Plaquenil is an antimalarial drug that can also be used to treat auto-immune conditions, including rheumatoid arthritis. Plaquenil is also known as hydroxychloroquine. It is part of the disease-modifying anti-rheumatic drug class of medication or the DMARDs.

Hydroxychloroquine is a strong alkaline or primary substance. This means it is attracted to acidic body parts, like inflamed tissues. It is also attracted to acidic cellular lysosomes in the plasmodia that cause malaria.

Lysosomes contain digestive enzymes that cells use to break down outside materials and waste. Plaquenil disrupts plasmodial cells and prevents them from digesting cellular waste, damaging their performance. Plaquenil also interferes with plasmodia’s communication, stability, and DNA activation. This damage can prevent malaria from infecting a patient and weaken current infections.

Plaquenil has a long half-life, which describes the time the body needs to metabolize the medication. This means that Plaquenil can take a long time to start working. Its effects also remain active for a long time after patients stop taking the medicine.

Plaquenil Precautions and Warnings

Plaquenil reduces your body’s immune responses, posing some risks. Patients with auto-immune disorders already have elevated immune responses, so lowering the immune response is beneficial. However, patients taking Plaquenil for malaria should know this effect. They may have weaker responses to illness or injury while on this medication. Before taking this drug, international travelers should discuss the risks and benefits of Plaquenil with their medical team.

Tell your doctor, your pharmacist, and the rest of your medical team about your medical history, including the medications you take. Plaquenil can interact with various other substances (more on this below). Your doctor must know about other prescription medications, over-the-counter drugs, supplements, herbs, vitamins, and more.

Plaquenil can be used during pregnancy and breastfeeding in some cases. The medication does pass into breast milk. However, the risks of malaria may be worse than the medication side effects. Patients in this situation should carefully discuss options with their medical team.

Patients should not take Plaquenil if they are allergic to hydroxychloroquine, chloroquine, or any of the medication’s inactive ingredients.

Some other conditions put you at risk for serious side effects while taking Plaquenil. Tell your doctor if you experience any of these issues:

  • Glucose-6-phosphate dehydrogenase deficiency
  • Eye or vision problems
  • Hearing problems
  • Kidney or liver disease
  • Alcohol abuse
  • Psoriasis or other skin conditions
  • Porphyria
  • Seizures
  • Diabetes
  • Heart problems or a family history of heart problems

Plaquenil Side Effects

Plaquenil is associated with several side effects. Not all patients experience these effects. You may not notice any side effects while taking hydroxychloroquine. However, some side effects can be severe. Please let your doctor know if you notice physical or mental changes.

Plaquenil side effects include:

  • Nausea or vomiting
  • Poor appetite
  • Diarrhea
  • Dizziness
  • Headache
  • Slow heartbeat
  • Shortness of breath
  • Swelling legs, ankles, or feet
  • Fatigue
  • Sudden weight gain or loss
  • Mood changes including anxiety, depression, hallucinations, suicidal thoughts
  • Hearing changes
  • Unusual bruising or bleeding
  • Stomach/abdominal pain
  • Jaundice
  • Dark urine
  • Uncontrolled twitching, movements, or seizures

Eye Damage

In some cases, hydroxychloroquine can cause eye damage. Plaquenil sometimes damages the retina at the back of the eye. This injury can cause vision loss and blindness, which is often permanent. Patients often don’t realize they have vision problems until the issue becomes serious.

Plaquenil eye damage is rare. Patients in the following circumstances are at the most risk:

  • Taking Plaquenil long-term (5+ years)
  • Taking doses that are too high
  • Taking other medications known to damage retinas (for example, Tamoxifen)
  • Existing retinal disease
  • Kidney or liver problems
  • 60+ years of age
  • Losing weight while on Plaquenil without moving to a lower dose

Drug Interactions with Plaquenil

Plaquenil can be taken with many other medications, including NSAIDs and prednisone. However, it does interact with some drugs, including those that treat:

Strengths and Dosages of Plaquenil

Plaquenil is given in different dosages based on its purpose. Malaria prevention, malaria treatment, and auto-immune treatment all have different recommendations. Plaquenil is also prescribed based on the patient’s weight. Children and adults are given different dosages as a result.

Purpose Dosage Frequency
Adult malaria prevention 400 mg Once per week
Adult malaria treatment 2000mg 800mg in first dose, then three more doses of 400mg each
Adult lupus treatment 200-400mg Once or twice daily
Adult rheumatoid arthritis treatment 200-400mg Once or twice daily
Pediatric malaria prevention 6.5mg/kg of body weight Once per week
Pediatric malaria treatment Varies 13mg/kg of body weight for first dose, then three more doses of 6.5 mg/kg of body weight

Alternatives to Plaquenil

Other medicines besides Plaquenil can give you similar results. However, it would depend on the condition you are trying to treat.

Arthritis Alternatives

  • Arava
  • Cuprimine
  • Ridaura
  • Leflunciclo
  • Thiola
  • Thiola EC

Lupus Alternatives

  • Prednisone
  • Methylprednisolone
  • Triamcinolone
  • Hydrocortisone
  • Dexamethasone
  • Prednisolone
  • Orapred
  • Pediapred

Anti-malarial Alternatives

  • Tetracycline antibiotics like doxycycline hyclate
  • Malarone
  • Mefloquine
  • Quinine
  • Aralen
  • Arakoda
  • Coartem

Plaquenil FAQs

Why did my doctor prescribe Plaquenil?

Plaquenil prevents and treats malaria, lupus, rheumatoid arthritis, and other auto-immune disorders. Your doctor may prescribe It as a preventative measure if you travel to places with high malaria rates. If you already have malaria, your prescription will help you fight the disease. If you have an auto-immune disorder, your doctor may prescribe It to reduce your inflammatory responses.

When does Plaquenil start working?

Plaquenil can take up to two weeks before it starts working. Patients should start their medication two weeks before traveling for the best preventative results. Patients taking Plaquenil to treat a current condition should be patient. It is building up in your body even before results take place.

Are there other ways to prevent malaria besides Plaquenil?

There are other antimalarial medicines besides Plaquenil. You can also reduce your malaria risk by avoiding mosquitos. Window screens, netting, long sleeves and pants, bug spray, and lemongrass can help prevent mosquitos from biting you.

What is the cost of Plaquenil in America?

Brand-name Plaquenil costs around $800 in America for a 60-day supply of 200mg tablets. This is the retail price before any discounts or insurance payments. There are ways to get this medication at a lower cost. The generic version, hydroxychloroquine, is usually available for a much lower price. Hydroxychloroquine is around $120.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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