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Chloroquine Disease Interactions

There are 7 disease interactions with chloroquine:

Major

4-Aminoquinolines (Includes Chloroquine) ↔ Oculotoxicity

Severe Potential Hazard, High plausibility

Applies to: Retinal Disorder

The use of 4-aminoquinolines is generally considered contraindicated in the presence of retinal or visual field changes, whether attributable to 4-aminoquinoline compounds or to any other etiology. However, in the treatment of acute attacks of malaria caused by susceptible strains of plasmodia, these agents may be considered if potential benefits are anticipated to outweigh the risks. 4-aminoquinolines are oculotoxic and can cause dose-related, irreversible retinal damage and vision loss during and up to several years after long-term or high-dose therapy (e.g., in the treatment of systemic lupus erythematosus or rheumatoid arthritis). Ophthalmologic monitoring, including visual acuity, expert slit-lamp, funduscopic, and visual field tests, is recommended at baseline and every three months during prolonged use. Therapy should be discontinued immediately if abnormalities develop in visual acuity, visual field, or retinal macular areas (e.g., pigmentary changes, loss of foveal reflex), or if the patient experiences visual symptoms such as light flashes and streaks that are not fully explainable by difficulties of accommodation or corneal opacities. Other common symptoms that may indicate retinopathy include nyctalopia, photophobia, blurred distance vision, difficulty reading or seeing (e.g., words or letters disappearing or parts of objects missing; misty vision; fog before the eyes), and missing or blacked out areas in the central or peripheral visual field. Retinal changes and visual disturbances may progress even after cessation of therapy. However, in a number of patients, early retinopathy (macular pigmentation sometimes with central field defects) diminished or regressed completely after therapy was discontinued. Paracentral scotoma to red targets, sometimes termed PREMACULOPATHY, is indicative of early retinal dysfunction and is usually reversible with cessation of therapy.

References

  1. Ehrenfeld M, Nesher R, Merin S "Delayed-onset chloroquine retinopathy." Br J Ophthalmol 70 (1986): 281-3
  2. Sassani JW, Brucker AJ, Cobbs W, Campbell C "Progressive chloroquine retinopathy." Ann Ophthalmol 15 (1983): 19-22
  3. "Product Information. Plaquenil (R). (hydroxychloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 8 references
Major

Aminoquinolines (Includes Chloroquine) ↔ Porphyria

Severe Potential Hazard, Moderate plausibility

Applies to: Porphyria

The use of aminoquinolines in patients with porphyria may exacerbate the condition. Aminoquinolines should not be used in these patients unless the potential benefits are anticipated to outweigh the risks.

References

  1. "Product Information. Aralen (chloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  2. Liu AC "Hepatotoxic reaction to chloroquine phosphate in a patient with previously unrecognized porphyria cutanea tarda." West J Med 162 (1995): 548-51
  3. "Product Information. Plaquenil (R). (hydroxychloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
Moderate

4-Aminoquinolines (Includes Chloroquine) ↔ Bone Marrow Suppression

Moderate Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Adverse hematologic effects including neutropenia, agranulocytosis, aplastic anemia, and thrombocytopenia have been rarely associated with 4-aminoquinolines. Therapy with 4-aminoquinolines should be administered cautiously in patients with preexisting bone marrow suppression. A complete blood count should be performed periodically in patients on prolonged therapy. If any severe blood disorder appears which is not attributable to the disease under treatment, discontinuance of the drug should be considered.

References

  1. Winkelman RK, Merwin CF, Brunsting LA "Antimalarial therapy of lupus erythematosus." Ann Intern Med 55 (1961): 772-6
  2. "Product Information. Aralen (chloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Plaquenil (R). (hydroxychloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 4 references
Moderate

4-Aminoquinolines (Includes Chloroquine) ↔ Ototoxicity

Moderate Potential Hazard, Low plausibility

Applies to: Hearing Loss

The use of 4-aminoquinolines has been associated rarely with ototoxicity. Nerve-type deafness, which is usually irreversible, has occurred during long-term, high-dose therapy. Deafness may not be apparent until several weeks after 4-aminoquinoline therapy. Tinnitus and reduced hearing have been reported in patients with preexisting auditory damage. Therapy with 4-aminoquinolines should be administered cautiously in such patients. If new auditory defects develop or if hearing loss becomes worse, therapy should be immediately discontinued and the patient closely monitored.

References

  1. "Product Information. Plaquenil (R). (hydroxychloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  2. "Product Information. Aralen (chloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
Moderate

4-Aminoquinolines (Includes Chloroquine) ↔ Seizures

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

4-aminoquinolines may cause epileptic seizures in susceptible individuals. Patients with epilepsy or an otherwise low seizure threshold may be at greater risk. Therapy with 4-aminoquinolines, particularly chloroquine, should be administered cautiously in patients with epilepsy.

References

  1. Fish DR, Espir ML "Convulsions associated with prophylactic antimalarial drugs: implications for people with epilepsy." Br Med J 297 (1988): 526-7
  2. Benbadis SR, Vanness PC "Chloroquine and nonconvulsive status epilepticus." Ann Intern Med 124 (1996): 614
  3. Mulhauser P, Allemann Y "Chloroquine and nonconvulsive status epilepticus." Ann Intern Med 123 (1995): 76-7
View all 5 references
Moderate

Aminoquinolines (Includes Chloroquine) ↔ Hepatotoxicity

Moderate Potential Hazard, Low plausibility

Applies to: Liver Disease, Alcoholism

Aminoquinolines may concentrate in the liver. Isolated cases of abnormal liver function and fulminant hepatic failure have been reported. Therapy with aminoquinolines should be administered cautiously in patients with hepatic disease or alcoholism and in patients receiving other hepatotoxic drugs. Periodic evaluation of hepatic function should be performed during prolonged therapy.

References

  1. "Product Information. Plaquenil (R). (hydroxychloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  2. Grossman I, Azaz-Livshits T, Fridlender Z, Muszkat M, Ben-Chetrit E "Mefloquine-induced acute hepatitis." Pharmacotherapy 20 (2000): 1517-9
  3. "Product Information. Aralen (chloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 4 references
Moderate

Aminoquinolines (Includes Chloroquine) ↔ Psoriasis

Moderate Potential Hazard, Moderate plausibility

Applies to: Psoriasis

The use of aminoquinolines in patients with psoriasis may precipitate a severe attack of psoriasis. Aminoquinolines should not be used in these patients unless the potential benefits are anticipated to outweigh the risks.

References

  1. Kuflik EG "Effect of antimalarial drugs on psoriasis." Cutis 26 (1980): 53-5
  2. "Product Information. Plaquenil (R). (hydroxychloroquine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. Okor RS "Onset of pruritogenicity of chloroquine and the implication for the timing of suppressive therapy." J Clin Pharm Ther 16 (1991): 463-5
View all 7 references

chloroquine drug Interactions

There are 497 drug interactions with chloroquine

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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