JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
Generic Drug (Trade name)
Adult Dose
Pediatric Dose
FDA Pregnancy Category*
Start Drug
Stop Drug
Potential Adverse Effects
4 weeks
1 week
C
8 mg/kg
500mg q day
Chloroquine phosphate (Aralen®)
• Widespread world resistence • Prolonged QT interval • Torsades de pointes • Blurred vision • Retinopathy • Pruritus • Exacerbated psoriasis
• Nausea and vomiting possible if taken on an empty stomach
Regions with chloroquine-resistant Plasmodium falciparum malaria
7 days
1-2 days
C
Daily dose by weight: • 1/2 ped tab 5-8kg; • 3/4 ped tab 11-20kg; • 2 ped tabs 21-30kg; • 3 ped tabs 31-40kg; • 1 adult tab >40kg.
250/100mg q day
Atovaquone- proguanil (Malarone®)
• Not recommended during pregnancy, during breast- feeding, or for children weighing less than 5kg. Contraindicated with renal impairment (creatinine clearance <30mL/min).
4 weeks
1-2 days
D
Adult dose > 8yrs. of age
100mg q day
Doxycycline hyclate (Vibramycin® et al.)
• Photosensitivity • Esophagitis • Gastritis
• Vaginal yeast infection • Pediatric dental enamel staining ≤ 8 years of age • Only limited resistance in rural areas of Southeast Asia • Vivid dreams • Nightmares • Altered mood • Prolonged QT interval • Av block • Contraindicated in patients with depression, seizure disorder, and psychosis. testing required. • Gastric irritation • Methemoglobinemia • Contraindicated during pregnancy and breast-feeding unless the infant has normal G6PD levels • Failures in P. vivax therapy reported in patients with hepatic CYP2D6 polymorphisms. •Hemolytic anemia with G6PD deficiency; pretherapy
2-3 days 4 weeks
B
Daily dose by weight: 5mg/kg ≤ 9 kg; 1/4 tab 9-19kg; 1/2 tab 20-30kg; 3/4 tab 31-45kg; adult dose > 45kg.
250mg q week
Mefloquine hydrochloride (Lariam®)
1 days
7 days
Avoid in pregnancy
Two 26.3mg tabs (30mg base) q day
Adult dose
Primaquine phosphate- off-label use (generic only). Not recommened in areas with significant P. falciparum risks.
J La State Med Soc VOL 169 SEPTEMBER/OCTOBER 2017 135
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