Agalsidase Beta
Severe
Database
Drug interaction classified as: antagonism
Source: DDInter
Drug reference
Chloroquine
4-aminoquinoline antimalarial / disease-modifying antirheumatic · Antirheumatic
Also known as Chloroquine phosphate, Chloroquine sulfate, Aralen, Resochin, Nivaquine
START
Baseline ophthalmologic exam (visual acuity, fundoscopy, visual fields) if using >3 months. Check glucose (risk of hypoglycemia). Verify malaria strain chloroquine-susceptible.
TYPICAL MAX
Do not exceed 2.5-3mg/kg/day actual body weight for long-term use. Dose >5mg/kg/day increases retinopathy risk exponentially.
STOP IF
Any visual changes, new arrhythmia, severe hypoglycemia, blood dyscrasia, muscle weakness (neuromyopathy).
WATCH
Ophthalmologic screening every 6-12 months with long-term use. ECG if cardiac disease (QT prolongation risk). Monitor blood glucose (especially with diabetes). Drug accumulates in tissues—load adjusts over months.
CDSCO approvedSchedule HJan AushadhiATC P01BA01
KDIGO 2024 + manufacturer label
- ONSET
- 2h · Onset ~2.0 hours
- PEAK
- 4h · Tmax ~3-12 hours
- t½
- 4.3w · Terminal t½ ~30-60 days
- DURATION
- 1w · Weekly prophylaxis dosing
EXCRETION
Renal unchanged (~50%), slow tissue release
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Safe for malaria prophylaxis and treatment in pregnancy (WHO recommended). For autoimmune disease, lowest effective dose preferred—retinal toxicity risk to fetus theoretical but unproven. Crosses placenta.
FDA category + note
Top interactionssee all 12 →
- Agalsidase BetaSevereDatabaseDDInter
- AlfuzosinSevereDatabaseDDInter
- AlimemazineSevereDatabaseDDInter
- AmiodaroneSevereDatabaseKimi deep-research + Cla
Available in India
137 branded formulations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
In malaria: concentrates in parasite food vacuole, inhibiting heme polymerization → toxic free heme accumulation → parasite death. In autoimmune disease: inhibits Toll-like receptor signaling, reduces cytokine production, and stabilizes lysosomal membranes.
Indications
Malaria prophylaxis (Plasmodium falciparum, P. vivax, P. ovale, P. malariae—chloroquine-sensitive strains)Malaria treatment (uncomplicated, chloroquine-sensitive)Extraintestinal amebiasisRheumatoid arthritisSystemic lupus erythematosus (SLE)Discoid lupus erythematosus
Dosing
- Adult
- Malaria prophylaxis: 500mg weekly (300mg base), start 1-2 weeks before travel, continue 4 weeks after. Malaria treatment: 1g (600mg base) PO, then 500mg (300mg base) at 6, 24, and 48 hours. RA/SLE: 150-300mg daily (max 2.5-3mg/kg/day actual body weight); max 400mg/day.
- Pediatric
- Malaria prophylaxis: 5mg/kg base weekly (max 300mg). Malaria treatment: 10mg/kg base, then 5mg/kg at 6, 24, 48h.
- Renal adjustment
- No adjustment for acute malaria; reduce dose 50% if CrCl <10 for long-term use.
- Hepatic adjustment
- Use caution; 50% reduction in severe hepatic impairment.
- Geriatric
- No specific adjustment; increased risk of retinopathy with age—baseline and annual eye exams essential.
- Max dose
- 2.5-3mg/kg/day actual body weight (long-term); max 400mg/day; 1g single dose (treatment)
Pharmacokinetics
Onset
Malaria: symptomatic relief within 24-48 hours; antimalarial effect after first dose
Peak effect
Tmax 3-12 hours; tissue distribution continues for days
Duration
Terminal elimination half-life determines duration: weeks to months
Half-life
α-phase 3-8h; β-phase 40-216h; terminal γ-phase 30-60 days
Bioavailability
~75-90%
Protein binding
50-65%
Metabolism
Hepatic via CYP2C8, CYP3A4/5; major metabolite desethylchloroquine (active)
Excretion
~50% renal unchanged; remainder as metabolites (biliary/renal); slow tissue release
Contraindications
- Hypersensitivity to 4-aminoquinolines
- Retinal or visual field abnormalities (pre-existing)
- Long-term therapy in psoriasis (may exacerbate)
- Porphyria
Side effects
Common
Gastrointestinal upset (nausea, diarrhea, cramps)HeadachePruritus (in dark-skinned patients)Skin discoloration (gray-blue)Insomnia
Serious
- Retinopathy (bull's eye maculopathy—irreversible with long-term use)
- Cardiomyopathy / QT prolongation / torsades de pointes
- Blood dyscrasias (agranulocytosis, aplastic anemia)
- Severe hypoglycemia
- Neuropsychiatric effects (seizures, psychosis)
- Ototoxicity
Pregnancy & lactation
Pregnancy
Safe for malaria prophylaxis and treatment in pregnancy (WHO recommended). For autoimmune disease, lowest effective dose preferred—retinal toxicity risk to fetus theoretical but unproven. Crosses placenta.
Lactation
Excreted in breast milk in small amounts (~2-3% of maternal dose); compatible with breastfeeding for malaria prophylaxis/treatment per WHO. Infant should receive complementary antimalarial prophylaxis.
Drug interactions
Alfuzosin
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Alimemazine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amiodarone
Severe
Database
Additive QT prolongation; risk of torsades de pointes and sudden cardiac death.
Avoid combination; if essential, monitor ECG (QTc) closely. Correct electrolytes (K+, Mg2+).
Source: Kimi deep-research + Cla
Amisulpride
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amitriptyline
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amoxapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Apomorphine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Arsenic Trioxide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Asenapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Astemizole
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Ask House about Chloroquine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19