Plaquenil

Plaquenil prevents and treats certain types of malaria infections. It is also used to treat lupus and rheumatoid arthritis.

Plaquenil Overview

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Plaquenil is a prescription medication used to reduce pain and swelling caused by diseases of the immune system such as rheumatoid arthritis, juvenile arthritis, and systemic lupus erythematosus (SLE). This medication belongs to a group of drugs called DMARDs (disease modifying antirheumatic drugs) which work by suppressing the excessive activity of the immune system.

Plaquenil is also used to prevent and treat malaria. For this reason, it is sometimes classified as an antimalarial drug. The exact way it works for this condition is unknown.

Plaquenil comes in tablet form. It is taken once or twice a day, unless it is used for the prevention of malaria, in which case it is taken once a week beginning 1 to 2 weeks prior to traveling to an area where malaria is common. Take this medication with a meal or a glass of milk to prevent stomach upset.

Common side effects include nausea, loss of appetite, headache, and diarrhea. Plaquenil can cause blurred vision and dizziness. Do not drive or operate heavy machinery until you know how it affects you.

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  • Arthritis, Rheumatoid
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Plaquenil Cautionary Labels

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Uses of Plaquenil

Plaquenil is a prescription medication used to prevent and treat certain types of malaria. It is also approved for the treatment of systemic lupus erythematosus (SLE), and rheumatoid arthritis.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Manufacturer

Plaquenil Drug Class

Plaquenil is part of the drug class:

Side Effects of Plaquenil

Common side effects include:

  • headache
  • dizziness
  • loss of appetite
  • nausea
  • diarrhea
  • stomach pain
  • vomiting
  • nervousness
  • rash

Tell your doctor if you have any side effect that bothers you or does not go away.

These are not all the possible side effects Plaquenil. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Plaquenil Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • aminoglycoside antibiotics such as amikacin
  • amiodarone (Cordarone)
  • antacids
  • medications for diabetes including insulin
  • medications for seizures
  • other antimalarials such as mefloquine
  • moxifloxacin (Avelox)
  • neostigmine
  • praziquantel (Biltricide)
  • pyridostigmine (Mestinon)
  • Rabies vaccine
  • agalsidase
  • cyclosporine (Gengraf, Neoral, Sandimmune)
  • cimetidine (Tagamet)
  • digoxin (Lanoxin)
 

This is not a complete list of Plaquenil drug interactions. Ask your doctor or pharmacist for more information.

 

Plaquenil Precautions

Serious side effects have been reported with Plaquenil including the following:

  • Heart failure. Plaquenil can cause weakening of the heart muscle, resulting in heart failure.Tell your healthcare provider right away if you have some or all of the following symptoms of heart failure.
    • breathlessness
    • swelling of the legs
    • irregular heart beat
    • fatigue
    • dizziness
  • Retinal damage. Plaquenil may cause irreversible damage to the retina (the back of the eye where vision is created). You are required to have an eye exam before taking Plaquenil, then a follow-up as often as needed while taking Plaquenil. Tell your healthcare provider right away if you have some or all of the following symptoms.
    • blurred vision
    • seeing halos around lights (especially at night)
    • seeing light flashes and streaks
    • visual field loss
    • change in eye color
    • difficulty focusing eye
    • difficulty reading (skipped words)
    • night blindness
  • Hypoglycemia (low blood sugar). Tell your healthcare provider right away if you have some or all of the following symptoms.
    • sweating
    • shakiness
    • weakness
    • dizziness
    • fast heartbeat
  • Muscular weakness. All patients on long term therapy should be questioned and examined periodically, including the examination of skeletal muscle function and tendon reflexes, testing of knee and ankle reflexes, to detect any evidence of muscular weakness. If weakness occurs, your doctor may need to discontinue the drug.
  • Low blood counts. Your doctor will monitor your blood counts and may have to discontinue medication depending on the results.

Plaquenil can cause blurred vision and dizziness. Do not drive or operate heavy machinery until you know how Plaquenil affects you.

Do not take Plaquenil if you:

  • are allergic to Plaquenil or to any of its ingredients
  • pre-existing retinopathy of the eye
  • use in children below 6 years of age (200 mg tablets not adapted for weight < 35kg)

Plaquenil Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Plaquenil , there are no specific foods that you must exclude from your diet when receiving this medication.

 

Inform MD

Before taking Plaquenil, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • are allergic to Plaquenil, allergic to any of its ingredients, or allergic to chloroquine
  • liver or kidney disease
  • blood disease, including a rare blood disease called porphyria
  • nervous system disease
  • a skin disease called psoriasis
  • a genetic condition known as “glucose-6-phosphate dehydrogenase deficiency”

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Plaquenil and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Plaquenil crosses the placenta. The data is limited regarding the use of Plaquenil  during pregnancy. However, Plaquenil have caused serious problems in the fetus. Plaquenil should not be used during pregnancy.

Plaquenil and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

Plaquenil has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from Plaquenil, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered. It is known that infants are extremely sensitive to the toxic effects of this medication.

 

Plaquenil Usage

Take Plaquenil exactly as prescribed.

Plaquenil comes in tablet form. It is taken once or twice a day, unless it is used for the prevention of malaria, in which case it is taken once a week beginning 1 to 2 weeks prior to traveling to an area where malaria is common. Take this medication with a meal or a glass of milk to prevent stomach upset.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Plaquenil at the same time.

Plaquenil Dosage

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

  • the condition being treated
  • other medical conditions you have
  • other medications you are taking
  • how you respond to this medication
  • your weight
  • your age
  • your kidney function
  • your liver function
 
Rheumatoid Arthritis
 
The recommended initial dosage of hydroxychloroquine (Plaquenil) for the treatment of rheumatoid arthritis is 400 to 600 mg daily.

The recommended maintenance dose range of hydroxychloroquine (Plaquenil) for the treatment of rheumatoid arthritis is 200 to 400 mg daily.

Lupus Erythematosus
 
The recommended initial dosage of hydroxychloroquine (Plaquenil) for the treatment of lupus erythematosus is 400 mg once or twice daily.

The recommended maintenance dose range of hydroxychloroquine (Plaquenil) for the treatment of lupus erythematosus is 200 to 400 mg daily.

Malaria:

Suppression

The recommended dose of hydroxychloroquine (Plaquenil) in adults is 400 mg on exactly the same day of each week.

The recommended weekly suppressive dose of hydroxychloroquine (Plaquenil) in children (6 years of age and older) is  5 mg base/kg. This dose should not exceed the adult dose reg ardless of body weight.

Suppressive therapy should begin two weeks before exposure.

  • When not administered before exposure, give an initial loading dose of 800 mg to adults, or 10 mg base/kg to children in two divided doses, six hours apart. The suppressive therapy should be continued for eight weeks after leaving the endemic area.

Treatment

The recommended dose of hydroxychloroquine (Plaquenil) for the treatment of malaria in adults is 800 mg followed by 400 mg in six to eight hours. This is followed by 400 mg on each of the next two days.

  • The dosage for adults may also be calculated by body weight.

For children (6 years of age and older) -dosage calculated by body weight is preferred. A total dose representing 25 mg of base/kg is administered over three days as follows:

  • First dose: 10 mg base/kg
  • Second dose: 5 mg base/kg 6 hours after the first dose
  • Third dose: 5 mg base/kg 18 hours after the second dose
  • Fourth dose: 5 mg base/kg 24 hours after the third dose

Plaquenil Overdose

If you take too much Plaquenil, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If you take too much Plaquenil, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

Other Requirements

Store Plaquenil at room temperature (15°C-30°C).

Keep in a safe place out of reach of children.

Plaquenil FDA Warning

WARNING

PHYSICIANS SHOULD COMPLETELY FAMILIARIZE THEMSELVES WITH THE COMPLETE CONTENTS OF PRODUCT LABELING BEFORE PRESCRIBING PLAQUENIL.