Chloroquine, a drug known for its antimalarial properties, is generating increasing interest, particularly in treatments for various conditions. Although its efficacy against certain autoimmune diseases and in the prevention of malaria has been established, its use in other contexts, such as with Covid-19, has raised many questions. The potential side effects and contraindications of chloroquine require special attention. A thorough understanding of the risks associated with this molecule is essential for its safe and responsible prescription.

Chloroquine is a drug that was previously used for the treatment of malaria and certain autoimmune diseases. Its prescription, particularly in the current context related to the Covid-19 pandemic, has raised many questions about its side effects and contraindications. This article aims to clarify these essential elements to ensure adequate and safe use of the medication.

Origin and indications of chloroquine

Chloroquine, first approved in the 1940s, has been a cornerstone in the fight against malaria. Its use has since expanded to other conditions such as rheumatoid arthritis and systemic lupus erythematosus. This medication is generally administered in tablets, by oral route, allowing for rapid absorption. It works by interfering with the reproductive mechanisms of the parasite responsible for malaria in the human body.

Its use has recently sparked renewed interest in the context of Covid-19 treatment. However, chloroquine is not approved for this indication, and several studies are seeking to determine its true efficacy against the coronavirus.

Side effects of chloroquine

Like any medication, chloroquine is not exempt from side effects. Among the most common side effects are:

• Digestive disturbances: Patients may experience nausea, vomiting, or diarrhea, although these symptoms are generally mild.
• Hypoglycemia: This medication can cause a severe drop in blood glucose levels, an effect that must be closely monitored in diabetic patients.
• Sleep disturbances: Some patients report difficulties falling asleep or nightmares.
• Itching, headaches, and allergic reactions may also occur.

It is crucial to note that one of the most serious side effects concerns retinal health. An overdose or prolonged use of chloroquine can lead to retinal toxicity, making regular ophthalmological examinations necessary. This monitoring is particularly important for patients with a history of eye diseases.

Contraindications of chloroquine

The use of chloroquine is subject to several contraindications that must be strictly adhered to. These include:

• Known allergies to chloroquine components, which may cause severe skin reactions.
• Retinal diseases, as the administration of chloroquine in this case could worsen the condition.
• Cardiopathies: Patients with a history of heart disease must be cautious, as chloroquine can induce arrhythmias and other cardiovascular complications.
• Liver or kidney insufficiency: In these situations, the drug’s metabolism and elimination may be impaired, increasing the risk of side effects.

Moreover, chloroquine is not recommended for pregnant or breastfeeding women, mainly due to the potential risk of harmful effects on the fetus or infant. Chloroquine crosses the placental barrier and can be found in breast milk. It is imperative that women planning a pregnancy or already pregnant avoid its use without thorough medical consultation.

The potential risks of drug interactions must also be considered. Chloroquine can interact with other medications, increasing the risk of side effects. Therefore, doctors must evaluate all of a patient’s prescriptions before initiating treatment with chloroquine.

Anticipated conclusion on chloroquine

Chloroquine represents a medication with a long history of use. In the context of medical treatments, it must be used with caution, considering its varied side effects and specific contraindications. Doctors must ensure that patients fully understand these risks before prescribing this medication. Remember that prescription decisions should always be based on a rigorous assessment of the benefits versus the risks associated with each patient.

Frequently asked questions about medical prescription and chloroquine

Q : What is chloroquine?

A : Chloroquine is an antimalarial medication used to treat malaria and certain autoimmune diseases, although it is prescribed less frequently due to parasite resistance.

Q : What is the difference between chloroquine and hydroxychloroquine?

A : Hydroxychloroquine is a derivative of chloroquine, considered to be less toxic and better tolerated. It is primarily used in the treatment of diseases such as rheumatoid arthritis and systemic lupus erythematosus.

Q : What are the main side effects of these medications?

A : Side effects include digestive disturbances (nausea, vomiting, diarrhea), severe hypoglycemia, and ophthalmic issues. Regular monitoring of the retina is necessary, as well as cardiac follow-up due to arrhythmia risks.

Q : What are the contraindications for using chloroquine and hydroxychloroquine?

A : Contraindications include retinal diseases, certain chronic conditions, and interactions with specific treatments. These medications should not be taken without prior medical consultation.

Q : Can pregnant women take chloroquine?

A : Chloroquine and hydroxychloroquine are generally not recommended during pregnancy or breastfeeding due to potential risks to the fetus and the infant.

Q : Which patients may benefit from these medications in the context of Covid-19?

A : These medications may be used in patients tested positive for Covid-19 with pneumonia requiring respiratory assistance, but only under strict medical supervision.

Q : What precautions should be taken when prescribing chloroquine?

A : An electrocardiogram is recommended before starting treatment, as well as regular monitoring of cardiac function during treatment to avoid complications.