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Guidelines on travel during pregnancy

Chloroquine to Prevent Malaria
Where is Chloroquine used?

Chloroquine (trade names include Nivaquine and Avloclor) is used to prevent malaria in areas where resistance has not developed to its effectiveness. It is now only considered effective in Argentina and Paraguay in South America, Central American regions north of the Panama Canal, the island of Hispaniola (Haiti and the Dominican Republic), some isolated rural parts of China, and some Middle Eastern countries. Resistance to chloroquine continues to increase so medical advice should always be sought to make sure it is the most appropriate malaria prevention medication for your travels. Most malaria experts no longer recommend using chloroquine in India or other countries in southern Asia as it is becoming less effective, even when taken with proguanil (trade names include Paludrine). What are the side-effects of chloroquine?
It is generally regarded as safe and you do not need a prescription in the UK to obtain it. In terms of side-effects, chloroquine can give minor stomach upsets, occasional headaches, dizziness and blurred vision. More details of side-effects can be found in the Patient Information Leaflet accompanying the medication. Chloroquine can make psoriasis worse and should be avoided if there is a history of epilepsy. In many people with black skin chloroquine causes troublesome itching. Prolonged use of chloroquine (e.g. over 5 years) can, in rare cases, affect eyesight. This usually only occurs if you have taken more than 2 tablets per week. If you are concerned, a slit-lamp examination can be carried out by an ophthalmologist. Chloroquine is regarded as safe to take during pregnancy and breastfeeding. It is also safe for children to take, and a chloroquine syrup is available in some countries. Current Guidelines from the Advisory Committee on Malaria Prevention for UK Travellers (ACMP) concluded that there were no problems with the long-term use over several years of chloroquine. How should chloroquine be taken?
Chloroquine should be taken weekly as two (150mg base) tablets. It is best taken with food. Start taking chloroquine one week before entering a malarious area, continue taking whilst there and for 4 weeks after leaving. Information listed below comes from the ACMP “Guidelines for malaria prevention in travellers from the United Kingdom for 2007”. Variation in doses does exist between Patient Information Leaflets and other authoritative sources. Chloroquine 150mg base: 2 tablets per week Chloroquine is available as a syrup (Nivaquine) for young children as well as tablets. Trade Names
Chloroquine is sold under a number of different trade names around the world including: Aralen, Avloclor, Delagil, Imagon, Malarivon, Nivaquine, Resochin, Tresochin. Which antimalarials are more effective?
For most of tropical Africa, South East Asia, the Pacific Islands and the Amazon rainforest mefloquine (Lariam), doxycycline and Malarone are considerably more effective. InterHealth has produced information sheets available on each of these drugs. Remember that you must also take every precaution to avoid being bitten by mosquitoes. Further Guidance and Information
More information can be found in: The Traveller’s Good Health Guide’, Ted Lankester; 3rd Edition 2006 Copyright InterHealth
While InterHealth endeavours to ensure that the information published in this guidance note is correct, InterHealth does not warrant the accuracy and completeness of the material in this guidance note. The information in this guidance note is for information only and should not be used for self diagnosis or self treatment. Readers are always encouraged to seek medical help from a doctor or other competent professional health adviser.

Source: http://www.interhealthworldwide.org/informationSheets/70/Chloroquine%20to%20Prevent%20Malaria.pdf

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