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Plaquenil (Hydroxychloroquine)
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Plaquenil

Plaquenil is an expensive drug used to treat rheumatoid arthritis and systemic lupus erythematosus. It is also used to treat malaria. It is more popular than comparable drugs. It is available in generic and brand versions.

Other names for this medication:
Hydroxychloroquine, Rutor, Zhquine

Similar Products:
Feldene, Inderal, Colcrys, Moduretic, Vermox, Xanax

Also known as: Hydroxychloroquine

Description

{name} (hydroxychloroquine) is used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Hydroxychloroquine is not effective against all strains of malaria, or against malaria in areas where the infection has been resistant to a similar drug called chloroquine.

{name} is also used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus.

Dosage

Usual Adult Dose of Plaquenil for Malaria Prophylaxis:

400 mg salt (310 mg base) orally once a week Weight-based dosing: 6.5 mg/kg salt (5 mg/kg base) orally once a week -Maximum dose: 400 mg salt (310 mg base)/dose Comments: -This drug should be administered on the same day of each week. -Suppressive therapy should begin 2 weeks prior to exposure and should continue for 4 weeks after leaving the endemic area. Use: For the prophylaxis of malaria in geographic areas where chloroquine resistance is not reported US CDC Recommendations: 310 mg base (400 mg salt) orally once a week Comments: -An alternative to chloroquine for prophylaxis only in areas with chloroquine-sensitive malaria -Prophylaxis should start 1 to 2 weeks before travel to malarious areas; should continue weekly (same day each week) while in malarious areas and for 4 weeks after leaving such areas -If malaria develops while using this drug for chemoprophylaxis, it should not be used as part of the treatment regimen. -Current guidelines should be consulted for additional information.

Usual Adult Dose of Plaquenil for Malaria:

800 mg salt (620 mg base) orally as an initial dose, followed by 400 mg salt (310 mg base) at 6, 24, and 48 hours after the initial dose Total dose: 2000 mg salt (1550 mg base) Weight-based dosing: -First dose: 13 mg/kg salt (10 mg/kg base) orally -Second dose (6 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally -Third dose (24 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally -Fourth dose (48 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Maximum Dose: -First dose: 800 mg salt (620 mg base)/dose -Second, third, and fourth dose: 400 mg salt (310 mg base)/dose Comments: -Concomitant therapy with an 8-aminoquinoline compound is necessary for radical cure of Plasmodium vivax and P ovale infections. Use: For the treatment of uncomplicated malaria due to P falciparum, P malariae, P ovale, and P vivax US CDC Recommendations: 620 mg base (800 mg salt) orally at once, followed by 310 mg base (400 mg salt) orally at 6, 24, and 48 hours Total dose: 1550 mg base (2000 mg salt) Comments: -Recommended for uncomplicated malaria (P falciparum or species not identified) in regions with chloroquine sensitivity -Recommended for uncomplicated malaria (P malariae, P knowlesi, P vivax [unless chloroquine-resistant P vivax suspected], or P ovale) in all regions; if treating P vivax or P ovale infections, concomitant treatment with primaquine (after quantitative testing to rule out glucose-6-phosphate dehydrogenase [G6PD] deficiency) is recommended. -Recommended for uncomplicated malaria treatment for pregnant women in regions with chloroquine sensitivity -Current guidelines should be consulted for additional information.

Usual Adult Dose of Plaquenil for Systemic Lupus Erythematosus:

200 to 400 mg salt (155 to 310 mg base)/day orally divided in 1 or 2 doses Comments: -Doses above 400 mg/day are not recommended. -Higher incidence of retinopathy reported when this maintenance dose is exceeded. Uses: For the treatment of chronic discoid lupus erythematosus and systemic lupus erythematosus

Usual Adult Dose of Plaquenil or Rheumatoid Arthritis:

Initial dose: 400 to 600 mg salt (310 to 465 mg base)/day orally divided in 1 or 2 doses Maintenance dose: 200 to 400 mg salt (155 to 310 mg base)/day orally divided in 1 or 2 doses Maximum dose: 600 mg salt (465 mg base)/day or 6.5 mg/kg salt (5 mg/kg base)/day, whichever is lower Comments: -The action of this drug is cumulative and may require weeks to months to achieve the maximum therapeutic effect. -When a good response is obtained, the initial dose may be reduced by 50% and continued at a maintenance dose. -Higher incidence of retinopathy reported when this maintenance dose is exceeded; 600 mg salt (465 mg base) or 6.5 mg/kg salt (5 mg/kg base), whichever is lower, should not be exceed per day. -Corticosteroids and salicylates may be used with this drug, and they can generally be decreased gradually in dosage or eliminated after a maintenance dose of this drug has been achieved. Use: For the treatment of acute and chronic rheumatoid arthritis

Usual Pediatric Dose of Plaquenil for Malaria Prophylaxis:

6.5 mg/kg salt (5 mg/kg base) orally once a week Maximum dose: 400 mg salt (310 mg base)/dose Comments: -This drug should be administered on the same day of each week. -Suppressive therapy should begin 2 weeks prior to exposure and should continue for 4 weeks after leaving the endemic area. Use: For the prophylaxis of malaria in geographic areas where chloroquine resistance is not reported US CDC Recommendations: 5 mg/kg base (6.5 mg/kg salt) orally once a week Maximum dose: 310 mg base (400 mg salt)/dose Comments: -An alternative to chloroquine for prophylaxis only in areas with chloroquine-sensitive malaria -Prophylaxis should start 1 to 2 weeks before travel to malarious areas; should continue weekly (same day each week) while in malarious areas and for 4 weeks after leaving such areas -If malaria develops while using this drug for chemoprophylaxis, it should not be used as part of the treatment regimen. -Current guidelines should be consulted for additional information.

Usual Pediatric Dose of Plaquenil for Malaria:

First dose: 13 mg/kg salt (10 mg/kg base) orally Second dose (6 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Third dose (24 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Fourth dose (48 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Maximum Dose: -First dose: 800 mg salt (620 mg base)/dose -Second, third, and fourth dose: 400 mg salt (310 mg base)/dose Comments: -Concomitant therapy with an 8-aminoquinoline compound is necessary for radical cure of P vivax and P ovale infections. Use: For the treatment of uncomplicated malaria due to P falciparum, P malariae, P ovale, and P vivax US CDC Recommendations: 10 mg/kg base orally at once, followed by 5 mg/kg base orally at 6, 24, and 48 hours Total dose: 25 mg/kg base Comments: -Pediatric dose should never exceed adult dose. -Recommended for uncomplicated malaria (P falciparum or species not identified) in regions with chloroquine sensitivity -Recommended for uncomplicated malaria (P malariae, P knowlesi, P vivax [unless chloroquine-resistant P vivax suspected], or P ovale) in all regions; if treating P vivax or P ovale infections, concomitant treatment with primaquine (after quantitative testing to rule out G6PD deficiency) is recommended. -Current guidelines should be consulted for additional information.

Detailed Plaquenil dosage information

Overdose

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of hydroxychloroquine can be fatal, and must be treated quickly.

Overdose symptoms may include drowsiness, vision changes, seizure, slow heart rate, weak pulse, pounding heartbeats, sudden dizziness, fainting, shortness of breath, or slow breathing (breathing may stop).

Keep this medicine out of the reach of children. A hydroxychloroquine overdose can be fatal to a child who accidentally swallows this medicine.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

After you prime the bottle, there will only be 120 doses or sprays. Keep track of the number of sprays you use. Throw the bottle away after you use 120 sprays even if some liquid remains in the bottle.

Detailed Plaquenil dosage information

Side effects

The most common side effects associated with Plaquenil are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

You should not use Plaquenil if you are allergic to hydroxychloroquine or chloroquine.

High doses or long-term use of Plaquenil may cause irreversible damage to your retina (the membrane layer inside your eye that helps produce vision). This could progress to permanent vision problems. The risk of retinal damage is higher in people with pre-existing eye problems, kidney disease, or people who also take tamoxifen.

To make sure Plaquenil is safe for you, tell your doctor if you have ever had:

vision changes or damage to your retina caused by an anti-malaria medication; heart disease, heart rhythm disorder (such as long QT syndrome); diabetes; a stomach disorder; an allergy to quinine; liver or kidney disease; psoriasis; alcoholism; porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Tell your doctor if you are pregnant or plan to become pregnant. Malaria is more likely to cause serious illness or death in a pregnant woman. Having malaria during pregnancy may also increase the risk of miscarriage, stillbirth, premature delivery, and low birth weight.

It is not known whether hydroxychloroquine will harm an unborn baby. If you are pregnant, ask your doctor about the risks of traveling to areas where malaria is common (such as Africa, South America, and Southern Asia).

It may not be safe to breastfeed while using Plaquenil. Ask your doctor about any risk.

Plaquenil is not approved for treating lupus or rheumatoid arthritis in anyone younger than 18 years old.

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The increase in serum calcitonin during pregnoncy raises the problem of the role of oestrogens in the secretion of calcitonin. Exposure to LPS, MDP and their combinations led to an over 2-fold increase in responses of the spleen cells to the effect of IL-2 as compared to the controls. Responses of diencephalic neurons to olfactory bulb stimulation, odor, and arousal. The numbers of inflammatory leucocytes that express the anti-inflammatory cytokine IL-10 are much more widely distributed than those that express the proinflammatory cytokines IL-6 and TNF-alpha. Armed with this new knowledge, we are pursuing strategies of permanently preventing atrial fibrillation by destroying these foci using radiofrequency ablation. Males generate a ridge and furrow system which is gradually replaced by a solid ankylosis at the mid-sagittal plane. Three-dimensional photon detection kernels and their application to SPECT reconstruction.

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Safety of cefoxitin: an approach to the analysis of laboratory data. From our results we can conclude that the type-specific gamma-determinant is not restricted to a distinct region on the adenovirus fiber knob but is composed of at least 17 amino acids. However, the hydropathy plot analysis suggests that PRP does not have any prominent membrane-spanning domains and thus is not typical of ABC transporters. Human placental lactogen was localized in the cells of the proximal tubules of the cortex and to a lesser extent in the tubular lumen and the tubules of the medulla region. In the fibrin sealant group, fibrinogen and topical bovine thrombin were sprayed onto the surgical site to form fibrin sealant at the conclusion of tonsillectomy.

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I have purified and characterized two products synthesized in vitro in a system for coupled transcription and translation programmed by DNA from a transducing bacteriophage carrying the gene for ribosomal protein S20. A case of septicemia with Pediococcus acidilactici after long-term antibiotic treatment. Thus, GSLs have important roles in signal transduction mediated by the microdomains. Various yeasts and filamentous fungal infections of human and animal heart and blood vessels, as well as the experimental investigations, are reviewed. This investigation assessed change in use of human immunodeficiency virus (HIV) testing by minors after removal of the parental consent requirement in Connecticut. Pleural effusion as the initial radiologic manifestation of chronic traumatic hernia of the diaphragm. To investigate the frequency of ECG abnormalities suggestive of myocardial ischaemia in patients with severe drug resistant epilepsy and without any indication of previous cardiac disease, assuming that these changes may be of significance for the group of epileptic patients with sudden unexpected death. Ultrastructural studies revealed that a basal lamina-like substance with anchoring fibrils was present between and within amyloid deposits.

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restoration by SSB of the activity of the mutant cell extract allowed replication like that of a wild-type crude extract, as shown by bidirectional DNA synthesis from the in vivo origin. Both the uptake of the genotoxicant(s) and their biological effect should be considered determinants of the hazard potential of the exposure. Reconstruction of electrocardiograph EKP-4m into a two-canal apparatus. After injection of oiled solutions of JH-I metamorphosis was much more disturbed than following the same treatment with JH-III. The sugar intake of businessmen and its inverse relationship with relative weight. Control of house dust mites and mite allergens by special mite-preventive futon.

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Fos expression in the midbrain periaqueductal grey after trigeminovascular stimulation. Enhanced ubiquitination was also observed in degenerating and necrotic fibers. The epileptogenic drug, pentylenetetrazol (PTZ) produces paroxysmal depolarization shifts in molluscan neurons that are similar to PDSs seen at a mammalian epileptic focus. Thioridazine and trifluoperazine, which have been previously found in this laboratory to be the most effective calmodulin antagonists in treatment of burns, are shown here to be also effective in the treatment of frostbite. In vitro effects of syngeneic lymphocytes and serum on F 1 hybrid fibroblasts. Although it is impossible to predict the effect of the unique amino acid residues without detailed knowledge of the three-dimensional structure and function of the proteins, they could affect the virulence of HV-IBDV. Thus, it may be confused with benign conditions such as cervical endometriosis.

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Newly-developed diamond points for conservative operative procedures. Disturbances of the hypothalamic-pituitary-adrenal (HPA) system have been found in delirious patients in various studies. The degree of anticoagulation was assessed by the prothrombin time. The electrophoretic analysis of serum lipoprotein is the usefull method for the study on hyperlipidemia in the cerebrovascular disease. Factors discriminating men with coronary heart disease from healthy controls. A new method combining experience of ultrasonic diagnostic and puncture technique with the how much does protonix 40 mg cost use of existing angiographic tools is described. The electrode response was found to depend on the structure of the surfactants. The study of the flavin mononucleotide (FMN)-reduced nicotinamide adeninedinucleotide (NADH) reaction was carried out both under aerobic and anaerobic conditions, using spectrophotometric and titrimetric methods. This was true within each of the five populations and for the average of all populations combined. 33 921) was chosen among a series of new daunorubicin analogues.

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The analysis revealed that of the factors (smoking, overweight, hypertension, diabetes, serum cholesterol and family history) considered, the smoking habit of the individual, presence of family history of the disease and overweight were the significant risk factors responsible for the development of the disease. Sidman and his colleagues derived behavioral tests for stimulus equivalence from the axiom in logic and mathematics neurontin 50 mg that defines a relation of equivalence. While there was a significant increase in cortisol, prolactin and TSH levels after both jumps, no alterations could be observed in STH and LH levels. A specific factor V gene haplotype (HR2) was defined by six polymorphisms and its frequency was found to be similar in normal subjects coming from Italy (0.08), India (0.1), and Somalia (0.08), indicating that it was originated by ancestral mutational events. Limited thoracoplasty in the management of complicated pulmonary aspergillomas. Only patients scheduled for weaning from the ventilator were selected for the study. The first is related to the test methods used to study the microbial insecticide interaction, the second area is concerned with the influence of environmental factors on the action of microbes and vice versa.

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Fentanyl with or without adrenaline in peridural administration in obstetrics: plasma analysis and analgesic effects. The inactivation rate decreased for one mutant (Arg-44----Ser), whereas no change was observed for another (Arg-42----Thr) and an increase was observed for a third (Lys-43----Thr). In general fewer hepatocytes survived ectopic transplantation after cryopreservation, but the surviving cells were ultrastructurally similar to ectopically transplanted cells not subjected to cryopreservation. Recent studies indicate that reception of photoperiodic cues begins during fetal life. Microbial products such as panepoxydone, cycloepoxydon and gliotoxin are known to inhibit activation of NF-kappaB. These results suggest that individual differences in rates of initiation, choice of abusing agent, and maintenance of drug self-administration may be partially determined by pre-existing differences in central nervous system functioning due to early experiences. Two abdominal muscle synergies emerged during the double straight leg lowering exercise: synergy I exhibited high rectus abdominis, high external oblique, and low internal oblique muscle activity, whereas synergy II exhibited low rectus abdominis, high external oblique, and high internal oblique. In birds ashore, which were hand-fed 2-15 g pieces of fish, all meal ingestions were detected with a sensor in the upper oesophagus. A family is described in which the father, son, and daughter have spondylometaphyseal dysplasia, consistent with an autosomal dominant pattern of inheritance.

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The drugs were added 20 min before S2, and their effects on NA release were assessed by the ratio S2/S1. The Swedish studies are evaluating the effectiveness of mammography alone, while studies in Britain will help to evaluate breast self-examination (BSE) and biannual mammography with annual physical examination. Commercial latex agglutination for detection of group B streptococcal antigen in body fluids. The random mechanism is different from the ordered addition of substrates found for uridine phosphorylase from other sources. Gross contamination of surfaces occurred in all experiments, but only three types of accident produced a measurable aerosol. Research into individual factors is limited protonix medication price , but age and gender both appear to be important.

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A comparison of pressure-volume lamisil dosage oral relations of the fetal, newborn, and adult heart. Modulation of pharmacological profile of diphenylethane (lefetamine-type) derivatives. This was explained by the solubilization theory of Higuchi and Connors. The condition was first suspected by hypokalemia (2.6 mEq/liter), which was incidentally found by routine checkup. Descriptions in the literature report an almost automatic ease in performance of the maneuver. The Lesch-Nyhan syndrome--an under-recognised condition in South Africa?. Kinetic evidence for peptide-induced oligomerization of the molecular chaperone DnaK at heat shock temperatures. Fusion of host cell secondary lysosomes with the parasitophorous vacuoles of Leishmania mexicana-infected macrophages. As the first step in insulin action is its binding to alfa subunits of the receptor we, therefore, studied the insulin binding kinetics in plasma membranes of the liver, heart and skeletal muscle in order to establish whether their ability to bind the hormone is altered with aging.

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