Hydroxychloroquine
Hydroxychloroquine is used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia. Hydroxychloroquine is also used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus.
Mechanism of effect
The precise mechanism of action is not known. it may be based on ability of hydroxychloroquine to bind to and alter DNA.
Pharmacodynamic
The drug possesses antimalarial actions and also exerts a beneficial effect in lupus erythematosus (chronic discoid or systemic) and acute or chronic rheumatoid arthritis.
Pharmacokinetics
Very rapidly and completely absorbed following oral administration. Protein binding: Approximately 45%.Metabolism: Partially hepatic, to active de-ethylated metabolites. Terminal elimination half-life In blood is approximately 50 days. In plasma it is approximately 32 days.
Drug indications
Rheumatoid arthritis , Malaria , Malaria Prophylaxis , Systemic Lupus ErythematosusDosage
Usual Adult Dose for Malaria Treatment of the acute attack: 800 mg (620 mg base) followed in 6 to 8 hours by 400 mg (310 mg base), then 400 mg (310 mg base) once a day for 2 consecutive days; alternatively, a single dose of 800 mg (620 mg base) has also been effective Usual Adult Dose for Rheumatoid Arthritis Initial dose: 400 to 600 mg (310 to 465 mg base) orally once a day Maintenance dose: 200 to 400 mg (155 to 310 mg base) orally once a day.
Drug contraindications
hypersensitivity to drug or its components. , retinal or visual field changes , long-term therapy in childrenSide effects
nausea , Headache , abdominal pain , dizziness , vomiting , Seizures , Blurred vision , Hepatic dysfunction , vertigo , Diarrhea , psychotic symptoms , anorexia , Hypersensitivity , ataxia , corneal changes , RetinopathyInteractions
Tetrabenazine , Thymoglubin , Deferiprone , Cyclosporine , Levamisole , Nilotinib , Bisoprolol , Praziquantel , pyrvinium pamoate , Adalimumab , Dolasetron , vandetanib , Quinine , sparfloxacin , Dofetilide , Golimumab , Anagrelide , Hib vaccine , Promazine , Tocilizumab , Halofantrine , Grepafloxacin , Canakinumab , Basiliximab , Alefacept , lenvatinib , Pitolisant , Entrectinib , Rilonacept , Hepatitis B Vaccine , glasdegib , Romidepsin , Bepridil , bedaquiline , Dasatinib , Gemtuzumab , Remdesivir , vemurafenib , Typhoid vaccine (live), oral , Rabies Vaccine , HalavenAlerts
1-Before starting a long-term treatment, both eyes should be carefully examined for visual acuity, central visual field and color vision. Examination should also include fundoscopy. These examinations should be repeated at least annually. Retinal toxicity is largely dose-related. 2-Suicidal behavior has been reported in very rare cases in patients treated with hydroxychloroquine. 3- Patients should be strongly warned to keep these drugs out of the reach of children. 4-Use of Hydroxychloroquine sulfate tablets in patients with psoriasis may precipitate a severe attack of psoriasis. When used in patients with porphyria the condition may be exacerbated. The preparation should not be used in these conditions unless in the judgment of the physician the benefit to the patient outweighs the possible hazard. 5-Antimalarial compounds should be used with caution in patients with hepatic disease or alcoholism or in conjunction with known hepatotoxic drugs. 6-The drug should be administered with caution in patients having G-6-PD (glucose-6-phosphate dehydrogenase) deficiency.
Points of recommendation
1-If any visual disturbance occurs (visual acuity, color vision), the drug should be immediately discontinued and the patient closely observed for possible progression of the abnormality. 2-Periodic blood cell counts should be made if patients are given prolonged therapy. 3- Each dose should be taken with a meal or a glass of milk.
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