INDICES> Chloroquine-induced itch (2)

[Kirsten Myhr <myhr@online.no>]

INDICES>Chloroquine-induced itch (2)
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George,

Meyler's side effects of drugs, 14th ed. (2000) says:

Pruritus is not uncommon, begnning about 10 hours after the start of
treatment, with a maximum intensity at about 24 hours. These times
correspond to maximum serum concentrations of chloroquine and its
metabolites after oral ingestion. In many cases the itch is confined to the
palms of the hands and the soles of the feet. In a study in Nigeria, the
incidence of pruritus was 60-75 %; the itch was considered unbearable in
40%, and 30% refused further chloroquine. In a second study there was an
even higher incidence. In a study elsewhere the incidence of pruritus was
27%. Not surprisingly, pruritus is a major cause of non-compliance with
treatment, and it may contribute largely to the emergence and spread of
resistant Plasmodium falciparum. Pruritus is more often seen in
black-skinned than in white-skinned people in Africa, a difference that has
been ascribed to the binding of chloroquine to melanin, and hence a racial
predisposition. No such reports have come from America.

Antihistamine treatment can have a preventive effect on pruritus. Other
treatments that have been mentioned include prednisone and niacin, but the
results were not impressive.

>From this I would conclude that a previous itch is no contraindication and
that there should be no major health problems. The main problem would be
compliance. Prophylactic antihistamines seem to be the action to take.

Kirsten Myhr
Head of Eastern Region Drug Information Centre

RELIS Ost
Ulleval University Hospital
0407 Oslo, Norway
Tel.: +47 23 01 64 11(o)   Fax: +47 23 01 64 10
+47 22 56 05 85 (h)   mobile: +47 416 38 747
myhr@online.no
www.relis.no



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