Potential toxicity of chlorpheniramine plus chloroquine for the treatment of childhood malaria.

Abstract

OBJECTIVES:

To compare the adverse effects of two regimens of chlorpheniramine plus chloroquine (CP+CQ) in children who live in a country where chloroquine resistant malaria is endemic.

METHODS:

99 children with acute uncomplicated malaria were randomised into two treatment groups. Group I received high dose chlorpheniramine (6 mg +12 mg/day for 7 days in children = 5 years; 8 mg + 18 mg/day for 7 days in those >5 years) plus chloroquine 10 mg/kg daily for 3 days. Group II received a 50% higher dose of chlorpheniramine plus chloroquine 10 mg/kg daily for 3 days. Outcome measures were vital signs, clinical response and parasite clearance on days 0-7 and day 14.

RESULTS:

Parasite clearance, fever clearance and cure rate were comparable for the two groups. Drowsiness occurred in 66.7% of high dose and 86.3% of higher dose CP+CQ subjects (p = 0.05). Compared to children treated with high dose, those treated with higher dose CP+CQ had significantly lower respiratory rates on day 2 (p = 0.001), day 6 (p = 0.015), and on day 14 (p = 0.003).

CONCLUSION:

The higher rates of drowsiness and lower respiratory rates in children treated with higher dose CP+CQ calls for caution in the clinical application of the higher dose combination. The higher dose has no additional benefit and may in fact be dangerous.

• Authors: A D A Adedapo, O G Ademowo, K S Adedapo, K Demissie, O Y O Osinubi
• Journal: Nigerian journal of clinical practice (Niger J Clin Pract) Vol. 12 Issue 3 Pg. 252-7 (Sep 2009) ISSN: 1119-3077 [Print] India
• PMID: 19803020 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Antimalarials
• Antipruritics
• Chlorpheniramine
• Chloroquine

Topics

• Adolescent
• Antimalarials (administration & dosage, adverse effects, therapeutic use)
• Antipruritics (administration & dosage, adverse effects, therapeutic use)
• Chi-Square Distribution
• Child
• Child, Preschool
• Chloroquine (administration & dosage, adverse effects, therapeutic use)
• Chlorpheniramine (administration & dosage, adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Female
• Humans
• Infant
• Malaria, Falciparum (drug therapy, epidemiology)
• Male
• Nigeria (epidemiology)
• Statistics, Nonparametric
• Treatment Outcome