Generic Name: Plaquenil Brand Name(s): Generics only. No brands available.

Uses

What is Plaquenil® (hydroxychloroquine) used for?

Plaquenil® belongs to a group of medicines called quinolines.

Plaquenil® 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. This medicine is not effective against all strains of malaria.

Plaquenil® is also an antirheumatic medicine and is used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus.

How should I take Plaquenil® (hydroxychloroquine)?

Take Plaquenil® exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Plaquenil® is sometimes given only once per week. Choose the same day each week to take this medicine if you are on a weekly dosing schedule.

Take Plaquenil® with a meal or a glass of milk.

To prevent malaria: Start taking Plaquenil® 2 weeks before entering an area where malaria is common. Continue taking the medicine regularly during your stay and for at least 8 weeks after you leave the area.

To treat malaria: Your doctor may recommend a single dose, or a high starting dose followed by a smaller dose during the last 2 days of treatment. Follow your doctor’s instructions.

Take Plaquenil® for the full prescribed length of time for malaria. Your symptoms may improve before the infection is completely cleared.

Use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria.

Call your doctor as soon as possible if you have been exposed to malaria, or if you have fever or other symptoms of illness during or after a stay in an area where malaria is common.

No medication is 100% effective in treating or preventing all types of malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.

When treating lupus or arthritis, Plaquenil® is usually given daily for several weeks or months. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 6 months of treatment.

While using Plaquenil®, you may need frequent blood tests and vision exams.

How do I store Plaquenil® (hydroxychloroquine)?

Plaquenil® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Plaquenil® in the bathroom or the freezer. There may be different brands of Plaquenil® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Plaquenil® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Plaquenil® (hydroxychloroquine)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Plaquenil® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

Plaquenil® should not be used for long-term treatment in children.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Plaquenil® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Plaquenil®. Plaquenil® is pregnancy risk category N, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Plaquenil® (hydroxychloroquine)?

Get emergency medical help if you have signs of an allergic reaction to Plaquenil®: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Taking Plaquenil® long-term or at high doses may cause irreversible damage to the retina of your eye. Stop taking Plaquenil® and call your doctor at once if you have trouble focusing, if you see light streaks or flashes in your vision, or if you notice any swelling or color changes in your eyes.

Call your doctor at once if you have:

  • Headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats
  • Very slow heart rate, weak pulse
  • Muscle weakness, numbness or tingling
  • Low blood sugar – headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky
  • Low blood cell counts – fever, chills, sore throat, weakness or ill feeling, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed

Common side effects may include:

  • Headache, dizziness, ringing in your ears
  • Nausea, vomiting, stomach pain
  • Loss of appetite, weight loss
  • Mood changes, feeling nervous or irritable
  • Skin rash or itching
  • Hair loss

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Plaquenil® (hydroxychloroquine)?

Plaquenil® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Other medicines to treat malaria
  • An antibiotic or antifungal medicine
  • Antiviral medicine to treat hepatitis or HIV/AIDS
  • Antidepressants or antipsychotic medicines
  • Birth control pills or hormone replacement therapy
  • Cancer medication
  • Cholesterol-lowering medication
  • Heart or blood pressure medicine
  • Pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve)
  • Seizure medication
  • Stomach acid reducers
  • Tuberculosis medicine

Does food or alcohol interact with Plaquenil® (hydroxychloroquine)?

Plaquenil® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Plaquenil® (hydroxychloroquine)?

Plaquenil® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • A history of vision changes or damage to your retina caused by an anti-malaria medication
  • Heart disease, heart rhythm disorder (such as long QT syndrome)
  • Diabetes
  • A stomach disorder
  • An allergy to quinine
  • Liver or kidney disease
  • Psoriasis
  • Alcoholism
  • A genetic enzyme disorder such as porphyria or glucose-6-phosphate dehydrogenase (G6PD) deficiency

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Plaquenil® (hydroxychloroquine).

What is the dose of Plaquenil® (hydroxychloroquine) for an adult?

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.

Dosage on the basis of body weight:

  • First dose: 10 mg base/kg (not to exceed 620 mg base)
  • Second dose: 5 mg base/kg (not to exceed 310 mg base) 6 hours after first dose
  • Third dose: 5 mg base/kg 18 hours after second dose
  • Fourth dose: 5 mg base/kg 24 hours after third dose

Each dose should be taken with a meal or a glass of milk.

Concomitant therapy with an 8-aminoquinoline drug is necessary for the radical cure of vivax and malariae malaria.

Usual Adult Dose for Malaria Prophylaxis:

Suppression: 400 mg (310 mg base) orally on the same day every week.

Suppressive therapy should begin 2 weeks prior to exposure; however, failing this, an initial dose of 800 mg (620 mg base) may be taken in 2 divided doses (6 hours apart). Suppressive therapy should continue for 8 weeks after leaving the endemic area.

Each dose should be taken with a meal or a glass of milk.

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.

Each dose should be taken with a meal or a glass of milk.

Usual Adult Dose for Systemic Lupus Erythematosus:

Discoid and systemic lupus erythematosus:

Initial dose: 400 mg (310 mg base) orally once or twice a day for several weeks or months, depending on patient response.

Maintenance dose: 200 to 400 mg (155 to 310 mg base) orally once a day.

Each dose should be taken with a meal or a glass of milk.

What is the dose of Plaquenil® (hydroxychloroquine) for a child?

Usual Pediatric Dose for Malaria:

Treatment of the acute attack:

1 year or older:

  • First dose: 10 mg base/kg (not to exceed 620 mg base).
  • Second dose: 5 mg base/kg (not to exceed 310 mg base) 6 hours after first dose.
  • Third dose: 5 mg base/kg 18 hours after second dose.
  • Fourth dose: 5 mg base/kg 24 hours after third dose.

Each dose should be taken with a meal or a glass of milk.

Concomitant therapy with an 8-aminoquinoline drug is necessary for the radical cure of vivax and malariae malaria.

Usual Pediatric Dose for Malaria Prophylaxis:

Suppression:

1 year or older: 5 mg base/kg of body weight (not to exceed 310 mg base) orally on the same day every week.

Suppressive therapy should begin 2 weeks prior to exposure; however, failing this, an initial dose of 10 mg base/kg (not to exceed 620 mg base) may be taken in 2 divided doses (6 hours apart). Suppressive therapy should continue for 8 weeks after leaving the endemic area.

Each dose should be taken with a meal or a glass of milk.

Usual Pediatric Dose for Dermatomyositis:

Juvenile Dermatomyositis (JDMS):

1.5 to 15 years: 7 mg/kg orally per day (added to first course treatment for JDMS if the patient presented with extensive skin rash and needed steroids in high doses)

Each dose should be taken with a meal or a glass of milk.

How is Plaquenil® (hydroxychloroquine) available?

Plaquenil® is available in the following dosage forms and strengths:

  • Tablet: hydroxychloroquine sulfate 200mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Plaquenil®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 2, 2017 | Last Modified: September 2, 2017