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Plaquenil (Hydroxychloroquine)
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Plaquenil

Plaquenil is a Disease Modifying Anti-Rheumatoid Drug (DMARD). It works by suppressing the overactivity of the immune system that causes inflammation (swelling) and pain in the joints. This slows the progression of the underlying disease.

Other names for this medication:
Hydroxychloroquine, Rutor, Zhquine

Similar Products:
Levlen, Terramycin, Aldactone, Sovaldi, Avapro, Drylin, Sildenafil, Clozipam, Neuropin, Innovace, Glophyllin, Vasopin, Zolium, Thiolent,

Also known as: Hydroxychloroquine

Description

Plaquenil (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.

Plaquenil 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 at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of reach of children.

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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Sistan and Baluchistan province is an area in southeastern Iran which is endemic for CCHF, and the most confirmed cases of the disease are reported from this province. Five compounds were evaluated for their inhibitory activities against HIV-1 in infected C8166 cells. The effect of various cationic surfactants on the initial rate of the 5-aminosalicylic acid peroxidation with horseradish peroxidase was studied. Assessment of hematopoiesis regeneration in patients with solid tumors after radiotherapy. The National Health and Nutrition Examination Survey (NHANES) 2005-2006 provides the most comprehensive information on IgE-mediated sensitization in the general US population. Consecutive nondialysis CKD patients hospitalized mainly for CKD educational program, regardless of their sleep complaints, were enrolled.

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In alcohol-exposed subjects, we found that smaller palpebral fissures were significantly associated with reduced volumes in the ventral diencephalon bilaterally, that greater dysmorphology of the philtrum predicted smaller volumes in basal ganglia and diencephalic structures, and that lower IQ scores were associated with both smaller basal ganglia volumes and greater facial dysmorphology. Photoneutron spectral measurements in the vicinity of a high energy medical accelerator have been performed. To identify the disease gene in a large Chinese family, we initially performed linkage analysis with microsatellite markers from 9p21, but failed to confirm the linkage to this region. Frequency resolved optical gating characterization of sub-ps pulses from single-section InAs/InP quantum dash based mode-locked lasers. One way to overcome this would be to transfer substances made locally by cells within the joint. 137Cs content in various soils as basis for a direct study on the 137Cs contamination of food of animal origin. Clinical and economic impact of implementing a comprehensive diabetes management program in managed care. To report the preliminary results of a study to delineate the changing trends in radical external beam radiotherapy usage for prostate cancer between the 1996-1998 and 1999-2001 survey periods in Japan. Lateral positions spread over a greater range for interaural level differences than for interaural time differences. Different tomato cultivars (Solanum lycopersicum L.) with differences in tolerance to drought were subjected to moderate water stress to test the effects on flavonoids and caffeoyl derivatives and related enzymes.

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Public health agencies may need to increase penetration of the Maastricht 2000 recommendations to primary care physicians. In normal skin, granular or dotted pattern of positive staining was observed along the granular layer of epidermis and hair follicle with apparent moderate to strong staining in sebaceous and eccrine glands. Trait EI was a significant predictor of state anxiety, worry regarding the appointment, worry regarding the outcome of the appointment and perceived social support. To develop practical Canadian guidelines for primary health care providers based on the best available evidence for addressing health issues in adults with developmental disabilities (DD). Our results demonstrate that the quantities of PaACS and PaM6PR transcripts from P. The chromosome substitution strain survey indicated that nearly all mouse chromosomes (with the exception of chromosome 2) each contain at least one quantitative trait locus (QTL) that is involved in modified hole board behavior.

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The following case report describes a patient with Human Immunodeficiency Virus (HIV) antibody who exemplifies this unusual manifestation of mycobacterial infection. The articulation agreements provide a clear pathway for students to the RN-to-BSN degree students. The state of peridontal microhemodynamics was investigated in 80 patients with an initial arterial hypotension (IAH) and 70 patients with an arterial hypertension (AH) of different age-groups (6, 15, 20-24, 40-45 years) according to the laser dopplerography method. Probing the reversibility of sidewall functionalization using carbon nanotube transistors. Does low-dose aspirin reduce preeclampsia and other maternal-fetal complications?. We conclude that TAC and CSA are closely related immunosuppressive drugs with regard to adverse effects. New derivatives of quinazoline and 1, 2-dihydroquinazoline n3-oxide with expected antitumor activity. The Recent Atlantic Cold Anomaly: Causes, Consequences, and Related Phenomena.

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Knockdown of IGFBP-3 in senescent HUVEC by lentivirally expressed shRNA did not revert but rather enforced senescence-associated beta-galactosidase staining and apoptosis. Recently, we reported that in rat, cyclosporine A (CsA) markedly decreases the levels of calbindin-D (CABP-D) 28 kDa in kidney. Mental effort induced similar responses for the -1 D and -3 D locations when sympathetic innervation to the ciliary muscle was blocked with the beta-receptor antagonist timolol maleate. The cytokines in question, TNF-alpha and IL-6, are strongly implicated in etiology of diseases such as rheumatoid arthritis. THE LATE RESULTS OF REMOVAL OF INTRAOCULAR FOREIGN BODIES WITH THE MAGNET. The long persisting and stable nanoelectrospray enabled the search for unknown metabolites by precursor-ion scanning experiments followed by product-ion scanning experiments of potential metabolites using a quadrupole time-of-flight (qTOF) mass spectrometer. In the present study, the acute and developmental toxicities of imidazolium ionic liquids (ILs) with different alkyl chain lengths, as well as the antioxidant response and lipid peroxidation levels were evaluated in the snail, Physa acuta.

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Subchronic/chronic toxicity of a mixture of four chlorinated dibenzo-p-dioxins in rats. Brain-natriuretic-peptide (BNP) for improvement of the diagnostic determination in a conserving emergency room. Stereospecific determination of cis- and trans-resveratrol in rat plasma by HPLC: application to pharmacokinetic studies. A 23-member committee, including general neurologists, pediatric neurologists, epileptologists, and doctors in pharmacy, evaluated the available evidence based on a structured literature review including MEDLINE, Current Contents, and Cochrane Library for relevant articles from 1987 to March 2003. A prospective analysis was performed on 57 patients who harbored high-risk HPV with histologically verified mild dysplasia or less between May 2005 and March 2006. Current knowledge of events regulating exacerbated inflammatory responses is scarce.

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Gymnemagenin-producing endophytic fungus isolated from a medicinal plant Gymnema sylvestre R.Br. Identification and characterization of HU protein from Mycoplasma gallisepticum. Juvenile psoriasis in European and Asian children: similarities and differences. Evidence was based on the observation that knock-out mice for the 5-HT2C receptor gene (HTR2C) develop obesity and that many atypical antipsychotics with potent 5-HT2C antagonism may induce weight gain in susceptible individuals. The aim of this study was to determine the significance of the obesity paradox in patients referred for CABG and to examine if omnicef dose ear infection a relationship exists between obesity and early coronary surgery outcome. Nuclear abundant poly(A) RNA-binding protein 2 (Nab2) is an essential yeast heterogeneous nuclear ribonucleoprotein that modulates both mRNA nuclear export and poly(A) tail length. Among the CD antibodies examined, negative EMA most reliably predict mucosal healing. We show that all descriptive measures can also be obtained by introducing constraints to a basic loglinear (or mixture) quasi-independence model. Pharmacists remuneration models in iran and selected countries: a comparative study. The influence of force magnitude on the perception of body position.

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There is replicated evidence that individual ADHD symptoms differentially predict ADHD diagnostic status, and that non- Diagnostic and Statistical Manual of Mental Disorders (DSM)-based symptom algorithms are superior to DSM criteria for ruling in or ruling out ADHD. Growth curve models that consider random patient effects were used to estimate the mean growth curve and ascertain its form. 3 months adds to the efficacy in treatment for AK and if this will influence tolerability and quality of life (QoL). Leveraging comparative population tricor medication lipitor genomics, analyses identify several genes that are potentially associated with the growth and development of bones and muscles. Women were eligible for inclusion in this study if they reported a sexual identity and were screened for urogenital gonorrhea (GC)/chlamydia (CT) in the clinic between January 2008 and December 2011.

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The pharyngeal endoderm and ectoderm both express high levels of FGF8. A look inside the National Cancer Institute budget process: implications for 2007 and beyond. The purpose of this study was to determine which prescription drugs have street value, what that value is and why these drugs are used. Analyses were conducted using data from the Midlife in the United States survey and the National Study of Daily Experiences. Comparisons of two polymorphic species of Ostertagia and phylogenetic relationships within the Ostertagiinae (Nematoda: Trichostrongyloidea) inferred from ribosomal DNA repeat and mitochondrial DNA sequences. These changes may translate to a decreased risk of falls and hip fracture. Crioconcentrated coffee extracts rich in odour components were used as a substrate core to evaluate microencapsulation with cashew gum from Anacardium occidentale L. As the substrate width is scaled to dimensions of a few microns, it should leave the extracellular field relatively undisturbed while providing mechanical support and suppressing crosstalk. The rate of endophthalmitis after 25-gauge PPV was significantly higher than that after 20-gauge PPV. Psoriasis is a systemic inflammatory and chronic disease that can be widespread and recurrent.

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A preliminary investigation of sex differences and the mediational role of food thought suppression in the relationship between stress and weight cycling. For both types of reaction the experimental conditions were optimized and a direct application was carried out on a commercial drug formulation. The pretreatment of immobilized mucus with portions of cultures of five of eight strains of lactobacilli inhibited subsequent attachment of the S. It was identified because of its unusual pigmentation pattern and molecular methods (flow cytometry, NOR staining) confirmed its mosaic genotype. Autosomal recessive anhidrotic ectodermal dysplasia: report of a case and discrimination of diagnostic features. Mapping of the subunit interacting surfaces of oligomeric proteins in solution by a comprehensive synthetic strategy. Our results provide evidence for a sucrose-specific sugar sensing and signalling system in plants. Treatment, monitoring, and economic outcomes of venous thromboembolism among hospitalized patients in China.

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The basal ganglia are involved in the organization of movement and function in the initiation and expression of generalized and limbic seizures. Facilitating treatment entry among out-of-treatment injection drug users. Multivalent systems are well known for their enhanced ability to bind multivalent counterparts. Hyperplasia of epithelium occurred in some parts of the cystic lesions. Conducted key informant interviews, interviewed health workers and observed services offered. In this paper, the methods for overcoming the drawbacks of the septal extension graft, such as instability, a fixed tip, and insufficiency of cartilage, are presented, and the applications of each method for greater satisfaction with surgical outcomes are also discussed. Here we report the identification of a dominant gene in soybeans that restricts nodulation with S. Hyaluronan concentration in the iris tissue after iridectomy was studied in order to establish the influence of trauma on the production of hyaluronan in the anterior chamber of the eye and whether the iris participates in this process or not. The findings support the hypothesis that depression exaggerates pre-existing weight change tendencies.

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When transiently expressed in Nicotiana benthamiana leaves, full-length RPS5 protein triggered programmed cell death, but only when coexpressed with AvrPphB and a second Arabidopsis protein, PBS1, which is a specific substrate of AvrPphB. The clindamycin, tetracycline, and mupirocin resistance genes identified in these isolates are commonly associated with plasmids. Glutamate decarboxylase immunoreactivity was also observed in a large number of terminal-like structures, most of which were distributed close to the somata and dendrites of both glutamate decarboxylate-positive and -negative neurons. Prospective cohort study in northern Thailand with 2-year follow-up. It is concluded that a dosage of 10 mg/kg/day of doxycycline is required to obtain effective plasma concentrations in dogs and cats for 24 hours, when this dose is administered once daily. Acute toxicity and antihymenolepiac activity of the new drug feliram. Changes in chemical signature and host specificity from larval retrieval to full social integration in the myrmecophilous butterfly Maculinea rebeli. Our results suggest that longitudinal tubules of the t-system may represent sites of physiological membrane damage targeted by this membrane repair complex. Continuous intrauterine delivery of LNG appears to be a promising alternative to hysterectomy for the treatment of endometrial hyperplasia and could enhance the success rate when compared with other routes of progestagen administration as well as intrauterine progesterone delivery. Also, a reduced HMW ratio is seen in males at the onset of puberty.

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The pneumatic tourniquet sensitises the nerve to trauma, and stretching of the nerve during correction of the deformation depends on the local anatomical factors and their marked variation. Determining the outcome of field-based competition between two Rhizopogon species using real-time PCR. Preservation of essential cervical structures and cosmetic of outcomes of cervical incisions are major concern. The video data clustering allows an effective use the low noise two channel contrast enhancement processing. The results suggest that these agents are not genotoxic carcinogens.

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