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©The Author(s) 2025.
World J Biol Chem. Jun 5, 2025; 16(2): 107042
Published online Jun 5, 2025. doi: 10.4331/wjbc.v16.i2.107042
Published online Jun 5, 2025. doi: 10.4331/wjbc.v16.i2.107042
Table 1 Clinically relevant drug interactions with chloroquine and hydroxychloroquine
Interacting drug/class | Mechanism of interaction | Clinical implication | Recommendation |
Proton pump inhibitors | Reduce lysosomal acidification, affecting HCQ accumulation | Decreased therapeutic efficacy | Consider dose separation or switching to H2 antagonists |
Digoxin | Inhibition of P-glycoprotein leads to increased digoxin levels | Risk of digoxin toxicity | Monitor serum digoxin levels |
Methotrexate | Overlapping immunosuppression, altered metabolism | Potential increased toxicity | Monitor hepatic and hematologic parameters |
Tamoxifen | Additive risk of retinopathy | Increased ocular toxicity | Ophthalmologic monitoring if used long-term |
Antacids (e.g., magnesium/aluminum) | Interfere with GI absorption of CQ/HCQ | Reduced drug bioavailability | Separate doses by at least 4 hours |
QT-prolonging agents (e.g., azithromycin, amiodarone) | Additive risk of QT prolongation | Increased risk of arrhythmias | Baseline and follow-up ECG monitoring |
Cytochrome P450 inhibitors (e.g., ketoconazole) | Impaired metabolism of CQ/HCQ | Elevated plasma drug concentrations | Dose adjustment and monitoring for toxicity |
Insulin and antidiabetic agents | HCQ enhances insulin sensitivity and lowers blood glucose | Risk of hypoglycemia | Monitor blood glucose closely |
- Citation: Al-Hamadani M, Darweesh M, Mohammadi S, Al-Harrasi A. Chloroquine and hydroxychloroquine: Immunomodulatory effects in autoimmune diseases. World J Biol Chem 2025; 16(2): 107042
- URL: https://www.wjgnet.com/1949-8454/full/v16/i2/107042.htm
- DOI: https://dx.doi.org/10.4331/wjbc.v16.i2.107042