hydroxychloroquine sulfate


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hydroxychloroquine sulfate

Apo-Hydroxychloroquine (CA), Gen-Hydroxychloroquine (CA), Plaquenil

Pharmacologic class: 4-aminoquinolone

Therapeutic class: Antimalarial, antirheumatic, anti-inflammatory (disease-modifying)

Pregnancy risk category C

FDA Box Warning

• Familiarize yourself completely with contents of the manufacturer's package insert before administering or prescribing this drug.

Action

Unknown. Thought to interfere with inhibition of protein synthesis and DNA replication, leading to parasitic death.

Availability

Tablets: 200 mg (155 mg base); 200 mg hydroxychloroquine sulfate is equivalent to 155 mg of hydroxychloroquine base

Indications and dosages

Malaria prophylaxis (dosages expressed as mg of base)

Adults: 310 mg P.O. q week, starting 1 to 2 weeks before entering endemic area and continuing for 4 weeks after leaving area

Children: 5 mg/kg P.O. q week, starting 1 to 2 weeks before entering endemic area and continuing for 4 weeks after leaving area

Acute malarial attack (dosages expressed as mg of base)

Adults: Initially, 620 mg P.O., then 310 mg 6 hours, 24 hours, and 48 hours later

Children: Initially, 10 mg/kg P.O., then 5 mg/kg 6 hours, 24 hours, and 48 hours later

Rheumatoid arthritis

Adults: 400 to 600 mg/day P.O. for 4 to 12 weeks, then reduced by 50%

Systemic lupus erythematosus

Adults: 400 mg P.O. once or twice daily for several months, then reduced to 200 to 400 mg daily, depending on response

Contraindications

• Hypersensitivity to drug or chloroquine

• Retinal or visual field changes

• Long-term therapy in children

Precautions

Use cautiously in:

• hepatic or renal impairment, G6PD deficiency, psoriasis, bone marrow depression, alcoholism

• obese patients

• pregnant or breastfeeding patients

• children.

Administration

• Give with food or milk.

• For malaria prophylaxis, schedule doses on same day each week.

Adverse reactions

CNS: anxiety, apathy, confusion, fatigue, headache, psychoses, mood swings, irritability, neuromyopathy, peripheral neuritis, seizures

CV: ECG changes, hypotension

EENT: visual disturbances, retinopathy, keratopathy, ototoxicity, tinnitus

GI: nausea, vomiting, diarrhea, abdominal cramps, anorexia

Hematologic: leukopenia, agranulocytosis, aplastic anemia, thrombocytopenia

Hepatic: jaundice, hepatotoxicity

Musculoskeletal: muscle weakness

Skin: dermatoses, rash, pruritus, pigmentation changes, pleomorphic skin eruption, worsened psoriasis, alopecia, bleaching of hair

Other: weight loss

Interactions

Drug-diagnostic tests. Granulocytes, hemoglobin, platelets: decreased values

Drug-behaviors. Sun exposure: exacerbation of drug-induced dermatoses

Patient monitoring

Monitor for signs and symptoms of overdose, such as nausea, vomiting, drowsiness, visual disturbances, cardiovascular collapse, and seizures.

• Watch for adverse reactions.

Patient teaching

• Advise patient to take with food or milk.

Instruct patient to immediately report such adverse reactions as vision changes, nausea, vomiting, drowsiness, mental changes, mood swings, headache, ringing in ears, muscle weakness, rash, bleeding, bruising, and yellowing of skin and eyes.

• In long-term therapy, advise patient to have regular eye exams.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.

hydroxychloroquine sulfate

(hī-drok″sē-klōr′ŏ-kwēn″, -kwin)
An antimalarial, antirheumatic drug, often used as a disease-modifying agent in rheumatoid arthritis, systemic lupus erythematosus, and some dermatological diseases.
References in periodicals archive ?
The most common drugs prescribed for lupus are nonsteroidal anti-inflammatory agents, such as aspirin or ibuprofen; acetaminophen; corticosteroids such as prednisone; cytotoxic agents such as cyclophosphamide and azathioprine; and antimalarials such as hydroxychloroquine sulfate (Plaquenil) and chloroquine (Aralen).
Copley launched seven ANDA products in 1995, including equivalents for Sandoz Winthrop Pharmaceuticals' Plaquenil tablets (hydroxychloroquine sulfate tablets) and A.H.