This page contains a brief description that does not cover the medication. For more information read the review in Felleskatalogen.no for the respective drug.
Contents
Definition
Originally, Plaquenil (hydroxychloroquine / hydroxychloroquine) is a drug for malaria, but is used little because the malaria parasites have become resistant (resistant). However, the drug has shown good effect by Systemic lupus (SLE). Plaquenil is also sometimes used for other connective tissue disorders.
Chloroquine / chloroquine is related to hydroxychloroquine (Plaquenil), but has approx. 40% higher risk of side effects, without the effect being better. Therefore, against rheumatic diseases, Plaquenil is preferred (reference: Liu J, 2020).
Laboratory research has shown that Plaquenil could have a protective effect against the coronavirus Covid-19. Research that will clarify this is ongoing (Liu J, 2020, Colson P, 2020), but results so far do not indicate effect (Boulware DR, 2020). The Norwegian Medicines Agency recommends the use of Plaquenil against Covid-19 and has introduced (from March 2020) rationing to ensure access for people with rheumatic disease using Plaquenil on a blue prescription (reference: The Norwegian authorities "Legemiddelwerket").
Dosage
Tablets: 1-2 tablets (200-400 mg) daily (depending on body weight and renal function). Preferably, doses below 5mg / kg / day. Doses above 6,5mg / kg / day are not recommended.
Indication and precautions
Disease relief by Systemic lupus erythematosus (SLE) and some other connective tissue disorders
SLE (Systemic Lupus Erythematosus)
- Plaquenil reduces the risk of relapse of the disease
- Increased survival (median dose 400mg / day,
- Reference Alarcon GS, 2007 )
- It is no longer usual to stop treatment for part of the year
Side Effects: Eyes / sight
- Eye surgery initially, at the latest during the first year of treatment
- Reference Norwegian Ophthalmological Society) (exclude pre-existing retinopathy)
- Then annually check (at least from 5 years of use;
- Reference: US Guidelines Marmor MF, 2016, Norwegian Ophthalmological Society)
- Eye-risk is most dependent on dose and number of years of treatment
- At doses below 5mg / kg / day, the risk of eye side effects is below 1% after 5 years, but increases to 2% after 10 years and whole 20% after 20 years of drug use
- Reference: Marmor MF, 2015, Marmor MF, 2016, Norwegian Ophthalmological Society)
- Modern screening studies can reveal changes in the retina of the eye (retinopathy) before they are otherwise visible in the background and before symptoms appear
- The eye examination should include Electro-retinography (ERG) or optical coherence tomography (OCT)
- Reference: Marmor_MF, 2016)
- With proper follow-up, permanent damage to vision is rare. In an American study of 2.900 patients with rheumatic diseases, no one was blinded by hydroxychloroquine (Plaquenil).
Interactions
- Simultaneous use of Tamoxifen (after breast cancer) increases the risk of eye-side effects (5-doubled risk)
- Plaquenil may increase the serum concentration of ciclosporin (Sandimmun Neoral) and digoxin (a cardiac medicine)
- Plaquenil may increase the effect of insulin and other diabetes treatments
- Plaquenil can reduce the effect of medication against epilepsy
- When using multiple drugs at the same time, risk interactions can be investigated via Interaksjoner.no
- Psoriasis (skin disease) can be aggravated by Plaquenil (reference: Wolf R, 1999)
Patient information
Other Links
- Medication (Bindevevssykdommer.no)
- Coronavirus and Rematic Disease (Bindevevssykdommer.no)
