How does it work?

This medicine contains the active ingredient chloroquine, which is an antimalarial medicine, though it also has uses in treating the auto-immune diseases rheumatoid arthritis and lupus erythematosus. Malaria is a potentially fatal disease caused by various types of parasites known as Plasmodium. Plasmodium are carried by mosquitoes and injected into the bloodstream during a bite from an infected mosquito. Once inside the blood the parasite travels to the liver, and then out again into the bloodstream where it invades the red blood cells and reproduces. An actual attack of malaria develops when the red blood cells burst, releasing a mass of parasites into the bloodstream. The attacks do not begin until a sufficient number of blood cells have been infected with parasites. Chloroquine is thought to prevent and treat malaria infection in two ways - by preventing the parasite from reproducing, and by killing the parasite once it is in the red blood cells. Chloroquine prevents the parasite from reproducing in the red blood cells by binding to and altering its genetic material (DNA). It kills the parasites by blocking the action of a chemical that they produce to protect themselves. Once inside the red blood cells the malaria parasites digest haemoglobin and this divides haemoglobin into two parts; haem and globin. Haem is toxic to the malaria parasite. To prevent itself from being damaged by haem, the malaria parasite produces a chemical that converts the toxic haem into a non-toxic compound. Chloroquine blocks the action of this chemical, which causes the levels of the toxic haem to rise and kills the malaria parasite. Chloroquine is usually taken in combination with another antimalarial medicine called proguanil to prevent malaria. However, the malaria parasite is resistant to these medicines in certain areas of the world, and it is important to check with your pharmacist which medicines are currently recommended to prevent malaria in the country you are travelling to. If chloroquine is recommended it should be started a week before travel to the malarious region. It should then be taken throughout the stay so that if you are bitten by an infected mosquito, there will be medicine in your blood to prevent malaria developing. Chloroquine should be continued for a further four weeks after leaving the malarious area so that there is still medicine in the blood to kill any parasite that is released from the liver in this time. Higher doses than those used for preventing malaria are used to treat malaria infection. Chloroquine can also be used to treat infections of the liver with amoebae. Chloroquine is a prescription-only medicine, but can be bought without a prescription from pharmacies for the prevention of malaria. Chloroquine also has anti-inflammatory activity and is used in high doses to treat the auto-immune diseases rheumatoid arthritis, systemic lupus erythematosus, and discoid lupus erythematosus. In these diseases the body's immune system is over-active and causes inflammation that results in the symptoms of these diseases. Chloroquine suppresses the inflammation and the disease process. In rheumatoid arthritis chloroquine is known as a disease-modifying antirheumatic drug (DMARD). It doesn't have an immediate effect but requires four to six months of treatment.

What is it used for?

Infection of the liver with amoebae causing liver inflammation or abscess (amoebic hepatitis and abscess)

Inflammatory disease of the joints

Prevention of malaria

Systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE)

Treatment of malaria infection

Warning!

Regular eye checks are recommended during long term treatment as this medicine can sometimes cause eye problems.

It is recommended that people taking this medicine for long periods of time have regular blood tests to monitor the levels of the different types of blood cells in the blood.

To prevent malaria it is important that you take this medicine regularly and try not to forget a dose. You should still take precautions to avoid being bitten by mosquitos, such as using mosquito repellants and sleeping under mosquito nets. This is particularly important if you have vomiting or diarrhoea. If you fall ill within one year of your return, and especially if within three months of your return, you should consult your doctor immediately and let him know that you have visited a country where malaria is endemic.

To prevent malaria this medicine should be started one week before travelling to the malarious area. It should be taken regularly thoughout the stay and continued for four weeks after leaving the malarious area.

This medicine may cause visual disturbances when you first start taking it. If affected you should use caution when driving or operating machinary.

Use with caution in

Abnormal muscle weakness

History of epilepsy

Kidney disease

Lack of the chemical G6PD in the blood (G6PD deficiency)

Life long inherited blood diseases which can cause a variety of symptoms, including mental health problems (porphyrias)

Liver disease

Psoriasis

Not to be used in

No known conditions

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

High doses of this medicine, eg to treat rheumatoid arthritis, during pregnancy may be harmful to a developing baby and should only be used if the potential benefits outweigh the risks to the foetus. The situation is different for low doses used to prevent malaria, and this medicine has a long history of safe use for preventing malaria during pregnancy. However, it should only be used after seeking medical advice from a doctor. Pregnant women who cannot avoid travel to malarious areas must take effective measures to prevent malaria and be diligent with measures to avoid mosquito bites.

This medicine passes into breast milk, but in doses taken to prevent malaria is not harmful to a nursing infant. However, the amount of medicine that passes into the milk is not sufficient to prevent malaria in the nursing infant and the child will also need to be given antimalarial medicine. You should seek medical advice from your doctor or pharmacist with regards to what medicine and what dose to give. If you are taking this medicine for reasons other than preventing malaria you should consult your doctor before breast feeding.

Label warnings

Do not take indigestion remedies at the same time of day as this medication.

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