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(1) desethylhydroxychloroquine, (2) desethylchloroquine,and (3) bisdesethylchloroquine.47 The parentcompound and metabolites are taken up by lysosomesand concentrated in lysosome-rich tissues. Renal clearanceaccounts for approximately 15%–25% of the totalclearance.53 The renal excretion of CQ, HCQ, and QEcan be enhanced with acidification of the urine.54 QE isexcreted in urine, bile, sweat, and saliva.50 Renal excretiononly accounts for approximately 11% of its clearance.The highest tissue concentrations of QE are foundin the liver and spleen.52 Equivalent doses of these
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