Plaquenil (Hydroxychloroquine)

Description

Indications

Hydroxychloroquine is primarily utilized to prevent and treat acute bouts of malaria in both adults and children who weigh over 31 kg (68 lbs). It can also be used to manage chronic conditions like discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE), which is an autoimmune disorder that causes the immune system to attack healthy parts of the body, including joints, skin, blood vessels, and organs.

Hydroxychloroquine is classified as an antimalarial and antirheumatic drug. It eradicates malaria-causing organisms and might alleviate rheumatoid arthritis and SLE symptoms by reducing immune system activity.

Uses and Dosage

Take this medication orally. To avoid stomach discomfort, take it with food or milk. The tablets should be swallowed whole, as breaking or crushing them may result in a bitter taste.

The dosage and duration of treatment are determined by your medical condition and how you respond to treatment. For children, the dose is based on their weight.

To prevent malaria, take this medication by mouth as prescribed by your doctor, typically once a week on the same day of the week. To assist with remembering, mark your calendar. This drug should be started 1 to 2 weeks before entering a malarious region, while in the region, and for 4 to 8 weeks after leaving- take it weekly or as prescribed by your doctor.

For lupus or rheumatoid arthritis, take this medication by mouth as directed by your doctor, usually once or twice a day. Your doctor may gradually increase your dose. After taking the medication for some time and your condition has improved, your doctor may instruct you to reduce your dose until you find the optimal dose with the fewest side effects.

If you are taking this drug for diarrhea or are also taking antacids (such as magnesium/aluminum hydroxide), take hydroxychloroquine at least 4 hours before or after these products. These products may bind with hydroxychloroquine, preventing your body from fully absorbing it.

To get the most out of this medication, take it regularly. If you take it every day, take it at the same time(s) each day. Follow your doctor’s instructions precisely. Do not stop taking it without consulting your doctor, especially if you are taking it to prevent malaria. Keep taking this medication for the prescribed length of time. Stopping prevention or treatment too early may result in infection or a recurrence of the illness.

Inform your doctor if your condition persists or worsens. It may take several weeks or months to see progress if you are taking this medication for lupus or arthritis.

Hydroxychloroquine may not prevent malaria in all cases. If you experience a fever or other symptoms of illness, seek medical attention right away. You may require a different medication.

Side Effects

Some side effects may occur that usually do not need medical attention:

• headache
• loss of appetite
• nausea
• diarrhea
• stomach pain
• vomiting
• difficulty hearing
• ringing in ears
• hair loss
• hair color changes

Inform your healthcare provider immediately if you experience any serious side effects:

• hives
• blisters on the skin, eyes, lips or in the mouth
• itching or burning skin
• muscle weakness
• burning, numbness, or tingling in the hands or feet
• unusual bleeding or bruising
• cough, fever, sore throat, runny nose, or other signs of infection
• mood or mental changes
• fast or irregular heartbeat
• lightheadedness, dizziness, or fainting
• unusual tiredness or weakness
• seizures
• new or worsening depression
• mood changes
• thinking about harming or killing yourself

Caution

Inform your doctor or pharmacist if you have an allergy to hydroxychloroquine, chloroquine, or any other allergies before taking this medication. Inactive ingredients in the product may cause allergic reactions or other complications.

Before using this medication, tell your doctor or pharmacist about your medical history, especially if you have a deficiency of a specific enzyme (glucose-6-phosphate dehydrogenase deficiency-G6PD), vision or eye problems, hearing problems, kidney disease, liver disease, regular alcohol use or abuse, skin problems, a specific blood disorder (porphyria), or seizures.

If you have diabetes, this product may affect your blood sugar. Check your blood sugar levels regularly as directed and share the results with your doctor. Inform your doctor immediately if you experience symptoms of low blood sugar. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This drug may cause dizziness. Consuming alcohol or marijuana may increase dizziness. Do not operate machinery, drive, or perform any activities that require alertness until you are able to do so safely.

This medication may make you more susceptible to sunburn. Limit your sun exposure, avoid tanning booths and sunlamps, and use sunscreen and protective clothing while outdoors. Immediately inform your doctor if you get sunburned or have skin blisters/redness.

Hydroxychloroquine may cause QT prolongation, a heart rhythm condition. QT prolongation may rarely cause serious (rarely fatal) fast or irregular heartbeat, and other symptoms such as severe dizziness or fainting, which require immediate medical attention.

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may be elevated if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting.

Older adults may be more sensitive to the side effects of this drug, particularly QT prolongation.

During pregnancy, use this medication only when it is clearly necessary. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Form and Strength

Plaquenil is available in the following forms and strengths:

• Plaquenil tablet:
  • 200mg

FAQ

How long does it take for Plaquenil to work?

Plaquenil works very slowly. In 1 to 3 months you should start to feel better. You may continue to get better for up to 1 year.

Can Plaquenil make anxiety worse?

Plaquenil can induce adverse effects on the central nervous system, from irritability, nervousness, and emotional changes to true psychoses.

Resources

1. https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/lupus-center/fact-sheets/lupus-medicine-hydroxychloroquine#:~:text=Plaquenil%20works%20very%20slowly.,medicines%20for%20pain%20and%20stiffness
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336441/#:~:text=Hydroxychloroquine%20can%20induce%20adverse%20effects,emotional%20changes%20to%20true%20psychoses
3. https://www.medbroadcast.com/drug/getdrug/plaquenil
4. https://www.webmd.com/drugs/2/drug-6986/plaquenil-oral/details
5. https://medlineplus.gov/druginfo/meds/a601240.html
6. https://www.drugs.com/plaquenil.html