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The 4-aminoquinoline compounds are very rapidly and completely absorbed after ingestionand in accidental overdosageor rarely with lower doses in hypersensitive patientstoxic symptoms may occur within 30 minutesThe symptoms of overdosage may include headachedrowsinessvisual disturbancescardiovascular collapseconvulsionshypokalemiarhythm and conduction disorders including QT prolongationtorsade de pointeventricular tachycardia and ventricular fibrillationfollowed by sudden potentially fatal respiratory and cardiac arrestImmediate medical attention is requiredas these effects may appear shortly after the overdoseTreatment is symptomatic and must be prompt with immediate evacuation of the stomach by emesisat homebefore transportation to the hospitalor gastric lavage until the stomach is completely emptiedIf finely powderedactivated charcoal is introduced by the stomach tubeafter lavageand within 30 minutes after ingestion of the tabletsit may inhibit further intestinal absorption of the drugTo be effectivethe dose of activated charcoal should be at least five times the estimated dose of hydroxychloroquine ingestedConvulsionsif presentshould be controlled before attempting gastric lavageIf due to cerebral stimulationcautious administration of an ultrashort-acting barbiturate may be tried butif due to anoxiait should be corrected by oxygen administrationartificial respiration orin shock with hypotensionby vasopressor therapyBecause of the importance of supporting respirationtracheal intubation or tracheostomyfollowed by gastric lavagemay also be necessaryExchange transfusions have been used to reduce the level of 4-aminoquinoline drug in the blood.

In adults400 mg310 mg baseon exactly the same day of each weekIn infants and childrenthe weekly suppressive dosage is 5 mgcalculated as baseper kg of body weightbut should not exceed the adult dose regardless of weight.

Not for treating complicated malariaNot effective against chloroquineor hydroxychloroquine-resistant strainsNot for preventing relapses of Pvivax or PovaleNot for treatment and prophylaxis in chloroquine-resistant areas.

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Usage of this drug during pregnancy should be avoided except in the suppression or treatment of malaria when in the judgment of the physician the benefit outweighs the possible hazardIt should be noted that radioactively-tagged chloroquine administered intravenously to pregnantpigmented CBA mice passed rapidly across the placentaIt accumulated selectively in the melanin structures of the fetal eyes and was retained in the ocular tissues for five months after the drug had been eliminated from the rest of the body.

In adultsfrom 400 mg to 600 mg310 mg to 465 mg basedailyeach dose to be taken with a meal or a glass of milkIn a small percentage of patientstroublesome side effects may require temporary reduction of the initial dosageLaterusually from five to ten daysthe dose may gradually be increased to the optimum response leveloften without return of side effects.

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