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Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations
Vangelis Karalis1, George Ismailos2, Eleni Karatza1
1Laboratory of Biopharmaceutics-Pharmacokinetics, School of Health Sciences, National and Kapodistrian University of Athens, Greece.
Safety Science
|June 6, 2020
Summary
Chloroquine use for COVID-19 pneumonia has safety concerns due to dosing. This study analyzes chloroquine
Area of Science:
- Pharmacology and Toxicology
- Infectious Diseases
- Clinical Medicine
Background:
- No specific treatment for SARS-CoV-2 exists, leading to widespread chloroquine use.
- Chloroquine use for COVID-19 pneumonia is associated with safety concerns, particularly regarding dosing.
- Lack of clear dosing information for chloroquine necessitates safety evaluations.
Purpose of the Study:
- Critically appraise safety information for chloroquine treatment.
- Utilize simulation techniques to link adverse events with chloroquine overdosing.
- Propose optimized chloroquine dosage regimens for improved safety.
Main Methods:
- Critical appraisal of existing chloroquine safety data.
- Application of simulation techniques to analyze dose-related adverse events.
- Identification of maximum tolerated doses and concentration levels.
Main Results:
- Chloroquine treatment can cause severe adverse effects, including QT interval prolongation and cardiomyopathy.
- Overdosing may lead to pulmonary edema, respiratory insufficiency, and circulatory collapse.
- Co-administration with drugs like azithromycin increases risks; elderly patients require dose reduction.
Conclusions:
- Widely used chloroquine dosing regimens pose risks, with serious adverse events linked to dosing.
- Simulation-based analysis identifies safer alternative dosage regimens.
- Recommendations for optimized chloroquine dosing are provided to mitigate risks.
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