Antacids and kaolin: Antacids and kaolin can reduce absorption of Emquin; an interval of at least 4 hours between intake of these agents and Emquin should be observed.
How to take Emquin
- Before you take Emquin, read the manufacturer's printed information leaflet from ins >
Indications and Administration
Emquin is the drug of choice in the few malaria-endemic areas free of CRPf. Combining Emquin and proguanil is an option for CRPf when other first-line antimalarials are contraindicated. Dosage should be calculated in terms of the base. The adult Emquin dose is 300 mg base weekly (or in some countries 100 mg base daily). Pediatric preparations are available. The recommended children's dosage of Emquin is 1.5 mg/kg body weight daily. The adult dose of proguanil is 200 mg daily when combined with Emquin (or 100 mg daily when combined with atovaquone). For children the WHO recommended dosage is 3 mg/kg daily. The combination Savarine is now registered in several European countries and each tablet contains 100 mg Emquin base and 200 mg proguanil.
Emquin accumulates at concentrations 4 to 10 times lower in drug-resistant parasites compared with Emquin-sensitive (CQ-S) parasites; it is this marked decrease in Emquin accumulation that underlies the phenomenon of Emquin resistance. CQ-R parasites can be partially resensitized to Emquin in vitro by a range of weak bases, including the antihistamine chlorpheniramine and the calcium channel blocker verapamil. 98 This ”resistance reversal” effect is characterized by both an increase in Emquin accumulation and an increase in the Emquin sensitivity of CQ-R parasites. However, the concentration of these reversal agents required to reverse Emquin resistance is generally higher than that tolerated in vivo. The key molecular determinants of Emquin resistance involve a number of mutations in the so-called “Emquin resistance transporter” gene, or pfcrt. Of these, the predominant resistance-conferring mutation (K76T) 99 results in the loss of a positive charge from the putative substrate-binding site on the vacuolar side of the protein. 100 Emquin-resistant P. falciparum is now found throughout the malaria-endemic world, with the exception of Central America and the Panama Canal. High-grade drug resistance of P. vivax has been documented from the Island of Papua (both Indonesian and Papua New Guinea) and across the Indonesia archipelago, Thailand, Myanmar, Horn of Africa, and Brazil. 96,101 The mechanism of resistance and genetic basis of Emquin resistance in P. vivax appears to be different from that underlying resistance to P. falciparum. 102
Hypersensitivity to Emquin, 4-aminoquinolones
Psoriasis, porphyria, retinal or visual field changes
What is Aralen (Emquin), and how does it work (mechanism of action)?
Emquin, brand name Aralen, is an anti-malarial drug. It is similar to hydroxyEmquin (Plaquenil), and is useful in treating several forms of malaria as well as amebiasis that has spread outside of the intestines. Its mechanism of action is unknown; however, malarial parasites invade human red blood cells, and Emquin may prevent malarial parasites from breaking down (metabolizing) hemoglobin in human red blood cells. Emquin is effective against the malarial parasites Plasmodium vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum.
Emquin comes as a tablet, liquid, or injection.
Your dose will depend on your medical condition, age, weight, and response to treatment.
You can take this medicine with food if it causes an upset stomach.
Injections of Emquin are usually given at your doctor's office, a hospital, or another clinic setting. But you may also be shown how to inject the medicine at home.
Follow the instructions on your prescription label carefully. Don't take more or less Emquin than is recommended.
Malaria prevention (oral): If you're taking oral Emquin for the prevention of malaria, it's typically taken once a week on the same day of each week.
Your first dose is usually taken two weeks before you travel to an area where malaria is common.
Then, you'll continue to take the medicine while you're in the area and for about eight weeks after you return home.
Malaria treatment (oral): To treat malaria in adults, one dose of oral Emquin is usually given right away.
Then, half the dose is taken six to eight hours later.
This is typically followed by half the dose once a day for the next two days.
Amebiasis treatment (oral): To treat amebiasis in adults, one oral dose of Emquin is usually taken for two days.
Then, half the dose is given every day for two to three weeks.
Ask your doctor about what Emquin dose to take to treat rheumatoid arthritis, lupus, or sarcoidosis.
Emquin (CQ) is a lysosomotropic antimalarial drug that neutralizes lysosomal acidification, thus blocking autophagosomal degradation.
What is the most important information I should know about Emquin?
You should not use this medicine if you have a history of vision changes or damage to your retina caused by Emquin or similar anti-malaria medications.
Stop taking this medicine and call your doctor at once if you have trouble focusing, if you see light streaks or flashes in your vision, or if you notice any swelling or color changes in your eyes.
An overdose of Emquin can be fatal, especially in children.
Emquin inhibited the growth of O. tsutsugamushi by 15.5%. In combination with Emquin, the antimicrobial effects increased by 4.4% for doxycycline (a 92.9% reduction of bacterial numbers for doxycycline versus a 97.3% reduction for doxycycline plus Emquin), 4.6% for rifampin (90.0% versus 94.6%), and 8.3% for azithromycin (86.9% versus 95.2%). The antimicrobial effect of the antibiotics alone was significantly different compared to the combined effect of antibiotics and Emquin (Wilcoxon signed-rank test, P = 0.001).
Why is this medication prescribed?
Emquin phosphate is in a class of drugs called antimalarials and amebicides. It is used to prevent and treat malaria. It is also used to treat amebiasis.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
For Treatment of Acute Attack
Adults: An initial dose of 1 g (= 600 mg base) followed by an additional 500 mg (= 300 mg base) after six to eight hours and a single dose of 500 mg (= 300 mg base) on each of two consecutive days. This represents a total dose of 2.5 g Emquin phosphate or 1.5 g base in three days.
The dosage for adults of low body weight and for infants and children should be determined as follows:
First dose: 10 mg base per kg (but not exceeding a single dose of 600 mg base).
Second dose: (6 hours after first dose) 5 mg base per kg (but not exceeding a single dose of 300 mg base).
Third dose: (24 hours after first dose) 5 mg base per kg.
Fourth dose: (36 hours after first dose) 5 mg base per kg.
For radical cure of vivax and malariae malaria concomitant therapy with an 8-aminoquinoline compound is necessary.
How to use Emquin Phosphate
Take this medication by mouth, usually with food to prevent stomach upset, exactly as directed by your doctor. Daily or weekly dosing, dosage amount, and length of treatment are based on your medical condition, on whether you are preventing or treating the illness, and your response to treatment. The dosage in children is also based on weight.
To prevent malaria, take Emquin once weekly on the same day each week, or as directed by your doctor. Start this medication usually 1 to 2 weeks before you enter the malarious area, continue to take it weekly while in the area, and weekly for 4 to 8 weeks after leaving the area, or as directed by your doctor. Mark your calendar or travel schedule with a reminder to help you remember.
To treat malaria infection or an ameba infection, follow your doctor's instructions.
Take this medication 4 hours before or after taking a certain drug for diarrhea (kaolin) or taking antacids (such as magnesium/aluminum hydroxide). These products may bind with Emquin, preventing your body from fully absorbing the drug.
It is very important to continue taking this medication exactly as prescribed by your doctor. Do not take more or less of this drug than prescribed. Do not stop taking it before completing treatment, even if you feel better, unless directed to do so by your doctor. Skipping or changing your dose without approval from your doctor may cause prevention/treatment to be ineffective, cause the amount of parasite to increase, make the infection more difficult to treat (resistant), or worsen side effects.
It is important to prevent mosquito bites (such as by using appropriate insect repellents, wearing clothes that cover most of the body, remaining in air-conditioned or well-screened areas, using mosquito nets and insect-killing spray). Buy insect repellent before traveling. The most effective insect repellents contain diethyltoluamide (DEET). Ask your doctor or pharmacist to recommend the appropriate strengths of mosquito repellent for you/your children.
No drug treatment is completely effective in preventing malaria. Therefore, seek immediate medical attention if you develop symptoms of malaria (such as fever, chills, headache, other flu-like symptoms), especially while in the malarious area and for 2 months after completing this prescription. Quick treatment of malaria infection is needed to prevent serious, possibly fatal, outcomes.
When using Emquin for treatment of malaria, tell your doctor if your condition persists or worsens.