Plaquenil 200mg #60

Plaquenil instruction for use

Reed more and buy Plaquenil on this page

Composition

One tablet contains:
    200 mg of the active substance (hydroxychloroquine sulphate);
    excipients: lactose monohydrate, povidone, corn starch, magnesium stearate, hypromellose, macrogol-4000, titanium dioxide, lactose monohydrate.

Form of issue

Round bulb-covered tablets covered with a film sheath, with the inscription "HCQ" on one side and "200" on the other.
One cardboard package contains 60 tablets: 6 blisters made of PVC and aluminum foil (in one blister - 10 tablets).

pharmachologic effect

Plaquenil has the following action:
    antiprotozoal - suppress the vital activity of the protozoa, causing infectious diseases; first of all, it concerns the pathogens of malaria, therefore the main effect of the drug is antimalarial;
    immunosuppressive - suppresses the excessively expressed reaction of the immune system, including allergies to the patient's own tissues;
    Anti-inflammatory - suppresses inflammatory reactions.

Pharmacodynamics and pharmacokinetics

Plaquenil belongs to the group of antimalarial and immunosuppressive drugs from the group of 4-aminoquinoline derivatives. The mechanism of its action has not been studied enough, but it is believed that it is associated with the following properties of this drug:
    The ability to suppress the action of toxic free radicals formed during the metabolism (antioxidant effect).
    The ability to suppress the action of enzymes that cause the disintegration of cartilaginous tissue.
    The ability to suppress the synthesis of prostaglandins - biologically active substances that take part in inflammatory processes.
    The ability to concentrate in leukocytes and strengthen the lysosome membranes - cell structures containing enzymes that can break down incoming nutrients into the cell. Lysosomes also participate in the digestion of bacteria trapped by leukocytes.
    The ability to suppress the synthesis of those types of cytokines (hormone-like proteins synthesized by cells to affect other cells) that activate immunity. This also contributes to a decrease in autoimmune processes (destruction of the body's own tissues by immune processes).
    The ability to suppress the activity of lymphocytes involved in immune responses.
    The ability to suppress the formation of rheumatoid factor - immunoglobulins (antibodies), perceiving the body's own tissues as foreign structures (antigens) and destroying them.
    The anti-malarial properties of Plaquenilus are the suppression of the life of the pathogens of three-day malaria, four-day malaria, malaria-oval, and also the forms of tropical malaria causing it (the majority of tropical malaria pathogens are insensitive to Plaquenil).
After taking Plaquenil's tablet, its active substance is quickly and almost completely absorbed and enters the bloodstream, and then accumulates in high concentrations in various organs and tissues. The maximum concentration of the active substance in the blood plasma is approximately 100 minutes. The drug decomposes in the liver into active and inactive exchange products (metabolites) and is excreted in the urine, but in part and with feces. The active ingredient of Plakvenyl penetrates the placenta and is excreted with human milk. The drug is withdrawn slowly, from plasma it disappears not earlier than a month later.

Indications for Plaquenal

Due to the fact that Plaquenil suppresses immune (including autoimmune) and inflammatory reactions, it is used to treat:
     rheumatoid arthritis;
     juvenile rheumatoid arthritis;
     systemic lupus erythematosus;
     discoid lupus erythematosus.
Plaquenil is used to treat and prevent acute attacks of three-day malaria, four-day malaria, malaria-oval, and also tropical malaria caused by susceptible strains of malarial plasmodium. Plaquenil is also used for the purpose of complete cure with tropical malaria caused by susceptible to this drug strains of malarial plasmodia.

Plaquenyl - contraindications for use

Plaquenyl is contraindicated:
    with increased sensitivity to its components of the patient's body;
    with hereditary intolerance of some types of simple sugars (for example, with lactase deficiency) and malabsorption syndrome (insufficient absorption of one or several nutrients in the intestine);
    with eye diseases associated with changes in the retina (retinopathy);
    children up to 6 years;
    during pregnancy and breast-feeding.

With caution, the drug is used when:

    visual impairment, as well as with the use of drugs that have a negative effect on the organs of vision;
    blood diseases (including in the past);
    severe neurological diseases and psychoses (including in the past);
    increased sensitivity of the skin to light, psoriasis and the use of drugs that enhance skin reactions;
    severe liver and kidney diseases and taking drugs that adversely affect these organs;
    severe diseases of the digestive system;
    hypersensitivity to quinine (due to the possibility of cross-allergic reactions).

Side effects of Plaquenil

Side effects of Plaquenil are related to the mechanism of its main action.
From the senses - with prolonged use of the drug, changes in the retina (visual field defects - scotoma), cornea (blurred vision, photophobia), as well as disruption of accommodation (the ability of the eye to see objects close to or far away), tinnitus, hearing.
From the nervous system - dizziness, headache, irritable weakness, muscle weakness, gait disturbances, psychosis, convulsive alertness.
On the part of the circulatory system - the toxic effect on the heart muscle (myocardium), accompanied by a violation of conductivity (cardiac blockade) or an increase in the volume of the myocardium of both ventricles.
On the part of the hematopoiesis - suppression of the formation of blood cells in the bone marrow and the development of a lack of red blood cells (various types of anemia), leukocytes (reducing the protective properties of the body) and platelets (there is a tendency to bleed).
On the part of the digestive system - nausea, vomiting, diarrhea, decreased appetite, abdominal pain. With prolonged use in large doses, the drug may have a toxic effect on the liver until the development of liver failure.
From the side of the skin and mucous membranes, the side effects of Plaquenyl are most often encountered. This is a different kind of rashes, increased sensitivity of the skin to light, changes in skin and hair pigmentation, skin itching, alopecia, exacerbation of various skin diseases, especially psoriasis. Severe allergic reactions of the delayed type are possible in the form of Stevens-Johnson syndrome (the blisters can cover the entire skin and mucous membranes) and the development of acute generalized exanthematous pustules (GHEP) in the form of pustules covering the entire skin.
Allergic reactions - urticaria, angioedema, bronchospasm.

Instructions for Plaquenil

Instructions for the use of Plaquenil provide for its use only as directed by a physician. Tablets Plaquenil taken inside, during a meal or washed down with a glass of milk.
In the treatment of rheumatoid arthritis and systemic lupus erythematosus, the therapeutic effect of Plaquenil's application develops in a few weeks or even months (the drug gradually accumulates in the body), while side effects can manifest much earlier. Therefore, the doctor must decide whether to continue treatment with this drug and in what dosage. In any case, the doctor chooses an individual effective dosage of the drug (it is 6.5 mg per kg of body weight or 1 - 2 tablets per day). If the therapeutic effect can not be achieved within six months, then Plaquenil is canceled.
For the prevention of malaria, the drug should be taken two weeks before going to the area where the disease occurs. It is taken once a week on the same day for 2 tablets (400 mg) during the entire stay in the endemic zone and for another two months after leaving it.
To treat acute attacks of malaria, first take 4 tablets Plaquenila (800 mg), after 8 hours - 2 tablets (400 mg) and in the next 2 days - 2 tablets (400 mg).
To completely cure of tropical malaria (in case the causative agent is sensitive to the drug), Plaquenil's reception is combined with taking medications belonging to the group of 8-aminoquinoline derivatives (Plasmocide, Plasmochin, Hinocid, Primachin).

Plaquenyl overdose

Overdose Plaquenil manifests itself in the form of increasing all the side effects of this drug.
Emergency care: gastric lavage, adsorbents (for example, activated charcoal). In some cases, intramuscularly injected with a tranquilizer Sibazon - it reduces the toxic effect of Plaquenilum on the heart muscle. If the patient's condition does not improve, further treatment is performed under resuscitation.

Interaction of Plaquenil with other medicinal preparations

Plaquenil can be combined with the intake of glucocorticosteroids (GCS), for example Prednisolone, non-steroidal anti-inflammatory drugs (NSAIDs), for example, Diclofenac, Ibuprofen, Methotrexate.
Plaquenil enhances (potentsiruet) action: cardiac glycoside Digoxin, Insulin and other medications for the treatment of diabetes mellitus, antibiotics from the group of aminoglycosides (Neomycin, Gentamycin).
When H2-antihistamine is used to reduce the acidity of the gastric juice of cimetidine, the process of decomposition of Plaquenil in the liver and increase in its concentration in the blood plasma are suppressed. This increases the risk of side effects and overdose.
Antacids - drugs that neutralize the action of hydrochloric acid in the stomach (for example, Almagel) contribute to a decrease in the absorption of Plaquenil. To prevent this from happening, it is recommended that the intervals between these drugs are at least 4 hours.
Plaquenil reduces the effectiveness of Proserin, since it is its antagonist.
With the use of Plaquenil, a decrease in the formation of antibodies is observed in response to the introduction of human diploid-cell vaccine against rabies.

Storage conditions

Plaquevenil tablets should be stored out of the reach of children at a temperature of no higher than 25 ° C.

Shelf life

The drug is stored for 3 years if the above conditions are met.

Reviews about Plaquenil

Reviews about Plaquenil largely depend on the correctness of his appointment. In addition, this drug is not suitable for all, in some patients, it immediately causes side effects.
Reviews about Plaquenil in the forums are mostly positive. Patients who took his long courses in systemic connective tissue diseases, note that side effects are very rare, the drug is perfectly combined with other anti-inflammatory and analgesic drugs and helps to reduce their dosage.
Negative responses about Plaquenil are associated with the side effects of this drug, which are rare, but can be significant.