Leitura clínica
Comentário
Derivado aminoquinolona. Indicado tratamento paludismo, amebiase hepática, HIV, artrite reumatoide, lúpus eritematoso sistêmico e sarcoidose, entre outras patologias. Administração oral ou intravenosa. Excreta-se no leite materno em quantidade clinicamente não significativa. (Law 2008, Edstein 1986, Deturmeny 1984) Não foram observados problemas em lactentes cujas mães a tomavam. (Chen 2010) É medicação autorizada lactentes a partir 4 semanas vida (BNF 2018). Dado que mefloquina podem prescrever-se maneira segura lactentes pequenos, também é segura exposição pequena quantidade que excreta-se no leite materno. (CDC 2019) Evitar em déficit glicose-6-fosfato-desidrogenase. Vigiar aparição icterícia período neonatal e em caso prematuridade. Diversas sociedades médicas, autores especialistas e consensos especialistas consideram seguro uso desta medicação durante amamentação. (Hale, CDC 2019, Saito 2018, Lalloo 2016, Lawrence 2016 p464 e 784, Götestam 2016, Levy 2016, Briggs 2015, Schaefer 2015, WHO 2010, Zrour 2010, Chen 2010, Law 2008, Østensen 2006, Fulton 1992) Listado medicamentos essenciais OMS: compatível com amamentação. (WHO 2002) Academia Americana Pediatria: medicação usualmente compatível com amamentação. (AAP 2001)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 9
- Fosfato de cloroquina
- Hidrocloruro de cloroquina
- Sulfato de cloroquina
- Χλωροκουΐνη
- كلوروكين
- Хлорохин
- 氯喹
- クロロキン
- P01BA01
Marcas comerciais na fonte 8
- Aralen
- Chlorquin
- Heliopar
- Malarex
- Nivaquine
- Palux
- Resochin
- Resochina
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 52 - 100 | % |
| Peso Molecular | 320 - 516 | daltons |
| Unión proteínas | 55 (46 - 74) | % |
| Vd | 200 - 800 | l/Kg |
| pKa | 10,1 | - |
| Tmax | 2,7 - 6,9 | horas |
| T½ | 72 - 291 | horas |
| Índice L/P | 0,4 | - |
| Dosis Teórica | 0,18 (0,03 - 0,42) | mg/Kg/d |
| Dosis Relativa | 2,6 (0,4 - 6,0) | % |
| Dosis Rel. Ped. | 2,1 (0,36 - 5,1) | % |
Rastreabilidade
Bibliografia
- Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consultado el 10 de Abril de 2024 Texto completo (enlace a fuente original)
- Pluma A, Hamroun S, Rüegg L, Cecchi I, Kramer M, Perez-Garcia LF, Rivero T, Finckh A, Meissner Y, Förger F. Antirheumatic drugs in reproduction, pregnancy, and lactation: a systematic literature review informing the 2024 update of the EULAR recommendations. Ann Rheum Dis. 2025 Sep;84(9):1561-1590. Resumen Texto completo (enlace a fuente original)
- 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 Texto completo (enlace a fuente original)
- Bitencourt N, Bermas BL. Pharmacological Approach to Managing Childhood-Onset Systemic Lupus Erythematosus During Conception, Pregnancy and Breastfeeding. Paediatr Drugs. 2018 Dec;20(6):511-521. Resumen
- BNF. British National Formulary for Children 2018-2019 2018
- 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. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- 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. Resumen Texto completo (enlace a fuente original)
- 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. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- 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 Resumen
- Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
- Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
- 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
- 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. Resumen Texto completo (en nuestros servidores)
- 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 Resumen
- WHO. Guidelines for the treatment of malaria. 2nd ed. Geneva: WHO, 2010 2nd ed. Geneva: WHO, 2010 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- 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. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- 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. Resumen
- 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 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- 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 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Ducharme J, Farinotti R. Clinical pharmacokinetics and metabolism of chloroquine. Focus on recent advancements. Clin Pharmacokinet. 1996 Oct;31(4):257-74. Review. Resumen
- 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. Resumen
- Akintonwa A, Gbajumo SA, Mabadeje AF. Placental and milk transfer of chloroquine in humans. Ther Drug Monit. 1988;10(2):147-9. Resumen
- Ette EI, Essien EE, Ogonor JI, Brown-Awala EA. Chloroquine in human milk. J Clin Pharmacol. 1987 Jul;27(7):499-502. Resumen
- 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. Resumen Texto completo (enlace a fuente original)
- 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. Resumen Texto completo (enlace a fuente original)
- 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. Resumen