Medication Guide for Plaquenil

Active Ingredient

Hydroxychloroquine sulfate is the active ingredient in Plaquenil. It belongs to the class of drugs known as antimalarials and antirheumatics.

Mechanism of Action

Plaquenil works by decreasing the activity of the immune system. It interferes with the communication of cells and inhibits certain pathways that lead to inflammation in autoimmune diseases.

Indications

Plaquenil is prescribed for managing rheumatoid arthritis and systemic lupus erythematosus. It is also used in the prevention and treatment of acute malaria.

Dosage Forms

Plaquenil is available in tablet form, usually containing 200 milligrams of hydroxychloroquine sulfate. The tablet is film-coated to ease swallowing.

Recommended Dosage

For rheumatoid arthritis, a typical dosage is 200-400 milligrams daily, divided into two doses. For malaria prevention, a typical dose is 400 milligrams once weekly.

Administration Guidelines

Take Plaquenil with food or milk to minimize gastrointestinal discomfort. Swallow the tablet whole; do not crush or chew it. Consistent intake is vital for effective long-term management.

Contraindications

Plaquenil should not be used by individuals with a history of retinal or visual field changes. Patients with hypersensitivity to 4-aminoquinoline compounds should avoid this medication.

Renal Impairment

Dosage adjustments may be necessary for patients with renal impairment. Lower doses might be required to prevent toxic accumulation of the drug.

Hepatic Impairment

In patients with liver disease, closer monitoring is recommended. The drug may affect liver enzymes and necessitate dosage adjustments.

Drug Interactions

Concurrent use with digoxin may increase digoxin levels. Antacids could affect Plaquenil’s absorption if taken simultaneously. Combining with methotrexate may enhance therapeutic effects.

Pregnancy Category

Plaquenil is classified under Category C. Animal studies have shown adverse effects, but there are no well-controlled studies in humans. Caution is advised.

Lactation

Hydroxychloroquine can be excreted in breast milk. The decision to continue or discontinue breastfeeding while on Plaquenil should consider potential risks and benefits.

Pediatric Use

The safety and efficacy of Plaquenil in pediatric patients under the age of 18 have not been established, except in the treatment of malaria.

Adverse Reactions

Common side effects include gastrointestinal disturbances, headache, dizziness, and skin rashes. Ophthalmic side effects such as retinopathy are rare but serious complications.

Storage Conditions

Keep Plaquenil stored at room temperature, away from moisture and heat. Ensure the medication is secured and out of reach of children.

Monitoring Requirements

Regular eye exams are recommended due to potential retinal toxicity. Monitor blood counts and liver function tests periodically to detect adverse reactions early.

Missed Dose

If you miss a dose, take it as soon as you remember. If it’s nearly time for your next dose, skip the missed dose. Do not double doses to make up for the missed one.

Overdose Management

Overdose symptoms may include drowsiness, headache, and vomiting. Immediate medical attention is crucial. Cardiac monitoring and supportive measures should be instituted.

Effect on Lab Tests

Hydroxychloroquine may interfere with certain lab tests, including liver functions and blood glucose measurements. Notify lab personnel if you take Plaquenil.

Dietary Considerations

No specific dietary restrictions are required. However, adequate hydration is recommended. Alcohol use should be minimized to avoid liver stress.

Drug Half-life

The elimination half-life of Plaquenil is approximately 40-50 days in adults. It is primarily excreted through the kidneys.

Special Populations

Elderly patients may show increased susceptibility to adverse reactions, requiring individualized dosage and monitoring. Patients with psoriasis should use cautiously due to risk of skin reactions.

Immune System Effects

Plaquenil may affect the immune response, which could alter an individual’s ability to fight infections. Regular medical follow-up is recommended.

Photo Sensitivity

Patients may experience an increased sensitivity to sunlight. Protective clothing and sunscreen use are advisable when outdoors.

Withdrawal Effects

Abrupt discontinuation may lead to a flare-up of disease symptoms. Any changes in dosage or cessation should be gradually implemented under medical supervision.

Viscosity Change

Plaquenil may alter the viscosity of tears, potentially causing dry eyes. Regular eye examinations are advised to monitor ocular health.

Gastrointestinal Tolerance

Long-term use can result in gastrointestinal disturbances. Use with food or milk may improve tolerance and decrease the likelihood of adverse effects.