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| Chloroquine
phosphate Injection IP |
L
A R I A G O |
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| DESCRIPTION |
| Chloroquine
is 4-aminoquinoline antimalarial drug. It is a rapid acting
blood schizontocide. |
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| COMPOSITION |
| Lariago
Injection - 2ml/5ml
Each ml contains chloroquine phosphate IP 64.5mg
(equivalent to 40mg of chloroquine base)
Chloroquine Phosphate Injection IP
Lariago 30ml
Each ml contains chloroquine phosphate IP 64.5mg
equivalent to chloroquine 40mg
Benzyl alcohol IP 2% v/v (as preservative) |
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| INDICATIONS |
LARIAGO
injectable may be used in the treatment of severe malaria,
especially severe falciparum malaria when Plasmodium falciparum
is sensitive to chloroquine. Unconsciousness, repeated vomiting
and inability to swallow also makes the parenteral treatment
necessary. As soon as the patient's condition permits, the
parenteral therapy with LARIAGO should be replaced by oral
therapy (LARIAGO Tablets/Liquid). |
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| CONTRAINDICATIONS |
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- Hypersensitivity to 4-aminoquinoline compounds or to any
of its derivatives.
- Retinal or visual field changes attributable to the drug
or any other etiology. |
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| PRECAUTIONS |
| Risk
benefit should be considered when the following medical problems
exist:
Severe blood disorders, glucose 6-phosphate dehydrogenase
(G6PD) deficiency, hepatic function impairment, alcoholism
and in patients receiving other hepatotoxic drugs, severe
neurological disorders, porphyria, psoriasis and presence
of retinal or visual field changes. |
| Usage
in pregnancy and lactation |
| Chloroquine
crosses the placenta. Safe use of chloroquine during pregnancy
has not been definitely established and the drug should be
used in pregnant women only when clearly needed.
However, chloroquine has been used for treatment of malaria
in pregnant women without evidence of adverse effects on the
fetus and as per WHO experts, the benefits of chloroquine
therapy in pregnant women suffering from malaria outweigh
the potential risks of the drug to the fetus.
Small amounts of chloroquine and desethylchloroquine are distributed
into breast milk. Because of the potential for serious adverse
effects from chloroquine in nursing infants, a decision should
be made whether to discontinue nursing or to discontinue the
drug, taking into account the importance of the drug to the
woman. |
| Usage
in paediatrics |
| Children
are extremely susceptible to overdosage of parenteral chloroquine.
Severe reactions and sudden death have been reported following
parenteral administration of chloroquine in children. If chloroquine
injection is given intravenously in pediatric patients, it
should be diluted and administered very slowly by intravenous
infusion. Oral therapy is preferred and should be initiated
as soon as possible. |
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| ADVERSE
EFFECTS |
| Cardiovascular
reactions : Hypotension, ECG changes, cardiomyopathy
(rare).
CNS reactions : Mild transient headache, psychic
stimulation, psychotic episodes, convulsions (rare).
GI reactions : Anorexia, nausea, vomiting, diarrhoea,
abdominal cramps.
Ophthalmic - Irreversible retinal
damage, visual disturbances, nyctalopia, scotomatous vision
with field defects.
Miscellaneous - Agranulocytosis,
blood dyscrasias, hair loss, pruritus, neuromyopathy, lichen
planus like eruptions, skin/mucosal pigment changes, pleomorphic
skin eruptions. A few cases of a nerve-type deafness have
occurred after prolonged high doses. |
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| DOSAGE
AND ADMINISTRATION |
| For
adults and children the initial dose of 10mg/Kg (base) should
be administered over a period of not less than 8 hours by
very slow intravenous infusion. Subsequent infusions of 5mg/Kg
(slowly over 8 hours) should be administered every 8 hours
until a total dose of 25mg/Kg has been given.
NaCl 0.9% (Normal saline) is used as a diluent.
Infusions should be discontinued as soon as the patient is
able to take chloroquine by mouth.
Excessive rapid administration results in toxic peak plasma
concentrations and a danger of fatal cardiovascular collapse.
Respiratory depression, hypotension, cardiovascular collapse
and seizures can follow excessively rapid parenteral administration.
Hence, very slow IV infusion is recommended
Where facilities for intravenous infusion are not available,
chloroquine can be administered by intramuscular or subcutaneous
injection at a dosage of 2.5mg/Kg every 4 hours or 3.5mg/Kg
every 6 hours until a total of 25mg/Kg has been given.
Intramuscular injection (Ampoules & Vials) LARIAGO should
be given deep intramuscularly (outer and upper quadrant of
the gluteal muscle) and slowly. The injectable dose should
be divided between two injection sites. After the injection
the patient should rest for 15 to 30 minutes. |
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| Storage |
| Store
in cool dry dark place. |
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| Presentation |
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Ampoule
of 2ml and 5ml (IM/IV*)
Vial of 30ml (For IM use only)
* IV use by very slow intravenous infusion
only
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