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Contains in one tablet:
- 200 mg of active ingredient (sulfate hydroxychloroquine);
- excipients: monohydrate of lactose, povidone, corn starch, magnesium stearate, gipromelloz, macrogoal-4000, titanium dioxide, monohydrate of lactose.
Round tablets, convex from two parties, film coated, with a text of "HCQ" on one party and "200" on another.
One cardboard packaging contains 60 tablets: 6 blisters from PHV and aluminum foil (in one blister – 10 tablets).
Plaquenil (Plaquenil) has the following effect:
- antiprotozoan — suppress life activity of the protozoa causing infectious diseases; first of all it concerns causative agents of malaria therefore the main effect of drug antimalarial;
- immunodepressive – suppresses excessively expressed reaction of immune system, including an allergy to own body tissues of the patient;
- antiinflammatory – suppresses inflammatory reactions.
Pharmacodynamics and pharmacokinetics
Plaquenil belongs to group of antimalarial and immunodepressive medicines of group derivative 4 aminoquinolines. The mechanism of its action is studied insufficiently, but it is considered that it is connected with the following properties of this drug:
- Ability to suppress action of the toxic free radicals which are formed in the course of a metabolism (antioxidant action).
- Ability to suppress effect of the enzymes causing disintegration of cartilaginous tissue.
- Ability to suppress synthesis of prostaglandins – biologically active agents which are taking part in inflammatory processes.
- Ability to concentrate in leukocytes and to strengthen covers of lysosomes – the structures of a cell containing enzymes which can split the feedstuffs coming to a cell. Lysosomes also participate in digestion of the bacteria taken by leukocytes.
- Ability to suppress synthesis of those types of cytokines (the gormonopodobny proteins synthesized by cells for impact on other cells) which activate immunity. It promotes also decrease in autoimmune processes (destruction of own body tissues immune processes).
- Ability to suppress a lymphocyte activity, participating in immune responses.
- Ability to suppress formation of a rhematoid factor – immunoglobulins (antibodies) perceiving own body tissues as alien structures (antigens) and destroying them.
- Antimalarial properties of Plaquenil consists in suppression of life activity of activators of a tetrian fever, quartan malaria, malaria oval, and also forms of causative agents of tropical malaria, sensitive to it (the majority of causative agents of tropical malaria to Plaquenil are insensitive).
After reception of a tablet of Plaquenil its active ingredient quickly and almost is completely soaked up and gets to blood, and then collects in high concentration in various bodies and fabrics. The maximum concentration of active ingredient in a blood plasma is reached approximately within 100 minutes. Drug decays in a liver on active and inactive products of an exchange (metabolites) and is removed with urine, but partially and with a stake. Active ingredient of Plaquenil gets through a placenta and is emitted with women's milk. Drug slowly is removed, from a blood plasma it disappears not earlier than in a month.
Indications to Plaquenil use
Because Plaquenil suppresses immune (including autoimmune) and inflammatory reactions, apply it to treatment:
- juvenile pseudorheumatism;
- system lupus erythematosus;
- diskoidny lupus erythematosus.
Plaquenil is applied to treatment and the prevention of bad attacks of a tetrian fever, a quartan malaria, malaria – an oval, and also the tropical malaria caused by strains of malarial plasmodiums, sensitive to this drug. Plaquenil is applied also for the purpose of a full izlechivaniye at the tropical malaria caused by strains of malarial plasmodiums, sensitive to this drug.
Plaquenil – contraindications for use
Plaquenil is contraindicated:
- at hypersensitivity to its components of an organism of the patient;
- at hereditary intolerance of some types of simple sugars (for example, at a lactose intolerance) and at a sprue (insufficient absorption of one or several nutrients in intestines);
- at diseases of the eyes connected with changes of a retina (retinopathies);
- to children till 6 flyings;
- during pregnancy and feeding of the child breast.
With care drug is used at:
- visual disturbances, and also at use of the medicines making negative impact on organs of sight;
- blood diseases (including in the past);
- serious neurologic illness and psychoses (including in the past);
- hypersensitivity of skin to light, the psoriasis and drug intake strengthening skin reactions;
- the serious illness of a liver and kidneys and drug intake which are negatively influencing these bodies;
- serious illness of digestive organs;
- hypersensitivity to quinine (because of a possibility of cross allergic reactions).
Side effects of Plaquenil
Side effects of Plaquenil are connected with the mechanism of its main action.
From sense bodys – at prolonged use of drug changes of a retina (defects of a field of vision – scotoma), corneas (a sight illegibility, a photophobia), and also accommodation disturbances (it is good to ability of an eye to see the objects located close or in the distance), a sonitus, decrease in hearing are possible.
From bodies of blood circulation – the toxic impact on a cardiac muscle (myocardium) which is followed by conductivity disturbance (cordial blockade) or increase in volume of a myocardium of both ventricles.
From bodies of blood formation — suppression of process of formation of blood cells in marrow and development of a lack of erythrocytes (different types of anemia), leukocytes (protective properties of an organism decrease) and thrombocytes (tendency to bleedings appears).
From digestive organs — nausea, vomiting, a diarrhea, loss of appetite, abdominal pains. At prolonged use in high doses drug can make toxic impact on a liver up to development of a liver failure.
From skin and mucous membranes side effects of Plaquenil meet most often. It different rashes, increase of sensitivity of skin to light, changes of a xanthopathy and a hair, a skin itch, baldness, an exacerbation of various skin diseases, first of all, psoriasis. Heavy allergic reactions of the slowed-down type in the form of Stephens-Johnson's syndrome (bubbles can cover all skin and mucous membranes) and development of the acute generalized exanthematous pustulez (AGEP) in the form of the pustules covering all skin are possible.
The instruction on Plaquenil
The application instruction of Plaquenil provides its use only on doctor's orders. The pill Plaquenil is taken inside, during food or washed down with a glass of milk.
At treatment of a pseudorheumatism and system lupus erythematosus the medical effect of use of Plaquenil develops in several weeks or even months (drug gradually collects in an organism) whereas side effects can be shown much earlier. Therefore the doctor has to resolve an issue of whether it is worth continuing treatment by this drug and in what dosage. Anyway the doctor selects an individual effective dosage of drug (it makes 6,5 mg on kg of body weight or 1 – 2 tablet a day). If the medical effect does not manage to be reached within half a year, then Plaquenil is cancelled.
For prevention of malaria drug should begin to be accepted in two weeks prior to departure to the district where this disease meets. It is accepted once a week in the same day on 2 tablets (400 mg) during the whole time of stay in a local zone and within two months after departure from it.
On purpose I treatments of bad attacks of malaria take at first 4 pill of Plaquenil (800 mg), in 8 hours — 2 tablets (400 mg) and in the next 2 days — on 2 tablets (400 mg).
For full treatment from tropical malaria (if the activator shows sensitivity to drug) reception of Plaquenil is combined with reception of the medicines relating 8 aminoquinolines (Plasmocidum, Plasmochin, Chinocidum, Primachinum) to group of derivatives.
Overdose of Plaquenil is shown in the form of strengthening of all side effects of this drug.
Acute management: gastric lavages, adsorbents (for example, absorbent carbon). In certain cases intramusculary enter a tranquilizer Sibazonum – it reduces toxic impact of Plaquenil on a cardiac muscle. If the condition of the patient does not improve, further treatment is carried out in the conditions of reanimation.
Interaction of Plaquenil with other medicines
Plaquenil can be combined with reception of glucocorticosteroids (GKS), for example Prednisolonum, non-steroidal anti-inflammatory drugs (NPVP), for example Diclofenac, the Ibuprofen, the Methotrexate.
Plaquenil strengthens (exponentiates) action: cardiac glycoside of Digoxin, Insulin and other medicines for treatment of a diabetes mellitus, antibiotics from group of aminoglycosides (Neomycinum, Gentamycin).
At reception of H2 antihistamine for decrease in acidity of a gastric juice of Cimetidinum there is a suppression of process of decomposition of Plaquenil in a liver and increase of its concentration in a blood plasma. It increases risk of development of side effects and overdose.
Antacids – the drugs neutralizing effect of hydrochloric acid of a stomach (for example, Almagelum) promote decrease in absorption of Plaquenil. That it did not occur, it is recommended to observe intervals between receptions of these drugs not less than 4 hours.
Plaquenil reduces Prozerin's efficiency as is his antagonist.
At use of Plaquenil reduction of antibody formation in response to introduction of a human diploid and cellular vaccine against rage is observed.
Terms of sale
In a drugstore Plaquenil can be bought only according to the recipe of the doctor.
The tablets Plaquenil have to be stored in the place, unavailable to children, at a temperature not above 25 °C.
Period of validity
Drug is stored 3 years at observance of the above-stated conditions.
Analogs of Plaquenil
Analogs are drugs of different medicinal groups which are used for treatment of the same diseases. Analogs of Plaquenil it:
- Delagil — derivative 6 aminoquinolines, has the same indications for use, as Plaquenil;
- The medicines relating to group of derivatives 8 aminoquinolines with antimalarial action — Plasmocidum, Plasmochin, Chinocidum, Primachinum.
About Plaquenil generally depend on correctness of its appointment. Besides, this drug suits not all, it at once causes side effects in some patients.
About Plaquenil at forums generally positive. Patients who accepted it long courses at general diseases of connecting fabric, note that side effects happen very seldom, drug is perfectly combined with other antiinflammatory and anesthetizing drugs and promotes decrease in their dosage.
Negative About Plaquenil are connected with side effects of this drug which meet seldom, but can be considerable.
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