3 ms·

>Patients were given 600mcg per day for 10 days. Did they really mean micrograms or is this a mistranslation of milligrams? 600mcg is much lower than any dose

by mrob 7y ago

>Patients were given 600mcg per day for 10 days. Did they really mean micrograms or is this a mistranslation of milligrams? 600mcg is much lower than any dose I've heard of for other conditions.

ibejoeb 7y ago
I'm sure it's mg. There is a similar experiment from Melbourne that cites similar dosage. I'll try to find it. Also, it looks like there is a US clinical trial of chloriquine to start in May: https://clinicaltrials.gov/ct2/show/NCT04303507 https://clinicaltrials.gov/ct2/show/NCT04303507
ComputerGuru 7y ago
EDIT: this source [0] seems to confirm that it is indeed milligrams, but I don't understand how any of this jives with what I found earlier from the FDA on therapeutic index and overdosing. [0]: https://docs.google.com/document/d/e/2PACX-1vTi-g18ftNZUMRAj2SwRPodtscFio7bJ7GdNgbJAGbdfF67WuRJB3ZsidgpidB2eocFHAVjIL-7deJ7/pub https://docs.google.com/document/d/e/2PACX-1vTi-g18ftNZUMRAj... See the original comment with my findings from the FDA below, however. --- I don't think it's a mistake. 600mg per day is 14x the recommended dosage for malarial suppression with cholorquine. Per the FDA, the dosage is 300mg of chloroquine per week for malarial suppression: > Adult Dose: 500 mg (=300 mg base) on exactly the same day of each week. For children: > The weekly suppressive dosage is 5 mg calculated as base, per kg of body weight, but should not exceed the adult dose regardless of weight. Source: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/006002s043lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/00... Additionally, it seems that it is incredibly easy to fatally overdose on this: > Chloroquine is very rapidly and completely absorbed after ingestion. Toxic doses of chloroquine can be fatal. As little as 1 g may be fatal in children. Toxic symptoms can occur within minutes. These consist of headache, drowsiness, visual disturbances, nausea and vomiting, cardiovascular collapse, shock and convulsions followed by sudden and early respiratory and cardiac arrest. Hypokalemia has been observed with arrhythmias in cases of intoxication. The electrocardiogram may reveal atrial standstill, nodal rhythm, prolonged intraventricular conduction time, and progressive bradycardia leading to ventricular fibrillation and/or arrest. Cases of extrapyramidal disorders have also been reported in the context of chloroquine overdose (see WARNINGS and ADVERSE REACTIONS) See also this paper about known cases of overdose in kids: https://pediatrics.aappublications.org/content/27/1/95.long?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token https://pediatrics.aappublications.org/content/27/1/95.long?... Note that is for all for cholorquine base, not chloroquine phosphate which is ~60% choloroquine.
bertil 7y ago
In the video he says that his hospital and Korea use 600 mg/d and that Chinese authors mention two times 500 mg per day. He describes that larger treatment as “harder to handle” and I suspect he’s referring to secondary effects.
- deleted 7y ago
  [deleted]
- jaclaz 7y ago
  The tests suggested in Italy also use a 500 mg per day dose, see article linked to here: https://news.ycombinator.com/item?id=22616404 https://news.ycombinator.com/item?id=22616404

by mrob 7y ago

>Patients were given 600mcg per day for 10 days. Did they really mean micrograms or is this a mistranslation of milligrams? 600mcg is much lower than any dose I've heard of for other conditions.

ibejoeb 7y ago

I'm sure it's mg. There is a similar experiment from Melbourne that cites similar dosage. I'll try to find it. Also, it looks like there is a US clinical trial of chloriquine to start in May: https://clinicaltrials.gov/ct2/show/NCT04303507 https://clinicaltrials.gov/ct2/show/NCT04303507

ComputerGuru 7y ago

EDIT: this source [0] seems to confirm that it is indeed milligrams, but I don't understand how any of this jives with what I found earlier from the FDA on therapeutic index and overdosing. [0]: https://docs.google.com/document/d/e/2PACX-1vTi-g18ftNZUMRAj2SwRPodtscFio7bJ7GdNgbJAGbdfF67WuRJB3ZsidgpidB2eocFHAVjIL-7deJ7/pub https://docs.google.com/document/d/e/2PACX-1vTi-g18ftNZUMRAj... See the original comment with my findings from the FDA below, however. --- I don't think it's a mistake. 600mg per day is 14x the recommended dosage for malarial suppression with cholorquine. Per the FDA, the dosage is 300mg of chloroquine per week for malarial suppression: > Adult Dose: 500 mg (=300 mg base) on exactly the same day of each week. For children: > The weekly suppressive dosage is 5 mg calculated as base, per kg of body weight, but should not exceed the adult dose regardless of weight. Source: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/006002s043lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/00... Additionally, it seems that it is incredibly easy to fatally overdose on this: > Chloroquine is very rapidly and completely absorbed after ingestion. Toxic doses of chloroquine can be fatal. As little as 1 g may be fatal in children. Toxic symptoms can occur within minutes. These consist of headache, drowsiness, visual disturbances, nausea and vomiting, cardiovascular collapse, shock and convulsions followed by sudden and early respiratory and cardiac arrest. Hypokalemia has been observed with arrhythmias in cases of intoxication. The electrocardiogram may reveal atrial standstill, nodal rhythm, prolonged intraventricular conduction time, and progressive bradycardia leading to ventricular fibrillation and/or arrest. Cases of extrapyramidal disorders have also been reported in the context of chloroquine overdose (see WARNINGS and ADVERSE REACTIONS) See also this paper about known cases of overdose in kids: https://pediatrics.aappublications.org/content/27/1/95.long?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token https://pediatrics.aappublications.org/content/27/1/95.long?... Note that is for all for cholorquine base, not chloroquine phosphate which is ~60% choloroquine.

bertil 7y ago

In the video he says that his hospital and Korea use 600 mg/d and that Chinese authors mention two times 500 mg per day. He describes that larger treatment as “harder to handle” and I suspect he’s referring to secondary effects.

deleted 7y ago
[deleted]
jaclaz 7y ago
The tests suggested in Italy also use a 500 mg per day dose, see article linked to here: https://news.ycombinator.com/item?id=22616404 https://news.ycombinator.com/item?id=22616404