.

According to the CDC, chloroquine and hydroxychloroquine have been given to different patients suffering from COVID-19 in hospitals all across the world.

Chloroquine is an anti-malarial drug that has been helping mankind for more than 70 years to get rid of malaria and is now, in some countries, considered to be a potential treatment for coronavirus. Its function is to block viruses from combining and replicating with cells in the body.

The immune system may also be stimulated with chloroquine. The research was made on February 4, 2020 in the journal Nature that chloroquine was effective in combating SARS-CoV-2. Thus, it was concluded that patients suffering from COVID-19 may get the right treatment by taking this drug. 

In some countries, chloroquine phosphate may be relatively easy to obtain but as we have seen there are some side effects that one needs to be aware of before using this drug. Health-care providers have strictly warned people not to use it without a valid prescription by a physician or a pharmacist.

On 23rd March 2020, the Nigerian government reported a case of chloroquine poisoning. A couple were ill and they self-medicated with chloroquine phosphate which was from fish tank cleaner. The man, who was more than 60 years old died and his wife was in a serious condition.

Other research carried out concluded that hydrochloroquine is considered as less toxic derivative.

Chinese, Italian and South Korean health-care providers have approved chloroquine as the first line of treatment for the COVID-19 patients and some believe it to be the reason for South Korea’s low fatality rate. And they also studied that it is contraindicated with the patients also suffering from diabetes and heart problems.
Doctors in the UK have been ‘strongly discouraged’ from prescribing it for the treatment of coronavirus.

The FDA authorized these drugs under a EUA (Emergency Use Authorization) on March 28, 2020. The treatment still needs to be further studied and verified. Only the experimental treatment is certified only for those cases which are in an emergency and are admitted in the hospital but do not get proper treatment.

Chinese medical researchers considered chloroquine to contain a strong inhibitory effect and they also requested to work on its clinical trials. They subsequently concluded on 3rd April 2020 that it has very little proof to treat COVID-19 completely.

The European Medicines Agency (EMA) suggested that this anti-malarial drug (chloroquine) is just helpful in the clinical trials or for the programs that are for emergency use.

Precautions

A doctor must be aware if a patient has an allergy to chloroquine. There are some inactive ingredients included in this drug that often cause irritation or allergies.

If a user is experiencing kidney infections, hearing difficulty, psoriasis, seizures or blood disorders, then a doctor must be aware prior to administering chloroquine.

One of the common side effects of this drug is blurry vision, so a user should not drive or operate heavy machinery. Additionally, alcohol should be avoided.

A person using chloroquine may become more susceptible to the sun. It is advised to either use sunscreen or limit yourself from going out at day time if in a warm climate. Failure to do so can result in blisters or redness of the skin.

Chloroquine may affect the sugar level of a person, therefore those with diabetes need to keep track of their blood sugar levels and consult with their physician daily. Symptoms of Low blood sugar levels should be reported to a doctor immediately.

Chloroquine is indeed a useful anti-malarial drug but one needs to thoroughly study before consuming it. A physician will carry out routine tests to ensure it is affecting a patient positively.

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Please be aware that the content within this post is for informational purposes only and should not be used as medical advice. We do not recommend administering chloroquine unless prescribed by a doctor or physician.