Volume 77, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Amodiaquine is an amino-4-quinoline with the basic spectrum of activity of chloroquine. It has been used widely to treat and prevent malaria. From the mid-1980s, there were reports of fatal adverse drug reactions described in travelers using amodiaquine as antimalarial prophylaxis. In 1990, the World Health Organization (WHO) stopped using this drug in malaria control programs. The WHO Expert Committee on Malaria modified this in 1993 and reported that amodiaquine could be used for treatment if the risk of infection outweighs the potential for adverse drug reactions. Currently, amodiaquine is a potential useful drug, especially if used with artemisinin-based combination therapy and with sulfadoxine-pyrimethamine to improve treatment efficacy for chloroquine-resistant strains of and . We report a case of fulminant hepatitis induced by antimalarial prophylactic use of amodiaquine that necessitated emergency orthotopic liver transplantation.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. World Health Organization, 1990. Practical chemotherapy of malaria. Report of a WHO Scientific Group. World Health Organ Tech Rep Ser 805 : 1–141.
    [Google Scholar]
  2. Coopman SA, Johnson RA, Platt R, Stem RS, 1993. World Health Organization 19th Expert Committee on Malaria Report. Geneva: World Health Organization.
  3. Hatton CS, Peto TE, Brunch C, Pasvol G, Russel SJ, Singer CR, Edwards G, Winstanley P, 1986. Frequency of severe neutropenia associated with amodiaquine prophylaxis against malaria. Lancet I : 411–413.
    [Google Scholar]
  4. Nefttel KA, Woodtly W, Schmid M, Frick PG, Fehr J, 1986. Amodiaquine-induced agranulocytosis and liver damage. BMJ 292 : 721–723.
    [Google Scholar]
  5. Larry D, Castot A, Pessayre D, Merigot P, Machayekhy JP, Feldmann G, Lenoir A, Rueff B, Benhamou JP, 1986. Amodiaquine-induced hepatitis. A report of seven cases. Ann Intern Med 104 : 801–803.
    [Google Scholar]
  6. Phillips-Howard PA, West LJ, 1990. Serious adverse drug reactions to pyrimethamine-sulphadioxine, pyrimethamine-dapsone and to amodiaquine in Britain. J R Soc Med 83 : 598–599.
    [Google Scholar]
  7. Pussard E, Verdier F, Faurisson F, Scherrmann JM, Le Bras J, Blayo MC, 1987. Disposition of monodesethylamodiaquine after a single oral dose of amodiaquine and three regimens for prophylaxis against Plasmodium falciparum malaria. Eur J Clin Pharmacol 33 : 409–414.
    [Google Scholar]
  8. Olliaro P, Taylor WR, 2002 Amodiaquine for the Treatment of Uncomplicated Falciparum Malaria. Geneva: World Health Organization.
  9. Clarke JB, Neftel K, Kitteringham NR, Park BK, 1991. Detection of atidrug IgG antibodies in patients with adverse drug reactions to amodiaquine. Int Arch Allergy Appl Immunol 95 : 369–375.
    [Google Scholar]
  10. Larry D, Pageaux GP, 1997. Genetic predisposition to drug-induced hepatoxicity. J Hepatol 26 (Suppl 2) : 12–21.
    [Google Scholar]
  11. Li XQ, Bjorkman A, Andersson TB, Ridderstrom M, Masimirembwa CM, 2002. Amodiaquine clearance and its metabolism to N-desethylamodiaquine is mediated by CYP2C8: a new high affinity and turnover enzyme-specific probe substrate. J Pharmacol Exp Ther 300 : 399–407.
    [Google Scholar]
  12. Olliaro P, Nevill C, LeBras J, Ringwald P, Mussano P, Garner P, Brasseur P, 1996. Systematic review of amodiaquine treatment in uncomplicated malaria. Lancet 348 : 1184–5.
    [Google Scholar]
  13. Obonyo CO, Juma EA, Ogutu BR, Vulule JM, Lau J, 2007. Amodiaquine combined with sulfadoxine/pyrimethamine versus artemisinin-based combinations for the treatment of uncomplicated falciparum malaria in Africa: a meta-analysis. Trans R Soc Trop Med Hyg 101 : 117–126.
    [Google Scholar]
  14. Ratcliff A, Siswantoro H, Kenangalem E, Wuwung M, Brockman A, Edstein MD, Laihad F, Ebsworth EP, Anstey NM, Tjitra E, Price RN, 2007. Therapeutic response of multidrug-resistant Plasmodium falciparum and P. vivax to chloroquine and sulfadoxine-pyrimethamine in southern Papua, Indonesia. Trans R Soc Trop Med Hyg 101 : 351–359.
    [Google Scholar]
  • Received : 15 Aug 2006
  • Accepted : 05 Feb 2007
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error