Information on Plaquenil Hydroxychloroquine

What Is Plaquenil Hydroxychloroquine

Hydroxychloroquine (HCQ) (or chloroquine, CQ) was first synthesized in the mid-1940s. In 1955 HCQ was detected in systemic lupus rheumatoid arthritis. In 1956, the American Food and Drug Administration approved HCQ for symptoms of this disorder (skin inflammation, hair loss, mouth ulcers, fatigue and joint pain). [Sources: 11]

During the first months of the coronavirus pandemic (COVID-19), some doctors used the antimalarial drug plaquenil hydroxychloroquine (Aralen chloroquine) as a potential treatment for the virus. However, the drug is no longer recommended for emergency use in inpatients with Covid-19. Patients treated with the drug should be aware of possible side effects, including eye problems. [Sources: 9]

Hydroxychloroquine is commonly prescribed for rheumatoid arthritis, systemic lupus erythematosus and other autoimmune diseases. It is used in treatment of arthritis to relieve inflammation, swelling, stiffness and joint pain and to control symptoms of Lupus ( Lupus) SLE. [Sources: 9, 10]

Hydroxychloroquine is used to treat the symptoms of rheumatoid arthritis and discoid systemic lupus erythematosus. It is also used to treat and prevent malaria, a disease caused by a parasite that enters the body through bites of a mosquito. It may not be effective against all malaria strains, especially malaria in areas where disease is resistant to a similar drug called chloroquine. [Sources: 3]

Hydroxychloroquine (plaquenil), chloroquine, aralene and quinacrine (atabrin) are medicines used to prevent or treat malaria. Plaquenils are prescribed because they are believed to cause fewer side effects than chloroquines and aralenes, and because they have a reputation for serious side effects, they are often prescribed in situations where hydroxyloroquine is not used. Chinakrine and atabrine are alternatives, but they are prescribed separately because they can lead to yellow discoloration of the skin. [Sources: 12]

After World War II, drugs to prevent or treat malaria were found to be effective in treating lupus symptoms. These drugs have been shown to improve muscle and joint pain, rashes, pericarditis (inflammation of the lining of the heart), pleurisy (inflammation of the lining of the lungs) and other lupu symptoms such as fatigue and fever. [Sources: 12]

Hydroxychloroquine belongs to a family of drugs called antimalarial (AMS), which are classified as disease-modifying anti-inflammatory drugs (DMARDs). These drugs were originally used to prevent or treat malaria, but are no longer used for this purpose as more effective drugs have been developed. Malaria drugs similar to chloroquine and aralene are useful in the treatment of various forms of malaria, lupus erythematosus and rheumatoid arthritis. [Sources: 5, 11]

Plaquenil is used to treat the symptoms of rheumatoid arthritis and discoid systemic lupus erythematosus. It comes in tablet form and can be taken by mouth for these and other diseases. It is also used to treat and prevent malaria, a disease caused by a parasite that enters the body through bites of a mosquito. [Sources: 0, 2, 4]

Plaquenil or hydroxychloroquine is a malaria drug used to treat malaria or prevent it, a disease caused by a parasite that enters through the bite of a mosquito in the body. Hydroxy chloroquine (plaquenil) (R-4 aminoquinoline) is an antiimalarial medication used to treat systemic Lupus erythematosus (SLE) and rheumatoid arthritis and related inflammation and dermatological diseases. It can have dangerous effects on your heart if you take certain other medications, including the antibiotic azithromycin (Z-Pak). [Sources: 0, 4, 7]

The mode of action of plaquenils is not well understood, but it is believed to modulate and not suppress the immune system. Hydroxychloroquine is the hydroxylated version of chloroquine and has a similar mechanism of action. The brand name that contains plaquenil hydroxychlorquine is Quineprox, but generic versions of the medicine are also available. [Sources: 2, 7]

It is not known exactly how plaquenil works, but researchers believe it disrupts communication between cells and the immune system. Take it with a meal or glass of milk, as your doctor will tell you. [Sources: 0, 2]

Taking plaquenil in long-term, high doses can cause irreversible damage to the retina in the eyes, which can lead to permanent vision problems. Stop taking and call your doctor immediately if you have blurred vision, difficulty concentrating, blurred vision, blind spots, reading problems, changes in color vision, or increased photosensitivity. You should not use it if you are allergic to hydroxychloroquine or chloroquine. [Sources: 0]

If you are taking hydroxychloroquine for rheumatoid arthritis symptoms, your symptoms should improve within 6 months. Start taking within 2 weeks of entering an area where malaria is widespread. [Sources: 0, 13]

If the symptoms of rheumatoid arthritis do not improve or get worse, stop taking hydroxychloroquine and call your doctor immediately. You and your doctor should be sure that the medicine is working for you and do not stop taking it without first talking to your doctor. [Sources: 13]

Hydroxychloroquine side effects Hydroxychloroquine oral tablets do not cause drowsiness, but may cause other side effects. If there are serious side effects, call your doctor immediately if you have them. [Sources: 6]

Speak to your doctor right away if you have a fever, vomiting or diarrhea after treatment. If you have been exposed to malaria, have a fever or other symptoms of the disease, or have been in an area where malaria is widespread, contact your doctor as soon as possible. Call 911 if your symptoms feel life-threatening or you think you have a medical emergency. [Sources: 3, 6]

For patients with lupus or rheumatoid arthritis, take it only by mouth as directed by your doctor. Continue to take it weekly in this area for 4 to 8 weeks and leave it alone, as directed by your doctors. Take the medication with food to prevent stomach upset as directed by your doctor. [Sources: 1]

The intake of direct oral hydroxychloroquine tablets can be used as a short-term treatment for malaria, but also for the long-term treatment of lupus erythematosus and rheumatoid arthritis. After you have taken this medicine, you should take it for 4 or more weeks until you leave the country where malaria occurs. [Sources: 6]

It is used to prevent malaria infections in areas or regions where other drugs such as chloroquine are known not to work. Hydroxychloroquine is also used to treat malaria, lupus erythematosus and rheumatoid arthritis. It is also used to treat coronavirus (COVID-19) in certain inpatient patients. [Sources: 6, 8]

Sources:

[0]: https://www.drugs.com/plaquenil.html

[1]: https://www.webmd.com/drugs/2/drug-6986/plaquenil-oral/details

[2]: https://www.verywellhealth.com/plaquenil-10-things-you-should-know-190228

[3]: https://www.uofmhealth.org/health-library/d00817a1

[4]: https://www.rxlist.com/plaquenil-side-effects-drug-center.htm

[5]: https://www.medicinenet.com/hydroxychloroquine/article.htm

[6]: https://www.medicalnewstoday.com/articles/hydroxychloroquine-oral-tablet

[7]: https://dermnetnz.org/topics/hydroxychloroquine/

[8]: https://www.mayoclinic.org/drugs-supplements/hydroxychloroquine-oral-route/description/drg-20064216

[9]: https://www.aao.org/eye-health/tips-prevention/covid-chloroquine-hydroxychloroquine-plaquenil

[10]: https://www.hopkinsarthritis.org/patient-corner/drug-information/hydroxychloroquine-plaquenil/

[11]: https://www.lupus.org/resources/drug-spotlight-on-hydroxychloroquine

[12]: https://www.hopkinslupus.org/lupus-treatment/lupus-medications/antimalarial-drugs/

[13]: https://medlineplus.gov/druginfo/meds/a601240.html

What Does The United States Government Say About Hydroxychloroquine

The United States will provide 2 million doses of hydroxychloroquine to Brazil for use against the COVID-19 coronavirus disease, both governments said on Sunday, despite medical warnings about risks associated with the drug hydroxychloroquine, which has been promoted by the United States as well as President Donald Trump in recent months and others as possible treatment for people infected with the virus. The drug is doing so well against Coronavirus (COVID-19) that The U.S. Food and Drug Administration on Monday reversed its controversial emergency decision on the malaria drug hydroxychloroquine, which could have far-reaching implications for America’s response to Covid-19. The FDA said that hydroxychloroquine, “may be effective in diagnosing, treating or preventing” COVID-19, the illness caused by the virus. [Sources: 2, 3]

The FDA’s decision runs counter to President Trump’s own advertising of malaria drug hydroxychloroquine as a treatment for COVID-19. This is more than a stunning rebuke of the president by his own administration. Or so it may seem that way. There are government documents that show that Dr. Fauci of the NIH understands that hydroxychloroquine works against COVID-19 or different strains of the nora virus family. The NIH National Library of Medicine goes on to say that “chloroquine has strong antiviral effects on SARS-CoV infection of primate cells.” Indeed, the repeal is likely to affect governors who stockpile the drug in their states, as well as patients who ask their GPs for a chance to try the drug. The Food and Drug Administration warned that the drug in treatment of the virus is unlikely to be effective and warned of serious side effects, but the decision could have a lasting impact on public confidence in the agency and its independence. [Sources: 2 and 12]

Today, the Food and Drug Administration (FDA) revoked the Emergency Use Authorization (EUA) that permitted the donation of chloroquine phosphate (hydroxychloroquine sulfate) to a national strategic stockpile for treatment of certain patients with COVID-19 when clinical trials are not available or when it is not possible to participate in clinical trials. The FDA determined that the legal criteria at issue in the EEA were no longer met. Based on its ongoing analysis of the Eua and new scientific data, the FDA has concluded that chloroquine phosphate is unlikely to be effective in the treatment of Covid-19 under the previously approved use of EEA. [Sources: 4]

As a result, the FDA has revoked its earlier emergency approval (EEA) for hydroxychloroquine. An EEA allows unapproved medicines to be prescribed in a limited, controlled manner during an emergency, such as a pandemic. The FDA warns against the use of chloroquine for the treatment of COVID-19 outside clinical trials. [Sources: 6]

Hydroxychloroquine (chloroquine) is approved for the treatment of autoimmune diseases and for the prevention and treatment of malaria. Many clinical trials are underway, but there is insufficient evidence that chloroquine itself is beneficial for COVID-19. [Sources: 1, 8]

Hydroxychloroquine received national attention as a potential treatment for the prophylaxis of 2019 coronavirus disease (COVID-19) in early March 2020 . For over a year, hydroxychloroquine (chloroquine) has been reported to have potential benefits in preventing and treating COVID-19, but recent data show that the potential benefits of this treatment do not outweigh the risks. [Sources: 1]

On February 20, 2020 the Food and Drug Administration (FDA) issued an emergency use authorization (EEA) for hydroxychloroquine (chloroquine) from the strategic national stock for use by licensed healthcare providers for the treatment of patients hospitalized with COVID-19 after determining that the potential benefits outweigh the potential risks to the patient. [Sources: 1]

The FDA approved the emergency use of hydroxychloroquine and chloroquine in late March, around the same time the U.S. government accepted 30 million doses of hydroxychloroquine and chlorquoquine donated by two foreign drug manufacturers. Millions of these doses were delivered to US hospitals to treat patients who were not taking part in clinical trials. Trump’s repeated advertisements for the drug have skyrocketed, contributing to the shortfall. [Sources: 11]

The president continued to approve the drug, contradicting the orders of the top officials of the National Institutes of Health. The NIH canceled clinical trials of hydroxychloroquine after finding it would be unlikely to benefit inpatient patients with COVID-19, the agency said in a statement. This confused the public since the NIH recently published a study saying that “Chloroquine is a potent inhibitor of SARS coronavirus infection and spread”. Now, the only remaining drug with FDA approval for Covid-19 is Remdesivir, an intravenous drug from Gilead Sciences shown to help inpatients recover. [Sources: 5, 11]

Approved decades ago for the prevention and treatment of malaria, the prescription drug hydroxychloroquine is similar to chloroquine, which is used to treat autoimmune diseases such as lupus and rheumatoid arthritis. [Sources: 5]

The drugs have shown no benefit for coronavirus patients because there have been no “official” government studies. There are other Doctors in America that say otherwise – like America’s Frontline Doctors who have updated news on what the government, or media, may, or may not be telling the public. However, hydroxychloroquine has been proven effective as prophylaxis, according to the Food and Drug Administration, the National Institutes of Health and the scientific community in general. Advocates say that it makes no sense for the government to stop the public from getting hydroxychloroquine, because the drugs has proven effective during a pandemic that has devastated the global economy and killed 200,000 people. But the FDA warns that if the public gets hydroxychloroquine that to use it in hospitals could risk heart arrhythmias. [Sources: 5, 9]

So what does the FDA and the Government do? Let’s take a look at the process. Once a drug is approved, the FDA releases a statement saying it can be prescribed for unapproved uses, depending on doctors’ assessment. Hydroxychloroquine, chloroquine and similar FDA-approved drugs treat malaria and other diseases. They can be purchased in addition to the national strategic stockpile and prescribed by physicians to treat COVID-19 when clinical trials are not available or feasible. [Sources: 7 13]

Chloroquine and hydroxychloroquine are listed as essential medicines by the World Health Organisation. They have been used for more than 70 years to treat malaria, and the drug has also proven effective against autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. However, “hydroxychlorquine, chloroquine and a similar drug have not been shown to be safe or effective in the treatment of COVID-19,” the FDA said in a statement. [Sources: 7, 8]

So, because hydroxychloroquine is not FDA approved as an effective medicine against COVID-19. The FDA only approved its’ effectiveness against malaria. Now, the federal government is stuck with 6.3 million doses of hydroxychloroquine after the US Food and Drug Administration revoked approval for distribution to treat coronavirus patients. On Monday, the FDA revoked its approval for use of COVID-19 to treat the virus and said there was no reason to believe the drug was effective against the virus and raised the risk of side effects, including heart problems. [Sources: 8, 10]

Last week, Trump said he had asked Prime Minister Modi for help to allow the sale of the US-ordered hydroxychloroquine tablets, just hours after India banned exports of the malaria drug. A significant portion of the 2.9 million doses of hydroxychloroquine bought by the United States to fight the coronavirus pandemic in India, he said, and he acknowledged that Prime Minister Modi was “great” in seeking his help in approving the sale. [Sources: 0]

Sources:

[0]: https://www.thehindu.com/news/international/more-than-29-million-hydroxychloroquine-doses-bought-by-us-have-come-from-india-says-president-trump/article31286633.ece

[1]: https://www.cdc.gov/mmwr/volumes/69/wr/mm6935a4.htm

[2]: https://www.statnews.com/2020/06/16/hydroxychloroquine-emergency-use-patients-politicians/

[3]: https://www.reuters.com/article/us-health-coronavirus-usa-brazil/u-s-sends-brazil-2-million-doses-of-hydroxychloroquine-drug-touted-by-trump-idUSKBN2370RU

[4]: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-chloroquine-and

[5]: https://abcnews.go.com/Health/timeline-tracking-trump-alongside-scientific-developments-hydroxychloroquine/story?id=72170553

[6]: https://www.lupus.org/resources/hydroxychloroquine-plaquenil-coronavirus-covid19-questions-answers

[7]: https://www.aljazeera.com/news/2020/4/24/us-fda-warns-against-use-of-hydroxychloroquine-to-treat-covid-19

[8]: https://theconversation.com/donald-trump-is-taking-hydroxychloroquine-to-ward-off-covid-19-is-that-wise-139031

[9]: https://www.usatoday.com/story/news/politics/2020/04/27/coronavirus-states-stockpile-hydroxychloroquine-drug-trump-touted/3031660001/

[10]: https://ktla.com/news/nationworld/u-s-stuck-with-63-million-doses-of-hydroxychloroquine-after-fda-revokes-emergency-use-of-drug-to-treat-coronavirus/

[11]: https://www.theguardian.com/world/2020/jun/15/hydroxychloroquine-coronavirus-fda-emergency-authorization

[12]: https://pubmed.ncbi.nlm.nih.gov/16115318/

[13]: https://americasfrontlinedoctors.org/news/

More Information On Plaquenil Hydroxychloroquine

For patients with lupus and rheumatoid arthritis, take it by mouth on the instructions of your doctor. Continue to take it weekly in this area for 4 to 8 weeks and then leave it alone, as directed by your doctors. Take the medication with food to prevent stomach upset as directed by your doctor. [Sources: 11]

If you are taking hydroxychloroquine for rheumatoid arthritis symptoms, your symptoms should improve after about 6 months. If the symptoms of rheumatoid arthritis do not improve or get worse, stop taking the medication and call your doctor. If you and your doctor are certain that the medicine is working for you, do not stop taking it without first talking to your doctor. [Sources: 1]

Use hydroxychloroquine for the entire prescribed period until your symptoms improve. Start taking it 2 weeks before you get to an area where malaria is rife. Keep it during your stay there up to 4 weeks after you leave the area. [Sources: 7]

Call 911 immediately if your symptoms feel life-threatening or you believe you have a medical emergency. Hydroxychloroquine Side Effects Hydroxychloroquine is an oral tablet and does not cause drowsiness, but may cause other side effects. If there are serious side effects, call your doctor immediately if you have them. [Sources: 2]

Clinical Monitor Your doctor will examine you regularly to check your health and make sure you have had no side effects from your medication. He or she will give you an eye exam before you start the medication, and every 3 months while you are taking it. If you are taking medication long term you will also test your knee and ankle reflexes and check muscle weakness. [Sources: 2]

Undesirable effects disappear during treatment as the body adapts to the drug. Not all adverse effects occur at once, but if they do, they may need medical attention. [Sources: 10]

Some patients rely on hydroxychloroquine or chloroquine to treat autoimmune diseases such as lupus or eye damage. Common side effects include rashes, changes in skin pigments (such as darkening or dark spots on the hair) and changes in muscle weakness. Another common side effect is nausea and diarrhoea, which can improve over time. [Sources: 0, 6]

Risk factors for retinal damage include the daily dosage of hydroxychloroquine sulfate above 5 mg / kg actual body weight, life span of more than five years, kidney damage, the use of concomitant medications such as tamoxifen citrate and concurrent macular diseases. Patients of Asian descent may experience retinal toxicity in the macula. Irreversible retinal damage has been observed in patients treated with hydroxychloroquine (sulfate) and may be related to cumulative dosage and duration of treatment. [Sources: 12]

Hydroxychloroquine is not effective against gametocytes in exoerythrocytic form, including the hypnozoite stage of Plasmodium ovale (Plasmodia ovale) and PlasModium parasites. The Plas modus falciparum strain, which has a reduced susceptibility to chloroquine, also shows a reduced susceptibility to hydroxyloroquine. In patients with chloroquine, the drug cannot prevent or cure clinical malaria parasitaemia in patients who have contracted malaria in a geographical area known to be resistant to chloroquine, and is treated as a form of malaria therapy (see indication for malaria warnings). [Sources: 4]

Hydroxychloroquine is used to treat and prevent malaria, a disease caused by a parasite that enters the body through bite of a mosquito. It is not effective against all malaria strains and malaria in some parts of the world is resistant to a similar drug called chloroquine. It can also be used to treat discoid lupus erythematosus (DLE) and systemic lupus (e.g. Erythematossus, SLE and lupus). [Sources: 5, 7]

Hydroxychloroquine is used to treat arthritis to relieve inflammation, swelling, stiffness and joint pain and to manage the symptoms of Lupus erythematosus (Lupus SLE). It is also used to treat symptoms of rheumatoid arthritis and discoid systemic lupus (erythematossus). It can be used for these purposes, but is not listed in the medication guide. [Sources: 7, 8]

Hydroxychloroquine belongs to a family of drugs called antimalarial (AMS), which are classified as disease-modifying anti-inflammatory drugs (DMARDs). These drugs were originally used to prevent and treat malaria, but are no longer used for this purpose as more effective drugs have been developed. Today’s AMs are hydroxychloroquine (plaquenil (r), chloroquines, aralene (r) and quinacrine as well as atabrine (r). [Sources: 9]

Malaria drugs similar to chloroquine and aralene are useful in the treatment of various forms of malaria, lupus erythematosus and rheumatoid arthritis. In the first months of the coronavirus pandemic (COVID-19), doctors used the antimalarial drugs plaquenil (hydroxychloroquine) and aralene (chloroquine), both potential treatments for the virus. [Sources: 0, 3]

The antimalarial drugs Plaquenil Hydroxychloroquine and Aralen Chloroquine are no longer recommended for emergency use in inpatient patients with COVID-19. Patients treated with these medications should be aware of possible side effects, including eye problems. [Sources: 0]

Hydroxychloroquine is prescribed at a daily dose of 65 milligrams per kilogram of body weight. It is also prescribed for rheumatoid arthritis, systemic lupus erythematosus and other autoimmune diseases. [Sources: 0, 9]

Since hydroxychloroquine is given as a tablet of 200 mg, many people taking it for lupus take two tablets a day. Those diagnosed with lupu can take 400 mg for several weeks while it builds up in their system (200-400 mg). Reducing the daily dose to accommodate a lower weight can cause kidney damage or kidney failure if the medication is taken every two days or if the tablet is halved. [Sources: 9]

Hydroxychloroquine Hydroxychloroquine is an oral tablet that is available as a branded and generic medicine. It is used to treat malaria, lupus erythematosus and rheumatoid arthritis. In some cases, generics may not be available as a branded starch version. [Sources: 2]

Sources:

[0]: https://www.aao.org/eye-health/tips-prevention/covid-chloroquine-hydroxychloroquine-plaquenil

[1]: https://medlineplus.gov/druginfo/meds/a601240.html

[2]: https://www.medicalnewstoday.com/articles/hydroxychloroquine-oral-tablet

[3]: https://www.medicinenet.com/hydroxychloroquine/article.htm

[4]: https://www.rxlist.com/plaquenil-drug.htm

[5]: https://www.mayoclinic.org/drugs-supplements/hydroxychloroquine-oral-route/description/drg-20064216

[6]: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Hydroxychloroquine-Plaquenil

[7]: https://www.uofmhealth.org/health-library/d00817a1

[8]: https://www.hopkinsarthritis.org/patient-corner/drug-information/hydroxychloroquine-plaquenil/

[9]: https://www.lupus.org/resources/drug-spotlight-on-hydroxychloroquine

[10]: https://www.goodrx.com/hydroxychloroquine/what-is

[11]: https://www.webmd.com/drugs/2/drug-6986/plaquenil-oral/details

[12]: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=34496b43-05a2-45fb-a769-52b12e099341