Conclusions

In the past, chloroquine and hydroxychloroquine became discredited because of possible severe side effects in the eye as a result of incorrect dosing. The rate of side effects, but not therapeutic efficacy, depends on plasma concentrations. Larger doses lead to accumulation of the drugs owing to their long half-lives. Therefore, maximal daily doses of 3.5 (to 4) mg/kg ideal body weight for chloroquine and 6 (to 6.5) mg/kg for hydroxychloroquine have to be observed. This is especially important for small people (women) and short corpulent persons. In case the of kidney or liver diseases, elimination may be impaired, and the dose has to be lowered. Control of the visual functions seems necessary. If these basic rules are observed, rather safe chloroquine and hydroxychloroquine therapy is possible for long periods. A combination of chloroquine and hydroxychloroquine with primaquine (or other substances) enhances the effectiveness. Because of their various effects (anti-inflammatory, corticosteroid sparing, lowering of corticosteroid side effects, antithrombotic), antimalarials are still essential drugs for the treatment of different variants of LE.

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