USE OF CHLOROQUINE IN PREGNANCY
Date of issue: August 2023, Version: 4
Chloroquine is used for chemoprophylaxis and treatment of malaria. It is also used in the treatment of amoebic hepatitis/abscess, lupus erythematosus and rheumatoid arthritis. This document covers data relating to use of chloroquine as an antimalarial only.
Travel to areas where malaria is endemic should be avoided during pregnancy wherever possible. If travel to such areas is unavoidable, insect repellents, bed nets, appropriate clothing to prevent mosquito bites and adequate chemoprophylaxis should be used.
Human pregnancy data relating to both prophylaxis and treatment with chloroquine provide no evidence that exposure to the medication itself increases the risk of miscarriage, congenital malformation or stillbirth/IUD, prematurity, growth restriction or neonatal complications, and no conclusive evidence of an increased risk of low birth weight. However, data for some of these outcomes is limited, particularly those related to first trimester/early pregnancy exposure. Due to the limitations of the available data, increased risks of congenital malformation or miscarriage cannot be completely excluded.
Where use of chloroquine is clinically indicated, it should not be withheld on account of the pregnancy as the known risks of maternal malaria infection are likely to be far greater than any potential risks to the fetus from the drug.
Exposure to chloroquine at any stage of pregnancy in the absence of maternal malaria infection would not usually be regarded as an indication for additional fetal monitoring. However, other risk factors may be present in individual cases which independently increase the risk of an adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.
Important: Please ensure that the selected antimalarial will provide appropriate prophylaxis for the area of travel. Advice is available from a number of sources (e.g. UKHSA[1], WHO[2], BNF,[3] Fit For Travel,[4] Travel Health Pro,[5] and TRAVAX[6]).
For further advice on malaria prevention in pregnancy please refer to the relevant UKTIS document below.
This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to NHS health care professionals who are logged in.
If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.
If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.