Plaquenil (Hydroxychloroquine)

What is Plaquenil?

Plaquenil (Hydroxychloroquine) has antimalarial properties.

In what kind of disease treatment, Plaquenil is helpful?

• Rheumatoid arthritis; juvenile RA; lupus (SLA and discoid)

• Malaria (except chloroquine-resistant strains of P. falciparum): for the prophylaxis and cure of acute episodes of malaria provoked by Plasmodium vivax, P. ovale and P. malariae, and susceptible strains of P. falciparum

• For the radical cure of malaria provoked by susceptible strains of P. falciparum

What should I discuss with my healthcare provider before taking Plaquenil?

• Intolerance to 4-aminoquinoline derivatives

• Retinopathy

• Young age if needed long-term care (kids are prone to the development of toxic effects)

• Kids under 6 (200 mg pills are not intended for kids with "ideal" weight< 31 kg)

• Gestation

• Hereditary lactose intolerance, lactase deficiency, galactosemia or malabsorption syndrome glucose / galactose (due to the presence of lactose in the composition of the preparation)

Carefully:

• With optic disturbances (decrease in visual acuity, misperception of colors, visual field loss); while receiving medicines that can provoke adverse ophthalmological responses

• Hematological sicknesses (including in anamnesis)

• Severe neurological disorders, psychosis (including in anamnesis)

• Late cutaneous porphyria (risk of aggravation), psoriasis, joint use of medicines that can cause skin reactions

• Renal failure and / or liver failure, hepatitis

• Severe gastro-intestinal ailments

• Intolerance to quinine (probability of cross-allergic reactions)

• G6PD

How should I take Plaquenil?

Take pills during the meals. In order to easily and without discomfort swallow the pill, you need to put it on top of the tongue, take a sip of milk in the mouth, and, bowing your head slightly back swallow the liquid and the tablet. Then drink a full glass of milk. Plaquenil must be accessible in drugstores of you city, or medical facilities on choice of your physician. Or you can buy Plaquenil online.

Plaquenil dosage information

Grownups and elderly people: apply the lowest productive dose. This number does not surpass 6.5 mg/kg of body weight (ideal, not actual) per day, and is 200 mg or 400 mg daily.

For individuals who may use a dose of 400 mg daily. Therapy stars with 400 mg split into 2 reception. This quantity could be lowered to 200 mg. Maintenance dose must be changed to 400 mg per day in case of efficacy reduction.

Kids: the lowest productive dose must not surpass 6.5 mg per kilogram of ideal body weight per day. Therefore, the remedy must not be used to treat kids with ideal body weight< 31 kg.

What may interact with?

With digoxin

Has been noted that hydroxychloroquine could increase the plasma concentration of digoxin, thus to prevent the development of glycoside intoxication while receiving of these agents, it is necessary to decrease the dose of digoxin under control of plasma digoxin concentrations.

With preparations used to treat diabetes

Plaquenil can amplify the effects of insulin and oral hypoglycemic agents.

With antacids

Antacids may decrease the absorption of Plaquenil.

With aminoglycosides

Potentiation of their direct blocking effect on the neuromuscular transmission.

With cimetidine

Cimetidine suppresses the metabolism of antimalarials, which may result in enhancing their plasma concentrations and increase the risk of their negative responses, especially toxic.

With neostigmine and pyridostigmine

Antagonism of action.

With any intradermal human diploid cell rabies vaccine

Decreasing the formation of antibodies in response to primary immunization of intradermal human diploid cell rabies vaccine.

What should I watch for while taking Plaquenil?

Prior to Plaquenil reception all individuals must undergo eye examination. Further, such an examination should be performed least once every 12 months. During the ophthalmological examination must be checked visual acuity, ophthalmoscopy and conduct a thorough fundoscopy and research of central fields of red target and color vision.

Inspection should be carried out more frequently, adapting it to the characteristics of the individual person, in the following cases:

• Daily dose exceeds 6.5 mg per kg ideal (not increased) body weight

• Renal failure

• Visual acuity below 6/8

• Age > 65

• Cumulative dose of over 200 g

Therapy has to be abolished at once if observed pigmentary disorders, visual field defects, or other pathologies that cannot be explained by the presence or breach of accommodation or corneal opacity.

Although the risk of suppression of red bone marrow is low, it is recommended periodically carry out blood tests.

People, who take the medication over a long period, must undergo researches of skeletal muscle function and tendon reflexes. In the event of muscle weakness the medication must be lifted.

Since shortly after initiation of the therapy the sick can encounter the violation of accommodation, the sick must be careful while driving transport and performance work requiring attention.

Plaquenil penetrates through the placenta. There is not enough data on the use of it during gestation period.

It is important to carefully consider the need for Plaquenil in nursing mothers.

Plaquenil side effects

•   Retinopathy with alteration in pigmentation and visual field defects. In the early stages it is reversible after ending of the remedy. Alteration in the retina could be asymptomatic at the beginning or sick may suffer from paracentral, perytsentralna or transient scotoma. Changes to the cornea, including edema and opacities.

• Dermatological effects. Rarely - cutaneous eruption; itching, changes in skin and mucous membranes color, bleaching of hair and alopecia. These changes usually pass quickly after therapy stopped. Bullous rash, including seldom events of erythema multiforme and Stevens – Johnson syndrome, photosensitivity

• Nausea, diarrhea, loss of appetite, pain in the abdomen; rarely – vomiting

• Dizziness, tinnitus, loss of hearing, head pain, anxious state, emotional instability, psychosis, convulsions

• Weak sensory changes, inhibition of tendon reflexes and abnormal nerve conduction

• Rarely – cardiomyopathy

• Hematologic effects. Sometimes — bone marrow suppression. Plaquenil can escalate porphyria

• In individual cases could be observed abnormal liver function indicators

Where can I keep Aralen?

Store the medicine at a temperature no higher than indicated in the annotation (25°С) in a darkened place, avoid heating by the sun's rays and do not store these tablets longer than 3 years since the date of release. Before buying this remedy, consult with your health care provider about different USA drugstores of your city, or, as an option — buy discount Plaquenil online.