Anti-Malarials

Supplied: Oral Suspension: 750 mg/5 ml.

Dosing (Adults):
Malaria, suppression or prophylaxis: Oral: 500 mg/week (300 mg base) on the same day each week; begin 1-2 weeks prior to exposure; continue for 4-6 weeks after leaving endemic area; if suppressive therapy is not begun prior to exposure, double the initial loading dose to 1 g (600 mg base) and administer in 2 divided doses 6 hours apart, followed by the usual dosage regimen.
Malaria, acute attack: Oral: 1 g (600 mg base) on day 1, followed by 500 mg (300 mg base) 6 hours later, followed by 500 mg (300 mg base) on days 2 and 3.

Extraintestinal amebiasis: Oral: 1 g/day (600 mg base) for 2 days followed by 500 mg/day (300 mg base) for at least 2-3 weeks.

Rheumatoid arthritis, lupus erythematosus (unlabeled uses): Oral: 250 mg (150 mg base) once daily; reduce dosage following maximal response (taper to discontinue after response in lupus); generally requires 3-6 weeks. Note: Not considered first-line agent.

Renal Dosing: Clcr <10 mL/min: Administer 50% of dose.

Supplied: Tablet: 250 mg [equivalent to 150 mg base];
500 mg [equivalent to 300 mg base]

Supplied: 210 mg, 650 mg tablet.

Malaria prophylaxis: Oral: 1 tablet (250 mg) weekly starting 1 week before, arrival in endemic area, continuing weekly during travel and for 4 weeks after leaving endemic area. Take with food and at least 8 oz of water.

Supplied: Tablet, as hydrochloride: 250 mg [equivalent to 228 mg base]

Treatment of malaria: To decrease risk of delayed primary attacks and prevent relapse: Oral: 15 mg/day (base) once daily for 14 days or 45 mg base once weekly for 8 weeks. CDC treatment recommendations: Begin therapy during last 2 weeks of, or following a course of, suppression with chloroquine or a comparable drug. Note: A second course (30 mg/day) for 14 days may be required in patients with relapse. Higher initial doses (30 mg/day) have also been used following exposure in S.E. Asia or Somalia.

Prevention of malaria (unlabeled use): Initiate prior to travel and continue for 7 days after departure from malaria-endemic area: Oral: 30 mg once daily.

Pneumonia due to Pneumocystis carinii (unlabeled use): Oral: 30 mg once daily for 21 days (in conjunction with clindamycin)

Supplied: Tablet, as phosphate: 26.3 mg [15 mg base]

Toxoplasmosis: Oral: 50-75 mg/day together with 1-4 g of a sulfonamide for 1-3 weeks depending on patient's tolerance and response, then reduce dose by 50% and continue for 4-5 weeks or 25-50 mg/day for 3-4 weeks.
Prophylaxis for first episode of Toxoplasma gondii: Oral: 50 mg once weekly with dapsone, plus oral folinic acid 25 mg once weekly.
Prophylaxis to prevent recurrence of Toxoplasma gondii: Oral: 25-50 mg once daily in combination with sulfadiazine or clindamycin, plus oral folinic acid 10-25 mg daily. Atovaquone plus oral folinic acid 10 mg daily has also been used in combination with pyrimethamine.

Supplied: 25 mg tablet.

Dosing (Adults): Treatment of acute malaria attacks: Oral: A single dose of the following number of Fansidar® tablets is used in sequence with quinine or alone: 3 tablets

Malaria prophylaxis: A single dose should be carried for self-treatment in the event of febrile illness when medical attention is not immediately available: Oral: 3 tablets

Supplied: Tablet: Sulfadoxine 500 mg and pyrimethamine 25 mg

Leg cramps: Oral: 200-300 mg at bedtime.
Leg Cramps: The mechanism by which quinine sulfate decreases the incidence of leg cramps remains obscure. It appears to reduce the excitability of the motor end plate, thereby reducing muscle contractility.

Other medications — The following medications have also been used for nocturnal leg cramps with variable success:

1) Diphenhydramine (Benadryl) 12.5 to 50 mg nightly
2) Muscle relaxant: E.G. Cyclobenzeprine 10mg qhs
3) Verapamil, 120 mg at bedtime
4) Chloroquine phosphate (250 mg daily for two to three weeks, followed by 250 to 500 mg once per week.
5) Also used hydroxychloroquine sulfate (200 mg daily for two weeks, then once per week) with good results.
6) Gabapentin (600 mg daily with increased dosage as necessary).
[Source: UpToDate.]

Renal Dosing: Clcr 10-50 mL/minute: Administer every 8-12 hours or 75% of normal dose. Clcr <10 mL/minute: Administer every 24 hours or 30% to 50% of normal dose. Not removed by hemo- or peritoneal dialysis; dose for Clcr <10 mL/minute.

Supplied: Capsule, as sulfate: 200 mg, 325 mg.
Tablet, as sulfate: 260 mg