Last update March 12, 2022

Chloroquine

Compatible

Safe substance and/or breastfeeding is the best option.

Derived from aminoquinolone. Indicated in the treatment of malaria, hepatic amebiasis, HIV, rheumatoid arthritis, systemic lupus erythematosus and sarcoidosis, among other pathologies. Oral or intravenous administration.

It is excreted in human milk in a clinically non-significant amount. (Law 2008, Edstein 1986, Deturmeny 1984)

No problems have been observed in infants whose mothers took it. (Chen 2010)

It is an authorized medication for infants from 4 weeks of age (BNF 2018). Since mefloquine can be safely prescribed to young infants, exposure to the small amount excreted in the mothers’ milk is also safe. (CDC 2019)

Avoid in glucose-6-phosphate-dehydrogenase deficiency. Monitor for jaundice during the neonatal period and in the event of prematurity.

Various medical societies, expert authors, and expert consensus consider the use of this medication safe during breastfeeding(Hale, CDC 2019, Saito 2018, Lalloo 2016, Lawrence 2016 p464 and 784, Götestam 2016, Levy 2016, Briggs 2015, Schaefer 2015, WHO 2010, Zrour 2010, Chen 2010, Law 2008, Østensen 2006, Fulton 1992)

WHO List of Essential Medicines: compatible with breastfeeding. (WHO 2002)

American Academy of Pediatrics: medication usually compatible with breastfeeding. (AAP 2001)

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Chloroquine is also known as


Chloroquine in other languages or writings:

Group

Chloroquine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Chloroquine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 52 - 100 %
Molecular weight 320 - 516 daltons
Protein Binding 55 (46 - 74) %
VD 200 - 800 l/Kg
pKa 10.1 -
Tmax 2.7 - 6.9 hours
T½ 72 - 291 hours
M/P ratio 0.4 -
Theoretical Dose 0.18 (0.03 - 0.42) mg/Kg/d
Relative Dose 2.6 (0.4 - 6.0) %
Ped.Relat.Dose 2.1 (0.36 - 5.1) %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  2. CDC. Centers for Disease Control and Prevention. Tan K, Arguin PM. Chapter 4. Travel-Related Infectious Diseases. Malaria. CDC Health Information for International Travel. 2019 Full text (link to original source)
  3. Saito M, Gilder ME, McGready R, Nosten F. Antimalarial drugs for treating and preventing malaria in pregnant and lactating women. Expert Opin Drug Saf. 2018 Nov;17(11):1129-1144. Abstract Full text (link to original source) Full text (in our servers)
  4. BNF. British National Formulary for Children 2018-2019 2018
  5. Lalloo DG, Shingadia D, Bell DJ, Beeching NJ, Whitty CJM, Chiodini PL; PHE Advisory Committee on Malaria Prevention in UK Travellers.. UK malaria treatment guidelines 2016. J Infect. 2016 Jun;72(6):635-649. Abstract Full text (link to original source)
  6. Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016 May;75(5):795-810. Abstract Full text (link to original source) Full text (in our servers)
  7. Levy RA, de Jesús GR, de Jesús NR, Klumb EM. Critical review of the current recommendations for the treatment of systemic inflammatory rheumatic diseases during pregnancy and lactation. Autoimmun Rev. 2016 Abstract
  8. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  9. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  10. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  11. WHO. Guidelines for the treatment of malaria. 2nd ed. Geneva: WHO, 2010 2nd ed. Geneva: WHO, 2010 Full text (link to original source) Full text (in our servers)
  12. Zrour-Hassen S, Jguirim M, Aouam K, Korbaa W, Younes M, Bejia I, Touzi M, Bergaoui N. [Safety of rheumatic disease drugs at childbearing age]. Therapie. 2010 Abstract
  13. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  14. Pérez JL, Carranza C, Mateos F. Antiparasitarios. Revisión de los fármacos útiles en el tratamiento de parasitosis clásicas y emergentes. \ [Antiparasitic drugs. Review of the useful drugs in the treatment of classic and emergent parasitic diseases]. Rev Esp Quimioter. 2009 Jun;22(2):93-105. Review. Spanish. Abstract Full text (link to original source) Full text (in our servers)
  15. Law I, Ilett KF, Hackett LP, Page-Sharp M, Baiwog F, Gomorrai S, Mueller I, Karunajeewa HA, Davis TM. Transfer of chloroquine and desethylchloroquine across the placenta and into milk in Melanesian mothers. Br J Clin Pharmacol. 2008 May;65(5):674-9. Abstract
  16. Østensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H, Doria A, Rai R, Meroni P, Cetin I, Derksen R, Branch W, Motta M, Gordon C, Ruiz-Irastorza G, Spinillo A, Friedman D, Cimaz R, Czeizel A, Piette JC, Cervera R, Levy RA, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006 Abstract Full text (link to original source) Full text (in our servers)
  17. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  18. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  19. Ducharme J, Farinotti R. Clinical pharmacokinetics and metabolism of chloroquine. Focus on recent advancements. Clin Pharmacokinet. 1996 Oct;31(4):257-74. Review. Abstract
  20. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Abstract
  21. Akintonwa A, Gbajumo SA, Mabadeje AF. Placental and milk transfer of chloroquine in humans. Ther Drug Monit. 1988;10(2):147-9. Abstract
  22. Ette EI, Essien EE, Ogonor JI, Brown-Awala EA. Chloroquine in human milk. J Clin Pharmacol. 1987 Jul;27(7):499-502. Abstract
  23. Ogunbona FA, Onyeji CO, Bolaji OO, Torimiro SE. Excretion of chloroquine and desethylchloroquine in human milk. Br J Clin Pharmacol. 1987 Apr;23(4):473-6. Abstract Full text (link to original source)
  24. Edstein MD, Veenendaal JR, Newman K, Hyslop R. Excretion of chloroquine, dapsone and pyrimethamine in human milk. Br J Clin Pharmacol. 1986 Dec;22(6):733-5. Abstract Full text (link to original source)
  25. Deturmeny E, Viala A, Durand A, Nosny Y. [Chloroquine transfer to milk. A case]. Therapie. 1984 Jul-Aug;39(4):438-40. French. No abstract available. Abstract

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