Hi doc, please is it safe to use chloroquine tab during pregnancy? Thanks
A: Is chloroquine safe in pregnancy? Well, there’s no clear evidence that it is unsafe in pregnancy when taken in the normal therapeutic doses. But there is, of course, the issue of chloroquine resistance.
You didn’t mention if you wanted to take chloroquine for prevention or for treatment I will address both.
Fansidar, which is a specific brand of the drug Sulphadoxine-Pyrimethamine (SP) is used for the prevention of malaria in pregnancy. Its use for this is referred to as Intermittent Preventive Treatment of Malaria in pregnancy (IPTp-SP). In the first trimester, it is not recommended for use but from the second trimester, it is considered appropriate and indeed is recommended by World Health Organization (WHO) for administration to pregnant women. If you live in a malaria endemic area like Nigeria, your doctor will ensure that you get your Intermittent Preventive Treatment (IPT) courses for malaria (sulphadoxine-pyrimethmine) during your pregnancy, as your doctor has already done. The assumed rule before was for pregnant women to receive 2 doses of this drug (full dose of 3 tablets) but WHO has since clarified that the appropriate regimen is for women to receive the full dose of Sulphadoxine-Pyrimethamine from week 13 of pregnancy. She should get a full dose at every antenatal visit provided the last dose was taken at least one month before. There is evidence that women who received 3 or more doses of IPTp had children with higher average birth weights than those who got 2 doses.
Your doctor will ensure that the Folic Acid dose you’re getting in your prenatal drugs is not more than 0.4mg (the usual amount in most over-the-counter folic acid tablets). Doses of Folic Acid higher than or equal to 5mg affects the efficacy of the anti-malarial, SP. So, be sure to check with your doctor before you start buying other non-prescribed prenatal vitamins.
If you do have malaria Quinine, Clindamycin, Proguanil are considered safe by the WHO treatment guideline in the first trimester. But, don’t be quick to go take any of them without prescription. Remember that every drug is a potential toxin and your doctor is really in the best place to weigh potential risks of taking any drug against the potential benefits. To put this in perspective, a recent study appears to now suggest that acetaminophen (the main ingredient in paracetamol) may lead to Attention Deficit Disorder in children! And yet, we refer to it as ‘ordinary’ paracetamol. There is nothing ordinary about any drug, my friends J
Doing all of the above will be meaningless if you do not pay any attention to the environment.
Those anopheles mosquitoes that are associated with malaria need a place to lay eggs so they can muster the right army to wreak havoc. So deprive them of a breeding camp. Who would know the conditions necessary for a terrorist camp to be set up and make their homes or environment, the right one for that? Nobody…in their right minds at least
If you have to go out in the evenings, depending on whether you will be out in mosquito infested areas, wear protective clothing that cover arms and legs, preferably in light colours. Mosquitoes love dark colours and the dark….no wonder their deeds are evilInsect repellent creams used on exposed areas are also not a bad idea.
Have a good night y’all 😀