Chloroquine Phosphate

Humblefish

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Chloroquine Phosphate *** The information contained here is subject to changes as I experiment and learn more about Chloroquine Phosphate ***

What It TreatsMarine Ich (Cryptocaryon irritans), Marine Velvet Disease (Amyloodinium ocellatum), Brooklynella hostilis and Uronema marinum.

How To Buy – Chloroquine phosphate (CP) is an antimalarial drug for humans which also treats external parasites that afflict marine fish (and possibly freshwater fish as well.) However, there are a few challenges to overcome with CP. The very first is obtaining it because a prescription is usually required to buy pharmaceutical-grade CP. While pharmaceutical-grade is not an absolute requirement, the closer the medication is to being 99% pure the more effective it is. Many CP failures can be traced back to buying the medication on eBay or from some other unknown source. The best strategy for obtaining CP is to ask your local veterinarian for a prescription which can then be filled by a compounding pharmacy: https://www.diamondbackdrugs.com/chloroquine/

A backup plan is to buy from this source, which has tested 94-96% pure for me (although I cannot guarantee every batch from this source will test the same): https://store.nationalfishpharm.com/items/view/616/chloroquine-phosphate

Sometimes CP is dispensed in tablet form instead of powder. The tablets are fine to use, but the downside is you get less “chloroquine base” out of them so you must dose more. The following was taken from Bob Goemans online book, THE LIVING AQUARIUM MANUAL:
In most cases, 250 mg tablets have an equivalence of 150 mg chloroquine base, and 500 mg tablets have an equivalence of 300 mg chloroquine base. Although the purity mentioned above is generally accurate, it would be best to verify the chloroquine base contained in the tablets of your choice in order to be able to properly calculate the exact dosage. Keep in mind if you decide to use the tablets, there are some inactive ingredients, which you may have to deal with, e.g., Camauba Wax, Colloidal Silicon Dioxide, Dibasic Calcium Phosphate, Hydroxypropyl Methylcellulose, Magnesium Stearate, Microcrystalline Cellulose, Polyethylene Glycol, Polysorbate 80, Pregelatinized Starch, Sodium Starch Glycolate, Stearic Acid, and Titanium Dioxide. And as mentioned earlier in this chapter there are occasions where some medicines are not in their pure form (100% pure), i.e., mixed with a substance called a ‘carrier,’ which should be noted on its label. If so its potency is reduced, and if not sure about the exact amount of medication needed, suggest contacting a more experienced aquarist for the way to resolve this situation.
How To Dose – In most cases CP is dispensed in powder form, and a digital scale is needed to accurately measure the dosage (more info on that below). This is the one I use: https://www.amazon.com/American-Weigh-GEMINI-20-Portable-MilliGram/dp/B0012TDNAM/

How To Treat – Okay, so you’ve got your CP + digital scale and are ready to dose! Well, this brings us to the next challenge to overcome: Bacteria and biofilm. All medications (except copper) that you dose into water are susceptible to biodegradation. With Chloroquine this can be a major problem because the medication needs to be at a therapeutic level at all times in order to be effective. Therefore, I highly recommend following one of these QT protocols when using CP:

CP Protocol #1 (preferred): Dose 15 mg/L (60 mg/gal) into a bare bottom, rockless QT (see pic below) and treat for 10 days. The tank (and all equipment) should have been cleaned/sterilized beforehand and no biological filtration should be used! The point is to limit the bacteria/biofilm found in the aquarium which could degrade CP. Ammonia can be controlled by dosing Prime/Amquel every 24-48 hours, or by doing water changes. (A Seachem ammonia alert badge can be used for active monitoring.) However, when performing a water change it is very important to dose CP back into any replacement water before adding it to the QT. This ensures that the concentration of medication in the QT remains therapeutic at all times. After 10 days, transfer the fish into an observation tank (see Posttreatment below) at least 3 m (10 feet) away from the QT.


CP Protocol #2: If you must treat in an established QT with a working biofilter, then you should redose the medication to compensate for possible biodegradation. Start off by dosing 10 mg/L (40 mg/gal) and then subsequently dose 1 mg/L (4 mg/gal) every day thereafter. Daily redosing is ideal, but if that conflicts with your schedule then redosing 3 mg/L or 12 mg/gal every 3 days (for example) should still be adequate. CP has a wide therapeutic range (20-80 mg/gal), so the objective is to keep it within that concentration at all times. After 10 days, transfer the fish into an observation tank (see Posttreatment below) at least 3 m (10 feet) away from the QT.

Posttreatment – To ensure treatment has been successful, transfer the fish into a nonmedicated observation tank for 2-4 weeks. Never transfer the fish directly into your display tank! The point of the observation tank is to ensure treatment has been successful, and symptoms of parasites do not resurface. One way to accomplish this is by housing black mollies (more info) in your observation tank. A freshwater black molly will have no immunity whatsoever to marine diseases, thus making it probable for visible symptoms to show. And evidence of ectoparasites (e.g. ich, velvet, brook) will show up as white spots on a black molly or translucent if a tankmate has flukes.

Pros – Gentle on most fish. (DO NOT USE with Hippo Tangs, anthias and flasher wrasses.) CP treats most external protozoa, and is probably the closest thing there is to a “wonder drug” in our hobby.

Cons/Side Effects – Expensive, hard to get (requires a prescription), powder is heat & light sensitive – so store in a cool, dark place. CP is quickly removed from the water if carbon is used and even by certain filter pads which are made from polyfiber. The medication is also susceptible to biodegradation, which makes dosing in an established QT somewhat unpredictable.
 

Dr.Reef

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Its medicated food. Does include CP as one of the ingredients. But my take on it is if I was to treat fish I would treat with pure (95%+) CP bought from a reputable source.
Ich shield does not show purity nor strength. Also it's not reef safe and I wouldn't recommend using with sand or rocks in tank due to absorption.
Just my take on it.
 

Humblefish

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williamch73

New member
I am from South America and we Can find CP as a mrdication for amebiosis.
I did mean Ick shield powder... This Can be used as a prophilactic use.... I have lost 2 ocellaris... The last one I do not know the exact cause... I saw dificult breathing and white poop... I treated with ick shiekd as a source of CP thinking it was brook... After that when I saw the white poop y add metro to the tank... And the clown was not eating at all. The other two fish do not seem to be ill... May I dose metro and Ick shield as a method to prevent they can get an infection... With the Ick Shield I only lost snails.. my cleaner shrimp is ok

Thanks
 

Humblefish

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White poop can mean intestinal worms or internal flagellates. For the latter you would treat with metronidazole; for the former use praziquantel or fenbendazole. But for internal problems it is always best to food soak medications using the recipe below:

Using a shot glass:
1 scoop (~ 1/8 teaspoon) of medication
1 scoop Seachem Focus (this makes it reef safe)
1 Tbsp food (preferably pellets or frozen food)
A pinch of Epsom salt to help expel dead worms/parasites
A few drops of saltwater or fish vitamins
Stir until a medicated food slurry has been achieved.
Feed after soaking for 30 mins.
Refrigerate or freeze any leftovers for future use.

You can feed this mix 1-2 times per day. Not recommend to exceed 2 feedings per day with medicated food.
 

williamch73

New member
In the case the fish is not eating at all..I imagine there is just a little hope to attack the parasites or pathogens.

I always use paraguard before adfing a fish to a DT or QT.

I thougt it was stress the reason the ocellaris was not eating ...What do you do i that cases...you treat inmediatly whit prazipro in case there afe internal pathogens?


Thanks a lot!
 

Humblefish

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Navarre, FL
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In the case the fish is not eating at all..I imagine there is just a little hope to attack the parasites or pathogens.

I always use paraguard before adfing a fish to a DT or QT.

I thougt it was stress the reason the ocellaris was not eating ...What do you do i that cases...you treat inmediatly whit prazipro in case there afe internal pathogens?


Thanks a lot!
White stringy poo is a fickle thing because it is technically a sign of intestinal irritation. However, worms/parasites inside the gastrointestinal tract are usually the cause. If a fish's poop goes back to normal after a few days then most likely a disease wasn't the culprit.

However, I both dose and food soak prazi + metro from Day 1 (as a preventative) because by the time you see the white stringy poo it is sometimes too late. I also use copper (or Chloroquine) from Day 1 to combat ectoparasites. Again, by the time you notice behavioral symptoms of disease in most fish it is already too late. Chemoprophylaxis is the lesser of two evils in a closed environment... Passive observation has always come back to bite me in the ass.
 

Jessican

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Fremont, CA
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Is it still okay to keep them in a full 30 days of CP if you don't have spare tanks to transfer to after 10 days? I'd assume that's not a good idea with no working biofilter, but if following protocol #2, could you just continue the daily 4mg/gal dosing until 30 days is up?
 

Humblefish

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but if following protocol #2, could you just continue the daily 4mg/gal dosing until 30 days is up?
Yes, that is correct. The only issue is sometimes (but not always) certain fish start acting strange after 3 weeks in CP. Refusing to eat, weird swimming patterns and acting "loopy" as @Dr.Reef calls it. If you ever observe this behavior, I highly recommend getting them out of the medication ASAP.
 

Jessican

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Fremont, CA
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Yes, that is correct. The only issue is sometimes (but not always) certain fish start acting strange after 3 weeks in CP. Refusing to eat, weird swimming patterns and acting "loopy" as @Dr.Reef calls it. If you ever observe this behavior, I highly recommend getting them out of the medication ASAP.
Thanks, I'll definitely keep a close eye out for that. I have two QT tanks, but they may both wind up being in use, so I wanted to make sure I had a backup plan for if I can't transfer to a clean tank.
 

TORREYA

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New Hampshire
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White poop can mean intestinal worms or internal flagellates. For the latter you would treat with metronidazole; for the former use praziquantel or fenbendazole. But for internal problems it is always best to food soak medications using the recipe below:

Using a shot glass:
1 scoop (~ 1/8 teaspoon) of medication
1 scoop Seachem Focus (this makes it reef safe)
1 Tbsp food (preferably pellets or frozen food)
A pinch of Epsom salt to help expel dead worms/parasites
A few drops of saltwater or fish vitamins
Stir until a medicated food slurry has been achieved.
Feed after soaking for 30 mins.
Refrigerate or freeze any leftovers for future use.

You can feed this mix 1-2 times per day. Not recommend to exceed 2 feedings per day with medicated food.
Can you do this with CP as well?
 

Humblefish

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Navarre, FL
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Can you do this with CP as well?
I've tried it a few times (to kill internal flagellates), but the fish don't seem much interested in eating it no matter how much garlic/vitamins I use to try to mask Chloroquine's metallic taste. I have noticed fish treated with Chloroquine seem less likely to develop white stringy poo - maybe they drink enough of the medication to be effective. :unsure:

P.S. This frozen food contains Chloroquine: http://drgsmarineaquaculture.com/frozen-antiparasitic.cfm

More info: http://drgsmarineaquaculture.com/frozen-antiparasitic-detail.cfm

But I can't say how well fish will eat it.
 

TORREYA

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Location
New Hampshire
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I've tried it a few times (to kill internal flagellates), but the fish don't seem much interested in eating it no matter how much garlic/vitamins I use to try to mask Chloroquine's metallic taste. I have noticed fish treated with Chloroquine seem less likely to develop white stringy poo - maybe they drink enough of the medication to be effective. :unsure:

P.S. This frozen food contains Chloroquine: http://drgsmarineaquaculture.com/frozen-antiparasitic.cfm

More info: http://drgsmarineaquaculture.com/frozen-antiparasitic-detail.cfm

But I can't say how well fish will eat it.
This claims to solve all issues.. I assume this is incorrect as most other treatments. As you know past messages I have been running a system with Ich or something in it for quite some time. Been good for a couple years. Added a Butterfly, and less than 24 hours Tang took it out. Next day fish showing spots. Guessing the stress brought it out. They seem to be fighting it off as no losses yet. Fish look better each day. But we will see. UV seems to be keeping the numbers down enough. IM feeding and they are eating LRS like pigs to keep them happy. So I am just looking for ideas. My LFS mentioned trying this with focus and garlic. Wanted your thoughts.
 

Humblefish

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Navarre, FL
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This claims to solve all issues.. I assume this is incorrect as most other treatments. As you know past messages I have been running a system with Ich or something in it for quite some time. Been good for a couple years. Added a Butterfly, and less than 24 hours Tang took it out. Next day fish showing spots. Guessing the stress brought it out. They seem to be fighting it off as no losses yet. Fish look better each day. But we will see. UV seems to be keeping the numbers down enough. IM feeding and they are eating LRS like pigs to keep them happy. So I am just looking for ideas. My LFS mentioned trying this with focus and garlic. Wanted your thoughts.
For fighting off external parasites, I can only see CP soaked food working this way: Enough of the medication builds up in their system so that it leaches back out. The presence of Chloroquine in the slime coat might do one of three things:
  1. Prevent free swimmers from latching on. Basically, it makes the fish an unsuitable host for the parasite.
  2. Damages/kills feeding trophonts because they are being "poisoned" by the medication.
  3. Causes trophonts to drop off the fish sooner rather than later. Whether these parasites become irreversibly damaged by consuming some of the medication (and thus unable to reproduce) I cannot say.
The problem is coverage period. Practically speaking, velvet will remain active in a tank for at least 2 weeks and for Ich it's more like 30 days. (This isn't taking prolonged strains into consideration - which would be 6 weeks and 76 days, respectively.) You would have to ensure that each & every fish is consistently eating the medicated food (i.e. every single day) for at least 30 days to have a reasonable chance of breaking the life cycle. It just seems like Murphy's Law kicks in at some point, which puts the odds NOT in your favour. :(
 

Jessican

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Fremont, CA
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Yes, that is correct. The only issue is sometimes (but not always) certain fish start acting strange after 3 weeks in CP. Refusing to eat, weird swimming patterns and acting "loopy" as @Dr.Reef calls it. If you ever observe this behavior, I highly recommend getting them out of the medication ASAP.
Sorry, follow up question. If the fish start acting loopy after three weeks, is it safe to use carbon/water changes to remove the med from the tank they are in at that point, or would they still have to be moved to a separate, sterile tank?
 

Humblefish

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Sorry, follow up question. If the fish start acting loopy after three weeks, is it safe to use carbon/water changes to remove the med from the tank they are in at that point, or would they still have to be moved to a separate, sterile tank?
I would transfer into a separate, sterile tank. The danger in lowering the CP concentration < 30 days is tomonts could be still active in the treatment tank. By moving the fish to a new tank (and the CP concentration is still at therapeutic), you are transferring the fish away from this danger.
 

Jessican

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Fremont, CA
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I would transfer into a separate, sterile tank. The danger in lowering the CP concentration < 30 days is tomonts could be still active in the treatment tank. By moving the fish to a new tank (and the CP concentration is still at therapeutic), you are transferring the fish away from this danger.
That's what I was afraid of. Both of my QT tanks are in use, so I don't have another sterile tank that I can transfer into. I'll just have to cross my fingers that nobody gets loopy. :)
 

Reefhog

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Chicago, IL
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Question on the CP levels in the two protocols. How come a higher level (60mg/gal) is recommended in QT with no working bio filter to degrade it and then a lower level (40mg/gal) in QT with a working bio filter which tends to degrade CP? I understand that we are to re-dose 4 mg/gal daily but even if there were no degradation, it would still take five days to reach the 60mg/gal were starting with in protocol #1.

I've used CP successfully in the past but always maintained 50mg/gal for 10 days mostly because my QT are a 20 gal tanks and the CP from Diamondback came in 1000 mg packets. No measuring was needed. I used Prime to maintain ammonia. I will be using N.F.P. CP this round, so I will be weighing it and can easily do the 60mg/gal.

Is there any issue using Prime every day for 10 days for ammonia control without water changes? I will most likely do 10% daily WC (pre dosed with CP) but curious if its necessary.

Thank You for your feedback.
 
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