Hydroxychloroquine overdose: Toxicokinetics and management

Background: The management and toxicokinetics of hydroxychloroquine overdos e are poorly described. Case Report: We report a case of an 18-year-old gir l who ingested 20 g of hydroxychloroquine. She developed marked hypokalemia , hypotension, and ventricular tachyarrhythmias but survived with treatment including intubation, adrenaline infusion, high-dose diazepam, and aggress ive potassium replacement. Plasma hydroxychloroquine level was 29.40 mu mol /L (9.87 mg/L) 2 hours after ingestion and the elimination half-life of hyd roxychloroquine was 22 hours. Conclusions: The clinical manifestations of t his hydroxychloroquine overdose were similar to those reported for chloroqu ine overdose and the management principles recommended for chloroquine over dose appeared to be efficacious in this case.