Adult Dosing

Suppression of malaria

• 400 mg PO qwk (same day of each week)
• Note: Begin 2 weeks prior to exposure, suppressive therapy should be continued for 8 weeks after leaving the endemic area

Acute attack of malaria

• Start dose 800 mg PO then 400 mg PO in 6-8 hours
• Total dose representing 25 mg/kg of body weight is administered in three days as follows:
• First dose: 10 mg/kg PO not exceeding a single dose of 620 mg base
• Second dose: 5 mg/kg PO not exceeding a single dose of 310 mg base 6 hours after first dose
• Third dose: 5 mg/kg PO 18 hours after second dose
• Fourth dose: 5 mg/kg PO 24 hours after third dose

Lupus erythematosus

• 400 mg PO qd-bid; dose can be prolonged for several weeks or months, depending on the patient response
• Prolonged therapy: 200-400 mg PO qd

Rheumatoid arthritis

• Initial dose: 400-600 mg PO qd
• Maintenance dose: 200-400 mg PO qd

Pediatric Dosing

Suppression of malaria

• 5 mg/kg PO qwk: Max: 400 mg
• Note: Begin 2 weeks prior to exposure, suppressive therapy should be continued for 8 weeks after leaving the endemic area

Acute attack of malaria

• Total dose representing 25 mg/kg of body weight is administered in three days as follows:
• First dose: 10 mg/kg PO not exceeding a single dose of 620 mg base
• Second dose: 5 mg/kg PO not exceeding a single dose of 310 mg base 6 hours after first dose
• Third dose: 5 mg/kg PO 18 hours after second dose
• Fourth dose: 5 mg/kg PO 24 hours after third dose

• Prophylaxis and treatment of acute attacks of malaria
• Treatment of discoid, systemic lupus erythematosus, and rheumatoid arthritis

• Hypersensitivity to any of the ingredients of the product
• Hypersensitivity to 4-aminoquinoline
• Long-term therapy in children
• Retinal or visual field changes
• Porphyria
• Psoriasis
• Pregnancy

• Physicians should be familiar with the complete content of leaflet before prescribing hydroxychloroquine

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined; Caution advised

• Therapy is not effective against chloroquine-resistant strains of P. falciparum
• Fatalities have been reported on accidental ingestion of chloroquine, Patients should be warned to keep these drugs out of the reach of children
• Use of therapy in patients with psoriasis may precipitate a severe attack of psoriasis
• Worsening of porphyria may occur when therapy is used in patients with porphyria
• Avoid using therapy during pregnancy; except in the suppression or treatment of malaria
• Check CBC before starting therapy and periodically thereafter during prolonged therapy. Consider discontinuation of therapy if any severe blood disorder appears

Cautions: Use cautiously in

• Hepatic impairment
• Alcoholism
• Concurrent hepatotoxic agents
• Pediatric patients
• Patients having G-6-PD deficiency

Plaquenil interacts with :

	Apixaban
	Betrixaban (Bevyxxa)
	Dabigatran
	Edoxaban
	Eliquis
	Lanoxicaps
	Lanoxin
	Lanoxin pediatric
	Pradaxa
	Rivaroxaban
	Savaysa
	Xarelto

Pregnancy Category:C

Breastfeeding: Newer information indicates that infants exposed to hydroxychloroquine during breastfeeding receive only small amounts of the drug in breastmilk. In a small number of infants up to 1 year of age, no adverse effects on growth were seen. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 09 March 2011)

• CV: Hypotension
• CNS: Seizures, dizziness, ataxia, headache, irritability
• NEURO: Neuromyopathy
• PSYCHIATRY: Psychoses
• GI: Abdominal pain, nausea, vomiting, diarrhea, anorexia
• HEMA: Agranulocytosis, thrombocytopenia, aplastic anemia, leukopenia
• HEPA: Fulminant hepatic failure
• METABOLIC: Weight loss
• DERM: Exfoliative dermatitis, Stevens-Johnson syndrome, psoriasis exacerbation, pruritus, hair bleaching, photosensitivity, alopecia
• EENT: Visual changes, retinopathy, myopathy, tinnitus
• RESP: Bronchospasm
• MISC: Porphyria exacerbation
• HYPERSENSITIVITY: Angioedema

• Antimalarial: Exact mechanism of action is unknown; binds and alter DNA and RNA polymerase, inhibiting protein synthesis in susceptible organisms
• Completely absorbed following oral administration
• Metabolized by liver; CYP450: Unknown
• Excreted unchanged by the kidneys
• Half-life: 32-50 days

US Trade Name(s)

• Plaquenil

US Availability

hydroxychloroquine (generic)

• TABS: 200 mg

Plaquenil

• TABS: 200 mg

Canadian Trade Name(s)

• Plaquenil
• Hydroxyquine
• Hydroxyquine-200

Canadian Availability

hydroxychloroquine (generic)

• TABS: 200 mg

Plaquenil

• TABS: 200 mg

Hydroxyquine

• TABS: 200 mg

Hydroxyquine-200

• TABS: 200 mg

UK Trade Name(s)

• Plaquenil

UK Availability

Plaquenil

• TABS: 200 mg

Quinoric

• TABS: 200 mg

Australian Trade Name(s)

• Plaquenil

Australian Availability

Plaquenil

• TABS: 200 mg

Antimicrobials

Antimalarials

Aminoquinolones

Infectious Disease

Antimalarials

Aminoquinolones

Rheumatologic

Antirheumatic Agents

Pricing data from www.DrugStore.com in U.S.A.

• Plaquenil 200 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
  60 mg = $182.99
  180 mg = $529.96

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Hydroxychloroquine sulfate 200 MG (hydroxychloroquine 155 MG) Oral Tablet (Ipca Laboratories Limited)
• Hydroxychloroquine sulfate 200 MG (hydroxychloroquine 155 MG) Oral Tablet (Kanetta Pharmacal)
• Hydroxychloroquine sulfate 200 MG (hydroxychloroquine 155 MG) Oral Tablet (Mylan Pharmaceuticals Inc.)
• Hydroxychloroquine sulfate 200 MG (hydroxychloroquine 155 MG) Oral Tablet (Sandoz Inc.)
• Hydroxychloroquine sulfate 200 MG (hydroxychloroquine 155 MG) Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Hydroxychloroquine sulfate 200 MG (hydroxychloroquine 155 MG) Oral Tablet (Watson Laboratories, Inc.)
• Plaquenil 200 MG Oral Tablet (sanofi-aventis U.S. LLC)