Hydroxychloroquine
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from 456 rub.
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Hydroxychloroquine is an antimalarial drug.
Release form and composition
The dosage form of Hydroxychloroquine is film-coated tablets: biconvex, capsule-shaped, beveled to the edge, the core and the shell are almost white or white, engraved on one side "ARO", on the other - "HCQ 200" (in polyethylene bottles of 10, 20, 30, 60 or 100 pcs., In a cardboard box 1 bottle; in blisters of 10 pcs., In a cardboard box 1–3, 6 or 10 packages).
Composition of 1 tablet:
- active substance: hydroxychloroquine sulfate - 200 mg;
- auxiliary components: magnesium stearate - 4 mg; croscarmellose sodium - 3 mg; microcrystalline cellulose (PH 102) - 92.5 mg; colloidal silicon dioxide - 0.5 mg;
- shell: hypromellose 2910 - 0.6 mg; hydroxypropyl cellulose, LF - 2.4 mg; titanium dioxide (E 171) - 2.4 mg; macrogol 8000 - 1.8 mg.
Indications for use
- malaria: for the relief of acute attacks; prevention of malaria, which is caused by Plasmodium vivax, R. malariae and R. ovale, as well as P. falciparum strains showing sensitivity; radical therapy of malaria caused by susceptible strains of P. falciparum;
- arthritis (rheumatoid, chronic juvenile);
- dermatological diseases: lupus erythematosus (discoid and systemic), diseases that are exacerbated / developed by exposure to sunlight (photodermatosis).
Contraindications
Absolute:
- maculopathy preceding maculopathy;
- galactose intolerance, glucose / galactose malabsorption syndrome or lactase deficiency;
- age up to 6 years (with a weight up to 31 kg);
- children's age in cases of the need for long-term therapy (associated with an increased risk of toxic effects);
- lactation period;
- individual intolerance to the components of the drug.
Relative (diseases / conditions in which the use of hydroxychloroquine requires caution):
- retinopathy;
- deficiency of glucose-6-phosphate dehydrogenase;
- visual disorders (decreased visual acuity, changes in visual fields);
- combined use with drugs that can lead to visual disturbances;
- psychosis (including indications in history);
- oppression of bone marrow hematopoiesis;
- psoriasis;
- porphyria;
- combined use with drugs that can lead to the development of skin reactions;
- renal / hepatic impairment (if it is necessary to use hydroxychloroquine, its dose should be adjusted under the control of plasma concentration);
- hepatitis;
- gastrointestinal diseases in severe course;
- pregnancy (the use of hydroxychloroquine is possible only for health reasons).
Method of administration and dosage
Hydroxychloroquine is taken orally, with meals, or with a glass of milk. All doses given below are for hydroxychloroquine sulfate and are not equivalent to hydroxychloroquine base.
To suppress malaria, the following drug regimen is usually prescribed:
- adults: every seventh day, 400 mg;
- children from 6 years old: weekly dose - 6.5 mg / kg, but not higher than the adult dose.
It is recommended to start prophylactic treatment, if conditions exist, 14 days before travel to the endemic area. If this is not possible, the following dosing regimen should be adhered to: adults - 800 mg, children - 12.9 mg / kg (but not> 800 mg), in 2 divided doses with an interval of 6 hours. Duration of use - 8 weeks after leaving the endemic zone.
The adult initial dose in the treatment of acute attacks of malaria is 800 mg, then after 6 or 8 hours - 400 mg, after which 400 mg is taken for 2 days (total - 2000 mg). As an alternative method, a single dose of 800 mg is possible. The dose for adults, as well as for children, can be calculated taking into account body weight.
The total dose for children from 6 years of age is 32 mg / kg (but not> 2000 mg), it is applied for more than 3 days as follows:
- I dose: 12.9 mg / kg (but not> 800 mg);
- II dose: 6.5 mg / kg (but not> 400 mg) 6 hours after taking the first dose;
- III dose: 6.5 mg / kg (but not> 400 mg) 18 hours after taking the second dose;
- IV dose: 6.5 mg / kg (but not> 400 mg) 24 hours after the third dose.
The adult initial daily dose for the treatment of rheumatoid diseases is 400–600 mg, the maintenance dose is 200–400 mg. It should be borne in mind that hydroxychloroquine has a cumulative effect, and it takes several weeks to achieve its therapeutic effect, while side reactions can appear relatively early. If within 6 months the patient's condition does not improve, then the therapy is canceled.
When treating systemic / discoid lupus erythematosus, the daily dose should not exceed 6.5 mg / kg (the calculation is carried out according to the "ideal" body weight) or 400 mg. It is recommended to prescribe the lowest effective dose or 200-400 mg per day. For light-sensitive dermatological diseases, therapy should be limited to periods of maximum light exposure.
Side effects
- skin: rarely - itching, skin rash, changes in the pigmentation of the mucous membranes and skin, alopecia, hair discoloration (in most cases, these disorders quickly disappear after stopping treatment); possible bullous rash, including very rare cases of Stevens-Johnson syndrome and polymorphic erythema, photosensitivity, and isolated cases of exfoliative dermatitis; very rarely - acute generalized exanthematous pustular rashes, which should be distinguished from psoriasis (it should be borne in mind that hydroxychloroquine can lead to exacerbation of psoriasis; these disorders can occur in combination with leukocytosis and fever; the prognosis after drug withdrawal is usually favorable);
- hematopoietic organs: rarely - agranulocytosis, inhibition of bone marrow hematopoiesis, thrombocytopenia, aggravation of porphyria, aplastic anemia, hemolytic anemia (against the background of glucose-6-phosphate dehydrogenase deficiency);
- organs of vision: rarely - retinopathy with defects in the visual field and changes in pigmentation (in the early stages, these disorders are reversible after discontinuation of the drug; if hydroxychloroquine is not promptly canceled, there is a possibility of progression of retinopathy even after its cancellation; changes in the retina may initially be asymptomatic or paracentral, transient or pericentral scotoma and color vision disorders); possible changes in the cornea, including opacity and edema (may be asymptomatic or cause the following disorders: halos, photophobia, blurred vision; such changes may be temporary, reversible if therapy is discontinued; blurred vision is associated with a violation of accommodation, it is reversible and dose-dependent); with a long course with the use of large doses - keratopathy, optic nerve atrophy,dysfunction of the ciliary muscle;
- hearing organs: hearing loss, tinnitus, hearing loss;
- digestive system: nausea, decreased appetite, vomiting (rarely), diarrhea, abdominal pain of a spastic nature;
- musculoskeletal and nervous system: likely neuromyopathy or myopathy of skeletal muscles (these disorders can lead to atrophy / progressive weakness of the proximal muscle groups; usually myopathy is reversible after discontinuation of the drug, but full recovery may occur after several months), mild sensory changes, abnormal nerve conduction (usually restored after drug withdrawal), suppression of the tendon reflex;
- central nervous system: occasionally - nervousness, dizziness, psychosis, headache, irritability, ataxia, emotional lability, convulsions;
- cardiovascular system: cardiomyopathy (in rare cases), decreased myocardial contractility, atrioventricular block (AV block), myocardial hypertrophy; with a long course with the use of large doses - myocardial dystrophy [in cases of detection of conduction disturbances (AV blockade, blockade of the His bundle) and hypertrophy of both ventricles, the likelihood of developing chronic intoxication must be taken into account];
- liver: hepatotoxicity (liver failure, hepatic dysfunction); in some cases - changes in indicators of functional liver tests; there is evidence of several cases of hepatic failure that developed suddenly;
- others: weight loss.
special instructions
Before the appointment of Hydroxychloroquine, and also periodically (at least once every six months) during its use, it is necessary to carry out ophthalmological examinations (when using doses exceeding 6.5 mg / kg, the risk of retinal damage increases).
In cases of adverse vision reactions (changes in color perception, decreased visual acuity, etc.), hydroxychloroquine is immediately canceled. It is necessary to take into account the likelihood of progression of changes in the retina even after discontinuation of therapy.
When taking hydroxychloroquine in doses higher than recommended, the risk of retinal damage increases and this process is accelerated. Before starting the course of treatment, ophthalmoscopy of both eyes should be performed in order to study visual acuity, optical field and color vision. In the future, such a survey should be carried out at least once a year.
With visual impairment, immediate withdrawal of Hydroxychloroquine is indicated. The condition of patients should be monitored, since even after the cancellation of therapy, further progression of retinal changes and visual impairment is possible.
Pregnant women can use Hydroxychloroquine only for health reasons, taking even therapeutic doses can lead to the development of damage to the central nervous system and other disorders in the fetus.
Patients with impaired renal / hepatic function may need a dose reduction (in order to reduce the toxic effect on these organs).
When conducting a long course, it is necessary to periodically conduct a detailed blood test and assess the function of tendon reflexes and skeletal muscles (in cases of detecting deviations from the norm, hydroxychloroquine is canceled).
During the period of therapy, care must be taken when driving.
Drug interactions
With the combined use of Hydroxychloroquine with certain drugs / substances, the following effects may develop:
- digoxin: an increase in its serum level (regular monitoring of this indicator is required, if necessary, the dose of digoxin is reduced);
- glucocorticoids, salicylates, quinidine-like antiarrhythmics, hepato-, hemato- and neurotoxic drugs: increasing their side effects;
- hypoglycemic drugs: increasing their action (it may be necessary to reduce the dose of antidiabetic drugs and insulin);
- penicillamine: an increase in its plasma concentration and the likelihood of developing its adverse reactions from the urinary system, hematopoietic organs, as well as reactions from the skin;
- cimetidine: increased suppression of its metabolism (may lead to an increase in the plasma concentration of the drug in the blood);
- aminoglycoside antibiotics: increased blocking effect on neuromuscular transmission;
- neostigmine, pyridostigmine: antagonistic action;
- antacids: decrease in absorption (the interval between taking these medicines should be at least 4 hours);
- rabies diploid cell vaccine (primary immunization): reducing the production of antibodies in response to the vaccine;
- alkalis, alkaline drinks: accelerating the elimination of hydroxychloroquine from the body
Analogs
Analogs of Hydroxychloroquine are: Immard, Plaquenil.
Terms and conditions of storage
Store in a place protected from light and moisture at a temperature of 15-30 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Hydroxychloroquine: prices in online pharmacies
|
Drug name Price Pharmacy |
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Hydroxychloroquine tab. p / o captivity. 200mg No. 30 456 r Buy |
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Hydroxychloroquine 200 mg film-coated tablets 30 pcs. 497 r Buy |
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Hydroxychloroquine tab. p / o film. 200mg No. 30 1059 r Buy |
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Hydroxychloroquine tablets p.p. 200mg 30pcs 1155 RUB Buy |
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
