Plaquenil

Description overdue on 05/08/2014

• Latin name: Plaquenil
• ATC code: R01VA02
• Active substance: Hydroxychloroquine sulfate (Hydroxychloroquine)
• Manufacturer: Sanofi-Synthelabo Ltd., UK

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• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications Plaquenil
• Contraindications
• Side effects
• Instructions on Plaquenil
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Analogs
• Reviews
• Price, where to buy

Composition

One tablet contains:

• 200 mg of the active substance ( hydroxychloroquine sulfate );
• Excipients: lactose monohydrate Povidone, corn starch, magnesium stearate, hypromellose, macrogol 4000, titanium dioxide, lactose monohydrate.

Product form

Round convex on both sides of the tablet, film-coated, with the inscription " HCQ "On one side and" 200 " another.

One carton contains 60 tablets: 6 blisters of PVC and aluminum foil (in a blister pack - 10 tablets).

Pharmacological action

Plaquenil (Plaquenil) has the following effect:

• protivoprotozoynymi   - Suppress the vital activity of protozoa that cause infectious diseases; in particular this applies to pathogens malaria So the main action of antimalarial drug;
• immunosuppressive   - Suppresses excessively pronounced response of the immune system, including allergy patient's own tissues;
• anti-inflammatory   - Inhibits inflammatory responses.

Pharmacodynamics and pharmacokinetics

Plaquenil belongs to the group of anti-inflammatory and immunosuppressive drugs from the group of 4-aminoquinoline . Its mechanism of action has not been studied, but it is believed that it is associated with the following properties of the drug:

• Ability to inhibit the action toxic free radicals Produced during metabolism (antioxidant effect).
• Ability to inhibit the action enzymes Causing the destruction of cartilage tissue.
• The ability to suppress the synthesis of prostaglandins   - Biologically active substances involved in inflammatory processes.
• The ability to concentrate in leukocytes   and enhance lysosome membranes - the cell structures containing enzymes that can cleave enters the cell nutrients. Lysosome   It is also involved in the digestion of trapped leukocytes bacteria.
• The ability to suppress the synthesis of those species Cytokine   (hormone-like proteins synthesized by cells to influence other cells), which activate the immune system. This also contributes to reduction of autoimmune processes (destruction of the body's own tissues by immune processes).
• The ability to suppress the activity of lymphocytes involved in the immune response.
• The ability to inhibit the formation of rheumatoid factor - immunoglobulins   (antibodies), perceiving the body's own tissue as foreign structures ( antigens ) And destroying them.
• Antimalarial properties Plaquenil is to suppress the vital activity of agents of the three-day malaria , A four-day malaria, malaria-oval, as well as sensitive to it forms a tropical malaria pathogens (pathogens most falciparum malaria to plaquenil insensitive).

After taking the pill Plaquenil its active ingredient rapidly and almost completely absorbed and enters the bloodstream and then accumulates in high concentrations in various organs and tissues. The maximum concentration of active substance in plasma is approximately 100 minutes. The drug is decomposed in the liver to active and inactive metabolites ( metabolites ) And excreted in the urine, but partially and faeces. The active substance Plaquenil crosses the placenta and is excreted in human milk. Withdrawal of the drug slowly from the blood plasma disappears not earlier than in a month.

Indications Plaquenil

Due to the fact that Plaquenil suppresses immune (including autoimmune) and inflammatory response, it is used for treatment of:

• rheumatoid arthritis ;
• juvenile rheumatoid arthritis;
• systemic lupus erythematosus ;
• discoid lupus erythematosus.

Plaquenil is used to treat and prevent acute attacks of falciparum malaria, the four-day malaria, malaria - oval, as well as tropical malaria caused by susceptible strains to the drug malaria parasites . Plaquenil is also used for the full curing at a tropical malaria caused by susceptible to the drug strains of malaria parasites.

Plaquenil - contraindications for use

Plaquenil is contraindicated in:

• hypersensitivity to its components of the patient;
• hereditary intolerance in some kinds of simple sugars (e.g., with lactase deficiency ) And malabsorption syndrome   (inadequate absorption of one or more nutrients in the intestine);
• in eye diseases associated with changes in the retina ( retinopathies );
• children up to 6 years;
• during pregnancy   and breast-feeding .

Be wary if the drug is used:

• visual disturbances, as well as the use of drugs that have a negative effect on the organs of vision;
• blood diseases   (including the last);
• heavy neurological diseases   and psychosis   (including the last);
• skin hypersensitivity to light, psoriasis   and medication, enhancing skin reactions;
• severe liver and kidney diseases and medication, adverse effect on these bodies;
• severe diseases of the digestive system;
• hypersensitivity to quinine   (due to possible cross allergic reactions).

Side effects Plaquenil

Plaquenil side effects associated with its main mechanism of action.

On the side senses   - Long-term use of the drug may be changes of the retina (visual field defects - scotoma ), Corneal ( blurred vision . photophobia ), and accommodation disturbances   (the eye's ability to see objects well located near or far), tinnitus, hearing loss.

On the side Nervous System   - dizziness . headache , Irritability, weakness, muscular weakness , Gait disturbance, psychoses , Convulsive readiness.

On the side of the circulatory system   - Toxic effects on the cardiac muscle ( myocardium ), Accompanied by a violation of the conductivity ( Heart block ) Or expanding both ventricular myocardium.

On the side of hematopoiesis   - The suppression of the formation of blood cells in the bone marrow and the development of a lack of red blood cells   (various kinds anemia ) leukocytes   (reduced the protective properties of the body), and Platelet   (a tendency to bleeding ).

On the side digestive organs   - Nausea, vomiting, diarrhea, loss of appetite, abdominal pain. With prolonged use at high doses, the drug can have toxic effects on the liver until the development hepatic insufficiency .

On the side skin   and mucosas   Plaquenil side effects occur more often. It's a different kind of rash, increased sensitivity of the skin to light, changes in skin pigmentation   and hair itching . baldness , Exacerbation of various skin diseases, primarily psoriasis . There are severe allergic reactions in the form of delayed-type Stevens-Johnson syndrome   (bubbles may cover all the skin and mucous membranes) and development acute generalized exanthematous pustulosis (OGEP)   in the form of pustules, covering the entire skin.

Allergic reactions   - hives . angioedema . bronchospasm .

Instructions on Plaquenil

Instructions for use Plaquenil provides its application only on prescription. Plaquenil tablets are taken orally, during a meal or drink a glass of milk.

When treating rheumatoid arthritis   and systemic lupus erythematosus   the therapeutic effect of the Plaquenil develops within a few weeks or even months (drug gradually accumulates in the body), while the side effects can occur much earlier. Therefore, the physician must address the question of whether to continue treatment with this drug, and in what dosage. In any case, the doctor selects individual effective doses 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, the Plaquenil overturned.

For prevention malaria   the drug should start taking two weeks before departure to the place where the disease occurs. It is taken once a week in the same day, 2 tablets (400 mg) for a total residence time in the endemic area, and for an additional two months after leaving it.

In order to treat I acute attacks of malaria   take 4 pills first Plaquenil (800 mg), after 8 hours - 2 tablets (400 mg) and in the following 2 days - 2 tablets (400 mg).

For a complete cure falciparum malaria (if the pathogen is sensitive to the drug) receiving Plaquenil combined with medication belonging to the group of 8-aminoquinoline   ( Plazmotsida . Plazmohina . Hinotsida . Primaquine ).

Plaquenil Overdose

Plaquenil overdose manifested in the form of strengthening of the side effects of the drug.

First aid: gastric lavage, adsorbents (eg, Activated carbon ). In some cases injected intramuscularly tranquilizer Sibazon   - It reduces the toxic effects on the heart muscle Plaquenil. If the patient's condition is not improving, further treatment is carried out under intensive care.

Plaquenil Interaction with other drugs

Plaquenil can be combined with glucocorticosteroids   (GCS), e.g. Prednisolone , Nonsteroidal anti-inflammatory drugs (NSAIDs), e.g. Diclofenac . Ibuprofen . Methotrexate .

Plaquenil enhances (potentiates) effect: cardiac glycosides Digoxin . Insulin   and other medicines to treat diabetes, antibiotics from the group aminoglycosides ( Neomycin . Gentamicin ).

When receiving H2-antihistamine to reduce gastric acidity Cimetidine It is suppressed Plaquenil decomposition process in the liver and increase its concentration in blood plasma. This increases the risk of side effects and overdose.

Antacids   - Drugs that neutralize gastric acid (eg, Almagell ) Help to reduce the absorption of Plaquenil. To avoid this, it is recommended to comply with the intervals between doses of these drugs for at least 4 hours.

Plaquenil reduces efficiency Neostigmine, So how is his antagonist.

When using Plaquenil a decrease in the production of antibodies in response to human diploid cell vaccine Rabies .

Terms of sale

The pharmacy Plaquenil is available only by prescription.

Storage conditions

Plaquenil Tablets should be stored out of reach of children at or above 25 ° C.

Shelf life

The drug is stored for 3 years, subject to the above conditions.

Analogs Plaquenil

Analogs - a variety of dosage formulations groups which are used to treat the same disease. Analogs Plaquenil is:

• Delagil   - Derivative 6-aminoquinoline It has the same indications for use as Plaquenil;
• Drugs belonging to the group of 8-aminoquinoline   with anti-malarial action - Plazmotsid . Plazmohin . Hinotsid . Primaquine .

Reviews plaquenil

Reviews plaquenil is largely dependent on the correctness of his appointment. Furthermore, this drug may not be suitable in some patients it immediately causes side effects.

Reviews plaquenil forums mostly positive. Patients who received him at the long courses of systemic connective tissue diseases, noted that the side effects are very rare, the drug is perfectly combined with other anti-inflammatory and pain-relieving drugs and helping to reduce their dosage.

Negative comments about plaquenil associated with side effects of this drug, which is rare, but can be significant.

Price Plaquenil

Price Plaquenil pharmacies in Moscow varies between 10060 - 1279 rubles per pack (60 tablets).

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