Lariago DS
✅ Treats severe malaria
✓ Hatékony rezisztenc törzsekkel szemben
✅ Gyors tüneti enyhülés
✅ Prevents malaria recurrence
✅ Shortens hospital stays
Lariago DS contains Chloroquine phosphate.
✓ Orvosi ellenőrzés Morgan Ellis — Gyógyszerkutató · 8 év tapasztalat · Utolsó felülvizsgálat: 2026 május
Gyors válasz
Lariago DS tartalmaz chloroquine phosphate 500 mg base equivalent (Ipca Laboratories). It treats chloroquine-sensitive malaria caused by P. falciparum, P. vivax, P. ovale, és P. malariae, and is also used for the prevention and treatment of extra-intestinal amoebiasis. Most modern endemic regions have widespread chloroquine resistance (sub-Saharan Africa, India, Southeast Asia, Amazon basin) — chloroquine is NOT appropriate prophylaxis for those destinations. Acute treatment dose: 1 g loading → 500 mg at 6 / 24 / 48 h. Prophylaxis (chloroquine-sensitive areas only): 500 mg once weekly starting 1–2 weeks before travel, continued for 4 weeks after return. Take with food. Mandatory baseline + annual ophthalmology screening after 5 years of continuous use.
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About Lariago DS
Lariago DS is a 500 mg chloroquine phosphate tablet manufactured by Ipca Laboratories under WHO-GMP certified conditions. Chloroquine is a 4-aminoquinoline antimalarial — first synthesised in 1934 and the cornerstone of malaria treatment for most of the second half of the 20th century, before resistance emerged in P. falciparum during the 1960s. It remains effective in the few remaining chloroquine-sensitive regions and is on the WHO Essential Medicines list.
How chloroquine works
The malaria parasite digests host haemoglobin inside an acidic food vacuole, releasing free haem (toxic to the parasite). Normally the parasite polymerises haem into inert haemozoin (malaria pigment). Chloroquine accumulates in the food vacuole because its weak-base nature traps it in acidic compartments, where it binds free haem and prevents polymerisation. Toxic free haem accumulates and kills the parasite. Chloroquine resistance arises from PfCRT (P. falciparum chloroquine-resistance transporter) mutations that pump chloroquine back out of the food vacuole.
Half-life is 1–2 months — chloroquine accumulates in tissue and is released slowly. This is why prophylaxis is dosed weekly and continued for 4 weeks after exposure.
What Agoprex is and how it works
| Agoprex is a 25 mg agomelatine tablet supplied by Sun Pharma. Agomelatine is mechanistically unique among antidepressants: it acts as an agonist at melatonin MT1 and MT2 receptors and an antagonist at 5-HT2C serotonin receptors. The dual mechanism resynchronises disrupted circadian rhythms (a feature of major depression) while indirectly increasing dopamine and noradrenaline release in the frontal cortex. | Dose (in mg base) | Megjegyzések |
|---|---|---|
| Chloroquine-sensitive malaria — acute treatment, adult | 1 000 mg base loading → 500 mg base at 6, 24, and 48 h (total 2 500 mg base over 48 h) | Add primaquine for radical cure of P. vivax / P. ovale (after G6PD test). |
| Chloroquine-sensitive malaria prophylaxis, adult | 500 mg base once weekly | Start 1–2 weeks before travel; continue weekly during exposure; continue 4 weeks after return. |
| Paediatric treatment | 10 mg/kg base loading → 5 mg/kg at 6, 24, 48 h | Same total over 48 h. Tablets can be crushed and mixed with food. |
| Paediatric prophylaxis | 5 mg/kg base once weekly (max 500 mg) | Same start / continue / stop schedule as adults. |
| Extra-intestinal amoebiasis (amoebic liver abscess) | 1 g/day for 2 days, then 500 mg/day for 2–3 weeks | Adjunct to metronidazole. |
Mellékhatások
- Common (5–15 %): nausea, abdominal cramping, headache, dizziness, blurred vision (early reversible accommodation), itching (especially in dark-skinned individuals — chloroquine pruritus is a hallmark side effect, sometimes intolerable).
- Less common (1–5 %): hair lightening, slate-grey skin / mucosal pigmentation, photosensitivity, dyspepsia, vivid dreams, mood change.
- Ritka, de súlyos: retinopathy (long-term, dose-dependent), cardiomyopathy and QT prolongation, myopathy, neuropathy, agranulocytosis, severe cutaneous reactions, and at high cumulative doses extrapyramidal effects.
- Overdose is exceptionally dangerous — as little as 5 g (10 tablets) has caused fatal arrhythmia in adults; one tablet has caused death in a small child. Keep out of reach of children.
Gyógyszerkölcsönhatások
| Kölcsönhatás | Hatás | Kezelés |
|---|---|---|
| Digoxin | Chloroquine raises digoxin level | Monitor digoxin level; reduce dose if needed. |
| Ciklosporin | Chloroquine raises cyclosporine level | Monitor cyclosporine level. |
| Antacids / kaolin | Reduce chloroquine absorption ~ 30 % | Separate by 4 hours. |
| Mefloquine | Additive lowering of seizure threshold + cardiac effects | Avoid combination — use one antimalarial agent. |
| QT-intervallumot meghosszabbító gyógyszerek | Additive QTc prolongation | Avoid in structural heart disease, electrolyte imbalance, or long-QT syndrome. |
| Ampicillin | Chloroquine reduces ampicillin absorption | Separate by 2 hours. |
| Praziquantel | Chloroquine reduces praziquantel level | Avoid combination during schistosomiasis treatment. |
Ellenjavallatok és óvintézkedések
- Absolute: known hypersensitivity to 4-aminoquinolines; pre-existing retinopathy.
- Óvatosan: psoriasis (often severe flare), porphyria, severe GI disease, hepatic impairment, neurological disease (epilepsy), G6PD deficiency, myasthenia gravis, severe cardiac disease (cardiomyopathy / conduction defects).
- Terhesség: chloroquine is considered safe at standard prophylactic and treatment doses; the absolute teratogenic risk is low and untreated malaria in pregnancy is far more dangerous than chloroquine.
- Szoptatás: compatible — excreted in breast milk in small amounts insufficient for infant prophylaxis.
Tárolás
Store below 25 °C in a dry place, in original packaging. Távol tartandó gyermekektől — single-tablet paediatric overdose has caused fatal cardiotoxicity.
Gyakran Ismételt Kérdések
Is chloroquine still useful?
Yes — for the few remaining chloroquine-sensitive areas (parts of Central America, Hispaniola, Middle East), and for amoebic liver abscess as an adjunct. For sub-Saharan Africa, India, Southeast Asia, or the Amazon, you need a different agent (mefloquine, doxycycline, or atovaquone-proguanil).
How do I know if my destination is chloroquine-sensitive?
Use the CDC Yellow Book country-specific recommendations (link) or the UK’s fitfortravel.nhs.uk. Resistance maps update annually — never rely on advice more than 1–2 years old.
What is chloroquine pruritus?
An idiosyncratic intense itch (palms, soles, scalp) seen mainly in dark-skinned individuals taking chloroquine. Mechanism unclear (probably mast-cell-related rather than allergic). Some patients tolerate hydroxychloroquine instead.
Can children take chloroquine?
Yes — paediatric prophylaxis is 5 mg/kg base once weekly (max 500 mg). Tablets can be crushed and mixed with food / honey. Keep blister packs out of reach — single-tablet paediatric overdose is potentially fatal.
Is chloroquine safe in pregnancy?
Yes at standard doses. Untreated malaria in pregnancy carries far higher risk to mother and foetus than chloroquine.
Why has chloroquine resistance appeared?
Mutations in the PfCRT (P. falciparum chloroquine-resistance transporter) gene let parasites pump chloroquine back out of the food vacuole. The mutations spread globally from Southeast Asia and South America starting in the late 1950s. P. vivax has acquired resistance more slowly and irregularly.
How is chloroquine different from hydroxychloroquine?
Hydroxychloroquine has an extra hydroxyl group that gives it a substantially better retinal-toxicity profile and slightly better GI tolerance. For autoimmune disease, hydroxychloroquine is preferred. For malaria treatment, chloroquine is more potent on susceptible strains.
Can I take Lariago DS for COVID-19?
No. Multiple high-quality randomised trials have shown chloroquine and hydroxychloroquine do not improve COVID-19 outcomes and may cause cardiac harm at the doses studied.
What should I do if I get a fever after returning from a trip?
Any febrile illness within 1 year of travel to a malaria-endemic area warrants urgent thick-and-thin blood film. Severe malaria is a hospital emergency. Tell whichever clinician you see exactly where you travelled and what prophylaxis you took.
Why is the dose specified in “base” and the tablet labelled in “phosphate”?
Chloroquine phosphate is the salt form (more stable). The active drug is chloroquine base. Tablets are labelled by the salt weight; doses in clinical references are usually given in base. 250 mg chloroquine phosphate ≈ 150 mg base; 500 mg phosphate ≈ 300 mg base. Lariago DS’s 500 mg label refers to the salt.
What about combination treatment with primaquine?
For P. vivax or P. ovale infections, chloroquine clears the blood-stage parasites but does not touch dormant liver-stage hypnozoites. Adding primaquine 0.5 mg/kg/day for 14 days (or 0.25 mg/kg/day for 14 days, after G6PD testing) provides radical cure and prevents relapse. Don’t skip the primaquine course.
Other Malaria Tablets
- Lariago 250 mg — Chloroquine 250 mg base — standard once-weekly dosing for chloroquine-sensitive prophylaxis
- HCQS 200/400 mg — Hydroxychloroquine — sister molecule with retinal-toxicity advantage and autoimmune indications
- Mefque 250 mg — Mefloquine — once-weekly prophylaxis for chloroquine-resistant areas
- Cendox 100 mg — Doxycycline — daily prophylaxis covering chloroquine-resistant malaria + leptospirosis + rickettsial diseases
More options in Malaria Tablets
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| Erősség | 500 mg |
|---|---|
| Mennyiség | 30 tabletta, 60 tabletta, 90 tabletta, 180 tabletta |
Lariago DS
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