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Plaquenil
Plaquenil (hydroxychloroquine) is an antimalarial medication that is also used to treat various autoimmune diseases, primarily rheumatoid arthritis and lupus erythematosus. It helps to reduce inflammation and modify the disease process in these conditions, providing relief from symptoms and preventing flares.
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Frequently Asked Questions
How quickly does Plaquenil start to work?
Patients may begin to notice improvements in symptoms within several weeks of starting Plaquenil, but it may take 3 to 6 months for the full effects to be realized.
Can I stop taking Plaquenil suddenly?
It is generally not advisable to stop taking Plaquenil abruptly without consulting your healthcare provider, as this may lead to a flare in disease symptoms.
Are there any specific dietary restrictions while using Plaquenil?
There are no specific dietary restrictions associated with Plaquenil, but patients should avoid excessive alcohol consumption as it may exacerbate liver side effects.
What should I do if I miss a dose of Plaquenil?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Is Plaquenil safe for long-term use?
Plaquenil can be used long-term under medical supervision, but regular monitoring is essential to check for potential side effects, particularly ocular toxicity and any hematological effects.
Comprehensive Drug Guide
How Does Plaquenil Work?
Hydroxychloroquine works by interfering with the communication of cells in the immune system and modulating the inflammatory response. It is thought to inhibit the activity of certain immune cells and decrease the production of inflammatory mediators, which helps to reduce the symptoms associated with autoimmune conditions.
What is Plaquenil Used For?
Plaquenil is approved to treat and prevent malaria and to manage symptoms of lupus and rheumatoid arthritis.
Common Dosages
- Tablets: Common strengths include 200 mg.
Typical Dosing
- For rheumatoid arthritis: The usual starting dose is 400 mg daily (administered as 200 mg twice daily) for the first week, followed by 200 mg daily for maintenance.
- For systemic lupus erythematosus: The starting dose is similar, with adjustments made based on clinical response.
Typical Dosing
FDA Approved Indications
- Treatment of malaria.
- Management of rheumatoid arthritis.
- Treatment of systemic lupus erythematosus.
Who Shouldn't Take Plaquenil?
- Known hypersensitivity to hydroxychloroquine or any components of the formulation.
- Retinal or visual field changes due to previous use of 4-aminoquinoline compounds.
Advice From The Pharmacist
- Instruct patients to take Plaquenil exactly as prescribed and to continue regular follow-ups for monitoring response and potential side effects.
- Advise patients to report any changes in vision, including blurriness or difficulty seeing, as early detection of retinal toxicity is important.
- Discuss the importance of adhering to recommended lab tests, such as eye exams, to monitor for any adverse effects on vision.
Side Effects of Plaquenil
Common Side Effects
- Nausea
- Diarrhea
- Abdominal cramps
- Headache
- Skin rash
Uncommon/Severe Side Effects
- Retinal damage or vision changes
- Severe allergic reactions (such as rash, itching, or difficulty breathing)
- Blood disorders, including hemolytic anemia
Risks and Warnings of Plaquenil
- Ocular Toxicity: Long-term use of hydroxychloroquine can lead to retinal damage; patients should be regularly monitored for vision changes, especially those on higher doses or with extended use.
- Cardiomyopathy: Rarely, hydroxychloroquine can cause cardiomyopathy, particularly in patients with pre-existing heart conditions.
Interactions with Plaquenil
Common Drug Interactions
- Other Medications: Plaquenil can interact with certain medications, including antacids containing aluminum or magnesium, which may reduce its absorption. Patients should separate doses of these medications by several hours.
- CYP450 Interactions: Although hydroxychloroquine is not extensively metabolized by CYP450 enzymes, interactions with other drugs metabolized by these pathways should be monitored.
Alternatives to Plaquenil
- Other Antimalarial Agents: Such as chloroquine may be considered for similar indications.
- Other DMARDs: Such as methotrexate or sulfasalazine for rheumatoid arthritis or lupus management.
