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While the usual dose of chloroquine used in treatment is 10 mg/kg, toxicity begins to occur at 20 mg/kg, and death may occur at 30 mg/kg. [24] In children as little as a single tablet can be fatal. [25] [16] Treatment recommendations include early mechanical ventilation, cardiac monitoring, and activated charcoal. [24]
It has a weak blood schizonticidal activity and is not recommended for therapy of acute infection. However it is useful in prophylaxis when combined with atovaquone or chloroquine (in areas where there is no chloroquine resistance). 3 mg/kg is the advised dosage per day, (hence approximate adult dosage is 200 mg). [13]
Eight people are known to have overdosed since the drug's introduction in the mid-1950s, of which three have died. [23] [24] Chloroquine has a risk of death in overdose in adults of about 20%, while hydroxychloroquine is estimated to be two or threefold less toxic. [25]
Chloroquine and hydroxychloroquine are anti-malarial medications also used against some auto-immune diseases. [1] Chloroquine, along with hydroxychloroquine, was an early experimental treatment for COVID-19. [2] Neither drug has been useful to prevent or treat SARS-CoV-2 infection.
It is approved in the United States as a treatment and preventive measure against malaria. [6] The combination is considered to be more effective in treating malaria caused by Plasmodium falciparum than that caused by P. vivax, for which chloroquine is considered more effective, though in the absence of a species-specific diagnosis, the sulfadoxine-pyrimethamine combination may be indicated. [7]
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The neuropsychiatric side effects of the antimalarial drug mefloquine are well documented. They include anxiety, depression, hallucinations, acute psychosis, and seizures. The incidence of these side effects is 1 in 13,000 with prophylactic use and 1 in 250 with therapeutic use.
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