What Is Plaquenil (Hydroxychloroquine)?
Plaquenil is the brand name for the prescription drug hydroxychloroquine.
It's used to treat and prevent malaria infection, and to reduce symptoms and progression of autoimmune diseases such as lupus, rheumatoid arthritis, and others.
Malaria is spread by mosquitoes, which transmit the parasites that cause the infection, usually in tropical and subtropical parts of the world.
Plaquenil is used to treat other types of infections too. For example, it may be combined with an antibiotic to treat chronic Q-fever, which humans usually catch from farm animals or raw milk.
The drug may be used to treat a type of blood disease called porphyria cutanea tarda, although it's only used in certain cases because it can worsen symptoms.
Plaquenil is in a class of medicines known as antimalarials. It's a less toxic version of the older antimalarials, including quinine and chloroquine.
The drug is also in a group of biologic medicines known as disease-modifying anti-rheumatic drugs (DMARDs), because of its effects on autoimmune illnesses, which develop when your body's disease-fighting system starts to turn against your healthy cells.
Medical researchers are exploring the use of Plaquenil for additional illnesses, including other autoimmune conditions, skin disorders, some cancers, and heart, blood, and infectious diseases.
Plaquenil was originally approved by the Food and Drug Administration (FDA) in 1955.
Before taking Plaquenil, tell your doctor if you have or have ever had:
- Liver disease
- Any blood disorders, such as porphyria, glucose-6-phosphate dehydrogenase deficiency (G6PD), or others
- A vision disorder
- Effects on your hearing caused by drugs
You should also tell your doctor if you drink large amounts of alcohol.
In rare cases, Plaquenil can cause cardiomyopathy, a chronic disease of the heart muscle.
If you're taking Plaquenil for an autoimmune condition, your symptoms should begin to improve after a few months, but it can take up to six months for full effects.
Stop taking the medicine and call your doctor if your symptoms worsen or don't improve.
Plaquenil and Children
Plaquenil can be dangerous to children, who are particularly sensitive to the drug. Kids shouldn't take Plaquenil as a long-term treatment.
Overdose can be fatal in children. So you should keep Plaquenil out of their reach.
Plaquenil and Eye Problems
Plaquenil can cause serious vision problems that aren't always reversible.
Tell your doctor immediately if you notice any changes in vision or if you've ever had vision changes while taking chloroquine (Aralen) or primaquine.
If you're taking this medicine for a long period of time, your doctor will probably recommend annual eye exams.
Pregnancy and Plaquenil
It's not known whether Plaquenil will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant before using this drug.
Malaria is more likely to cause death if you are pregnant. Talk to your doctor about the risks of traveling to areas where malaria is more common if you are pregnant.
It's not known whether Plaquenil passes into breast milk or could harm a breastfeeding baby. Talk to your doctor before breastfeeding while taking this medicine.
Plaquenil Side Effects
Common Side Effects of Plaquenil
Tell your doctor if any of the following side effects, as they may be indications of a more serious reaction:
- Loss of appetite
- Diarrhea, vomiting, or stomach pain
- Skin rash
Serious Side Effects of Plaquenil
If you are taking Plaquenil long-term, such as for an autoimmune condition, your doctor should regularly check you for potential serious side effects.
Call your doctor immediately or get emergency medical help if you experience any of the following serious side effects:
- Any vision problems, such as reading difficulties, sensitivity to light, seeing light flashes or streaks, blurred distance vision, or other issues
- Hearing problems, such as ringing or ticking in the ears, or hearing changes (Plaquenil may have toxic effects on your inner ear)
- Loss of balance, coordination, room spinning, or other vertigo symptoms
- Muscle weakness
- Bleeding or bruising of the skin
- Irregular heartbeat
- Mood or mental changes, such as confusion or other changes in thinking, feelings, or behavior
- Bleaching or loss of hair
Be extra careful about taking medicines that affect your blood cells or immune system, or that may be harmful to your liver when you are taking Plaquenil.
Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking, especially:
Don't take any drugs known as "gold preparations" (or "gold salts") when you are taking Plaquenil.
These are older drugs for autoimmune disease that are not commonly used in the United States but may be used where more modern drugs are not available. Examples include:
There may be a potential interaction with drugs that affect your eyes, such as vigabatrin (Sabril).
Plaquenil and Alcohol
Alcoholic beverages may increase your risk of liver problems while you take Plaquenil.
Avoid consuming alcohol while using this medicine.
Plaquenil and Other Interactions
The drug may make you dizzy. You shouldn't drive, operate machinery, or perform any other activity that requires you to be alert until you are certain you can do so safely.
If you are elderly and the medicine is making you dizzy, tell your doctor, who may take you off of Plaquenil to prevent falling during your normal activities.
Plaquenil comes in 200 milligram (mg) tablets that are taken by mouth.
To prevent malaria in adults, two tablets are typically taken once a week, on the same day each week.
The first dose of Plaquenil is usually taken one to two weeks before traveling to an area where malaria is prevalent. Doses are then continued for four weeks after exposure.
If two weeks' time is not available before you will be exposed to malaria, talk to a doctor about how much to take. Usually the initial dose is doubled.
To treat an attack of malaria in adults, four tablets are usually taken right away. After that, two tablets are taken six to eight hours later, followed by two tablets on each of the next two days.
Dosing is usually much lower in children and infants (depending on their body weight), usually 5 mg, calculated as base, per kilogram (kg) of body weight (one 200 mg tablet = 155 mg base).
Child dosages should never exceed adult dosages.
To treat lupus, one or two tablets are usually taken once or twice a day. Dosing is usually higher in the first few weeks, then lowered for longer maintenance treatment.
To treat rheumatoid arthritis, the dosage is higher, with one to three tablets typically taken once a day.
The higher dose may have side effects in a small percentage of people.
In such cases, doses may be reduced at first, or stopped altogether -- your physician will determine which. Some patients will be able to go back to the same dose eventually.
After one to three months, people with rheumatoid arthritis usually have a good response. Then the dose is lowered by 50 percent for maintenance therapy.
This medicine may be taken with a glass of milk or a meal to reduce nausea.
You should follow the instructions on your prescription label carefully when taking Plaquenil. Don't take more or less of the medicine that your doctor prescribes.
Overdose symptoms may include:
- Vision changes
- Slow heart rate
- Chest pain or heavy feeling
- Pain spreading to the arm or shoulder
- Shallow breathing
- Breathing that stops
If you suspect an overdose, you should contact a poison-control center or emergency room immediately.
You can reach a poison-control center at (800) 222-1222.
Missed Dose of Plaquenil
If you miss a dose of Plaquenil, take it as soon as your remember.
However, if it's almost time for your next dose, skip the missed dose and continue on your regular dosing schedule.
Don't double-up on doses to make up for a missed one.
Video: Plaquenil (Hydroxychloroquine) for use in Autoimmune disease. Side effects Medication.
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