Hydroxychloroquine

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

See Also

• Antimalarial medications
• Malaria