Medication 101: Plaquenil/Hydroxychloroquine

I started taking Plaquenil/Hydroxychloroquine in November 2014 after being diagnosed with an autoimmune disease that doesn’t quite fit the criteria for Lupus. So far I haven’t noticed much difference but it can take 3 months for plaquenil to take effect.

Plaquenil is actually an anti malarial medication but is used in autoimmune conditions as a Disease Modifying Anti-Rheumatic Drug [DMARD]. Plaquenil works to reduce the inflammation caused by certain autoimmune conditions [where a person’s immune system attacks their body]. Plaquenil can be used to treat Lupus [both Systemic and Discoid],Connective Tissue Diseases [including Mixed Connective Tissue disease, and Undifferentiated Connective Tissue Disease], Rheumatoid Arthritis and Juvenile Arthritis.

Doses:

The usual dose of Plaquenil is 200-400mg but it has been known to be prescribed in doses as high as 600mg for people with Rheumatoid Arthritis. Plaquenil comes in 200mg tablets and doses of 400mg and over are usually split, taken once in the morning and once in the evening/nighttime.

[Note: Plaquenil is prescribed in much higher doses when used in the treatment for malaria] 

Right now I take 200mg twice a day, with the hopes of reducing this dose in March 2015 if my disease activity is at an adequate level, however Plaquenil is considered relatively safe so I won’t be too concerned if I need to stay on 400mg a day for longer.

Precautions:

Plaquenil is not indicated for use for people who are allergic to hydroxychloroquine, or similar medications [e.g. quinines, and quinones], for people who are pregnant or breastfeeding, or are intending to get pregnant or for people who have retina problems.

Before taking Plaquenil you should have your eyes examined as a baseline assessment, and this examination should be repeated every year that you are on Plaquenil to compare your vision to your baseline assessment. This is because in some cases plaquenil can build up behind your retina causing retina toxicity.

Side Effects:

Side effects that require medical attention [speak to your doctor]:  Allergic reactions [rash, swallowing and/or breathing problems, swelling of eyelids, lips, tongue, face and/or throat], visual changes [blurry vision, changes in the way you see colour, and/or light sensitivity], muscle weakness, muscle cramps, muscle spasms, changes in sensation [e.g. tingling], severe skin reactions [especially where blistering/peeling of skin occurs around mouth, eyes, nose and genitals], high temperatures, bruising more easily, anaemia [possible symptoms include dizziness, pale skin, fatigue, feeling faint, shortness of breath], liver problems [causing jaundice], lower blood glucose levels [feeling shaky, nervous, sweaty], seizures, Psoriasis

Side effects that might not need medical attention if persist for less than a few days [speak to your pharmacist]: Skin rashes, itching, changes in colour of skin inside mouth and nose, hair loss, loss of hair colour/lightening, feeling sick, diarrhoea, loss of appetite, stomach pain, feeling nervous, ringing in ears [tinnitus], headaches

Pros:

+ Considered a mild DMARD as it’s side effects are relatively mild in comparison to other DMARDs

Cons:

Takes a while to work. People usually notice a reduction in symptoms around the 3 month mark but it can take up to 6 months to take full effect. I have been taking this for about 5 weeks and I haven’t noticed a difference yet but it’s early days… I will keep you updated for when I do]

There is currently a shortage of Plaquenil in the US [see here]

This is the first of many Plaquenil tablets that I will be taking.... LETS DO THIS!

 

Sources:

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