Generic Plaquenil 200 mg – Hydroxychloroquine
- 1 Hydroxychloroquine sulfate
- 2 Pharmachologic effect
- 3 Indications
- 4 Hydroxychloroquine and Coronavirus
- 5 Dosage
Release form, composition and packaging
The film-coated tablets are white, round, biconvex. One tablet contains 200 mg hydroxychloroquine sulfate
Plaquenil possesses antimalarial properties, and also has anti-inflammatory and immunosuppressive effects in chronic discoid or systemic lupus erythematosus (SLE), acute and chronic rheumatoid arthritis. The mechanism of its action in malaria, SLE and rheumatoid arthritis is not fully known.
Hydroxychloroquine has the properties of a moderate immunosuppressor, inhibiting the synthesis of rheumatoid factor and components of the acute phase reaction. It also accumulates in leukocytes, stabilizing lysosomal membranes, and inhibits the activity of many enzymes, including collagenases and proteases that cause cartilage breakdown.
- rheumatoid arthritis
- juvenile rheumatoid arthritis
- Malaria (excluding chloroquine-resistant strains of Plasmodium falciparum):
- for the prevention and treatment of acute malaria attacks caused by Plasmodium vivax, Plasmodium ovale and Plasmodium malariae, as well as sensitive strains of Plasmodium falciparum
- for the radical treatment of malaria caused by susceptible strains of Plasmodium falciparum.
Update March 2020 / On March 19, Donald Trump announced that Plaquenil would be available as a prescription in the United States. He noted that hydroxychlorogin showed “encouraging results”, but at the same time he understood that the treatment of coronavirus with this drug requires further research.
Plaquenil is for oral use only. The drug is taken with meals or with a glass of milk.
All doses of the drug are based on hydroxychloroquine sulfate and are not equivalent to the doses of the base.
Hydroxychloroquine has cumulative activity. For the manifestation of its therapeutic effect, several weeks of taking the drug are necessary, while side effects can occur relatively early. The necessary therapeutic effect develops after several months of taking the drug. In the absence of objective improvement in the patient’s condition within 6 months of taking hydroxychloroquine, the use of the drug should be discontinued
For adults (including the elderly), the drug is prescribed in the minimum effective dose. The dose should not exceed 6.5 mg / kg body weight per day (calculated on the basis of ideal rather than real body weight) and can be either 200 mg or 400 mg / day.
In patients who are able to take 400 mg daily, the initial dose is 400 mg daily in several doses. When an obvious improvement is achieved, the dose can be reduced to 200 mg. With a decrease in effectiveness, the maintenance dose can be increased to 400 mg.
Rarely: retinopathy with changes in pigmentation and visual field defects. In an early form, retinopathy is reversible when the course of treatment with hydroxychloroquine is discontinued.
Corneal changes are possible, including swelling and clouding. They can be asymptomatic or cause disorders such as the appearance of halos, blurred vision or photophobia. These changes may be reversible upon discontinuation of treatment.
Perhaps a decrease in vision due to a violation of accommodation, which is dose-dependent and is reversible.
Skin rashes, itching, changes in pigmentation of the skin and mucous membranes, hair bleaching and alopecia are possible. These reactions usually pass quickly when treatment is discontinued.
From the digestive system: nausea, diarrhea, anorexia, abdominal pain; rarely – vomiting. These reactions usually go away immediately after a dose reduction or treatment discontinuation. With prolonged use and in high doses, hepatotoxicity is possible.
From the side of the central nervous system and peripheral nervous system: sometimes
- hearing loss
- emotional instability
- muscle weakness
In some cases, skeletal muscle myopathy or neuromyopathy, leading to progressive weakness and atrophy of the proximal muscle groups. Myopathy may be reversible after discontinuation of the drug, but it may take several months to fully recover. Mild sensory changes, suppression of the tendon reflex and a decrease in nerve conduction are possible.
From the cardiovascular system: rarely – cardiomyopathy. After discontinuation of the drug, the reverse development of these changes is possible.
From the side of metabolism: hydroxychloroquine can provoke or cause exacerbation of porphyria.
Allergic reactions: urticaria, angioedema, bronchospasm.