Delagil

Drug name: Delagil

Other names used:

Aralen®
Avloclor®

Active Ingredients: chloroquine phosphate

Therapeutic actions: Avloclor tablets contain the active ingredient chloroquine phosphate, which is an antimalarial medicine, though it also has other uses, for example, in treating the autoimmune diseases rheumatoid arthritis and lupus erythematosus.
However, chloroquine is no longer recommended for treating falciparum malaria (the most serious kind, caused by a type of malaria parasite called Plasmodium falciparum), because there is widespread resistance of the Plasmodium falciparum parasite to chloroquine.
Chloroquine can be used both to prevent and to treat malaria. For prevention it is usually taken in combination with another antimalarial medicine called proguanil.

Indications:

Prevention of malaria (chloroquine can be bought from pharmacies without a prescription for this purpose; it is not prescribable on the NHS for preventing malaria)
Treatment of malaria
Infection of the liver with Entamoeba histolytica (hepatic amoebiasis or amoebic hepatitis)
Inflammatory disease of the joints (rheumatoid arthritis)
Systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE)

Recomended Dosage: Should be prescribed to you by your physician. An average course for prevention of malaria consists:

First week 2 times a week on tablet 0,5g
Second week and the folowing one tablet 0,5g a week on the same day AVOID MISSING A DOSE because it can result in onset of malaria.
continue your course for 4 weeks after leaving malaria contaminated zone.

Contraindications and cautions:

To prevent malaria this medicine should be taken once a week, on the same day each week, starting one week before travelling to the malarious area. It should be taken regularly thoughout the stay and continued for four weeks after leaving the malarious area.
To prevent malaria it is important that you take this medicine regularly and try not to forget a dose. You may find it helpful to make a note of the day you take your dose in your diary or calender. You must still take precautions to avoid being bitten by mosquitos, such as using mosquito repellants and sleeping under mosquito nets. This is particularly important if you have vomiting or diarrhoea, as this could affect the absorption of this medicine from the gut. If you fall ill within one year of your return, and especially if within three months of your return, you should consult your doctor immediately and let him know that you have visited a country where malaria is endemic.
This medicine may cause visual disturbances when you first start taking it. If affected you should use caution when driving or operating machinary.
This medicine can sometimes cause eye problems when used for long-term treatment (eg for rheumatoid arthritis) . For this reason, you should have an eye examination before you start long-term treatment and then regularly every three to six months while you are taking the medicine. Stop taking this medicine and seek medical advice immediately if you notice any deterioration in your vision that lasts for longer than 48 hours. (These precautions also apply to people who have been taking chloroquine on a continuous basis every week for more than three years to prevent malaria.)
People taking this medicine for long periods of time should also have regular blood tests to monitor the amounts of the different types of blood cells in their blood. This is because chloroquine may rarely cause a decrease in the normal amounts of blood cells in the blood. Consult your doctor if you experience any of the following symptoms while taking this medicine: unexplained bruising or bleeding, purple spots, sore throat, mouth ulcers, high temperature (fever), feeling tired or general illness. Your doctor may want to take a blood test to check your blood cells.

Use with caution in:

Elderly people
Liver disease
Kidney disease
History of epilepsy
Disorders affecting the brain, nerves or spinal cord (neurological disorders)
Abnormal muscle weakness (myasthenia gravis)
Severe gut disorders
Blood disorders
Rare hereditary blood disorders called porphyrias
Lack of the enzyme G6PD in the blood (G6PD deficiency)
Psoriasis

Not to be used in:

Allergy to any ingredient.
People with a history of epilepsy should not take this medicine for preventing malaria.

Adverse effects: Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Disturbances of the gut such as diarrhoea, nausea, vomiting or abdominal pain
Headache
Skin rashes
Itching (pruritus)
Low blood pressure (hypotension), this might make you feel dizzy
Visual disturbances
Loss of hair colour
Hair loss (alopecia)
Fits (convulsions)
Disturbance in the normal numbers of blood cells in the blood
Damage to the retina of the eye (long-term use)
Discolouration of skin, nails, or mucous membranes, eg inside of mouth
Hearing distubances, eg ringing in the ears (tinnitus) or hearing loss
Anxiety, confusion, hallucinations or strange or abnormal thoughts
Weakening of muscles
Weakening of the heart muscle (long-term use at high doses)
Changes in the electrical signals in the heart (seen on an ECG)
Liver disorders

When chloroquine is taken in low doses to prevent malaria it is generally well tolerated and any side effects that are experienced are not normally of a serious nature.
Prolonged use at high doses, eg for treating rheumatoid arthritis, is more likely to be associated with side effects, though you still may not experience any.
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

Interactions: It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Antacids (used to treat indigestion and heartburn) and kaolin reduce the absorption of chloroquine from the gut, which may mean the full dose is not absorbed into the body. To avoid this, antacids and kaolin should not be taken in the two to three hours before or after taking your chloroquine dose.
Cimetidine may prevent the breakdown of chloroquine by the liver and lead to increased levels of chloroquine in the blood. You should avoid taking cimetidine with chloroquine as it may increase the risk of side effects. If you do take cimetidine in combination with chloroquine, let your doctor or pharmacist know if you experience any new or increased side effects.
Chloroquine may increase the blood level of the following medicines, which may result in an increased risk of their side effects:

ciclosporin
digoxin.

There may be a risk of abnormal heart rhythms if chloroquine is taken in combination with any of the following medicines:

medicines for abnormal heart rhythms, eg amiodarone, quinidine
the antihistamines terfenadine and astemizole
halofantrine
mefloquine
certain antipsychotics, eg chlorpromazine, thioridazine
certain antidepressants, eg imipramine, amitriptyline, maprotiline
moxifloxacin

There may be an increased risk of convulsions (fits) if chloroquine is taken with mefloquine.
Chloroquine may reduce the effectiveness of the rabies vaccine. If you need to have a rabies vaccine you should have it before you start taking chloroquine.
Chloroquine may reduce the effectiveness of neostigmine or pyridostigmine for treating myaesthenia gravis.

Additional Information: DO NOT SHARE THIS MEDICINE with others. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT, as well as syringes and needles, if needed during treatment, out of the reach of children. Do not reuse needles, syringes, or other materials.