What is hydroxychloroquine?
Hydroxychloroquine belongs to a group of drugs known as antimalarials. It is used to prevent or treat malaria (a red blood cell infection transmitted by the bite of a mosquito). However, this drug is not used to treat severe or complicated malaria. Before traveling to areas where there is a possibility of malaria, you should consult an infectious disease doctor to prescribe the necessary drugs to prevent malaria, including hydroxychloroquine sulfate.
Hydroxychloroquine is also used to treat some autoimmune diseases (lupus, rheumatoid arthritis). Hydroxychloroquine reduces skin problems in lupus and prevents swelling and pain in arthritis.
Uses of tablets Hydroxychloroquine
This medicine is prescribed for the treatment and prevention of malaria caused by mosquito bites. You should take anti-malarial drugs when traveling to areas where malaria is a possibility.
This drug can also be used to treat some autoimmune diseases such as rheumatoid arthritis and lupus. Hydroxychloroquine sulfate is prescribed in various types of lupus disease such as discoid lupus erythematosus or systemic lupus erythematosus to reduce skin problems and relieve pain and swelling. Also, sometimes arthritis does not respond to other treatments and the doctor replaces the previous drugs with this drug.
Hydroxychloroquine is also used in the treatment of infections. For this reason, it is used in some hospitals to treat corona. Of course, some doctors do not consider this medicine suitable for the treatment of Corona.
Mechanism of action Hydroxychloroquine
Hydroxychloroquine or Hydroxychloroquine; It increases the pH in intracellular vacuoles and changes processes such as protein degradation by acid hydrolases in lysosomes, assembly of macromolecules in endosomes, and modification of post-translational proteins in the Golgi apparatus.
Acidic cytoplasmic compartments are required for antigenic protein digestion and assembly of peptides with alpha and beta chains of MHC class II proteins. As a result, antimalarial drugs reduce the formation of peptide-MHC protein complexes required to stimulate CD4+ T cells and lead to down-regulation of the immune response against self-antigenic peptides.
Because this mechanism is different from other antirheumatic drugs, antimalarial drugs are well suited to complement these compounds in combination drug therapy.
Hydroxychloroquine tablets and other antimalarial drugs interfere with the life cycle of malaria. This drug interferes with the digestion of hemoglobin in the blood stages of the malaria life cycle and in this way eliminates the infection. Also, this drug suppresses immune response receptors in autoimmune diseases in the treatment of lupus.
Pharmaceutical forms
This medicine is taken orally and is available only in tablet form. Hydroxychloroquine tablets should not be chewed or crushed. Because it creates a bitter taste in the mouth.
Dosage of Hydroxychloroquine
This medicine is supplied in the form of hydroxychloroquine sulfate 200 tablets. The dose of the drug should be determined by the doctor. The type of disease and its severity as well as the age of the patient are effective in determining the dose. You should take this pill with a specific dose in the following cases.
Prevention of malaria
Adults should take two hydroxychloroquine sulfate 200 tablets once a week. You should start taking the medicine two weeks before the trip and use it every week until 4 weeks after leaving the area.
In children over 30 kg, the drug dose is determined based on weight. 6.5 mg of drug per kilogram is determined and no more than 2 tablets of hydroxychloroquine sulfate 200 should be used. It is not recommended to use the medicine in children weighing less than 30 kg.
Treatment of malaria
To treat malaria in adults, 4 tablets of hydroxychloroquine sulfate 200 should be used first. Then 2 tablets of hydroxychloroquine sulfate 200 should be used 6 hours, 24 hours and 48 hours after taking the first dose.
In children over 30 kg, 13 mg of medicine should be determined per kg. In the next sessions, 6.5 mg of medicine should be taken per kilogram of weight. The interval of subsequent turns is the same as for adults. Children’s dose should not be more than 4 tablets in the first time and 2 tablets in the following times. This medicine is not prescribed for children weighing less than 30 kg.
Arthritis treatment
Adults should first use 2 or 3 tablets of hydroxychloroquine sulfate 200 per day. Tablets can be taken at the same time or at intervals. In the following days, the doctor will probably prescribe one or two tablets of hydroxychloroquine sulfate 200. For children, the dosage should be determined by the doctor.
Lupus treatment
Adults should take one or two tablets of hydroxychloroquine sulfate 200 per day. For children, the dosage should be determined by the doctor.
consumption instruction
You must follow the doctor’s instructions to take the medicine. This medicine is available in the form of tablets. Taking pills may cause stomach upset. For this reason, it is better to take it with food or milk. Swallow the tablet whole. Breaking or chewing it causes a very bitter taste in the mouth. The doctor determines the dose of medicine based on the disease and its severity. For children, the dose of medicine is determined based on age and weight.
Malaria:
Take hydroxychloroquine by mouth, usually with food, to avoid stomach upset.
Dosage and length of treatment: based on medical conditions and response to treatment.
Children: The dose is also based on weight.
To prevent malaria, take this medicine orally as directed by your doctor. which is usually used once a week.
Mark the calendar to help you remember.
This medicine is usually started 1-2 weeks before entering the malaria epidemic area.
Continue taking it weekly while in the area and for 4 to 8 weeks after leaving the area or as directed by your doctor. For example, you should take one pill every Saturday. The medication should be started 1 or 2 weeks before the trip.
Lupus or rheumatoid arthritis:
Take hydroxychloroquine by mouth as directed by your doctor, usually once or twice a day.
Your doctor may gradually increase your dose.
After you have been using the medicine for a while and you feel better, your doctor may order you to reduce your dose. Until you get a more suitable dose with the least side effects.
If you are also taking a specific medicine for diarrhea (kaolin) or antacids (such as magnesium/aluminum hydroxide), take hydroxychloroquine at least 4 hours before or after these products. These products may bind with hydroxychloroquine and prevent it from being fully absorbed by the body.
Use hydroxychloroquine regularly to get the most benefit from it.
If you are taking it on a daily basis, take it at the same time every day.
Do not stop taking hydroxychloroquine without talking to your doctor, especially if you are taking it for malaria.
It is important to continue taking this substance for the prescribed period of time.
Stopping prophylaxis or treatment too early may lead to infection or re-infection.
If you are taking hydroxychloroquine for lupus or arthritis, it may take several weeks or months.
side effects of Hydroxychloroquine
This drug, like many other drugs, may cause side effects. In case of serious side effects, be sure to contact your doctor.
Hydroxychloroquine may cause side effects. Tell your doctor if the following symptoms become severe:
Headache
dizziness
Loss of appetite
nausea
diarrhea
Stomach ache
Vomit
rush
Ringing or tinnitus
Darkening of the skin
Hair loss or thinning hair
Increased skin sensitivity to sunlight
Irritability
shaking
Uncontrolled eye movements
Instability, tremors and lack of control of muscle movements
Vomit
Weight Loss
If you notice the following symptoms, call your doctor immediately:
Difficulty reading or seeing (words, letters, or parts of objects)
sensitivity to light
blurred vision
Vision changes
Seeing hot flashes or light streaks
hearing problem
Ringing in the ears
muscle weakness
Unusual bleeding or bruising
Graying or hair loss
Mental or psychological changes
Irregular heartbeat
Drowsiness
convulsions
Decreased consciousness
You think about harming or killing yourself.
Symptoms of liver disease (such as severe stomach and abdominal pain, yellow eyes or skin, dark urine)
muscle weakness
Unwanted or uncontrolled movements
anxiety
Black and tarry stools
bleeding gums
blindness
Blisters and loose skin
Blood in the urine or stool
Blurred vision or other vision changes
Discomfort, tightness or pain in the chest area
Shivering
Cold sweat
confusion
Cough and hoarseness
dark urine
Decreased urination
diarrhea
Night vision problem
Dizziness or fainting
Fast heartbeat
Feeling your thoughts are being read by others
Feeling that others are watching you.
Seeing or hearing things that are not there.
Fever
Headache
Inability to move the eyes
Eyelid spasm
increased hunger
Joint or muscle pain
Hive-like swelling on the face, eyelids, tongue, throat, hands, feet, and genitals
hearing loss
Back and side pain
getting angry
the nightmare
Noisy breathing
Painful or difficult urination
Pale skin
heart beat
Red spots on the skin
Eye irritation
convulsions
Severe mood or mental changes
shaking
Tongue tie
Sore throat
Sores or white spots on the mouth or lips
Stomach ache
Difficulty breathing, speaking, or swallowing
Unusual tiredness or weakness
Weight Gain
Yellowing of the eyes or skin
This medicine may cause low blood sugar (hypoglycemia). Tell your doctor right away if you develop symptoms of low blood sugar, such as sudden sweating, tremors, hunger, blurred vision, dizziness, or tingling in the hands and feet.
Very serious side effects of Hydroxychloroquine
Get medical help right away if any very serious side effects occur, including: severe dizziness, fainting, fast or irregular heartbeat, seizures.
This medicine may cause serious eye and vision problems.
The risk of developing these complications increases with long-term use of this drug and with the use of this drug in high doses.
Tell your doctor if you have signs of serious eye problems, including: sensitivity to light, vision changes (such as flashing/streaks of light, blurred vision, trouble reading, loss of vision).
A very serious allergic reaction to this drug is rare.
However, if you notice the symptoms of a serious allergic reaction such as the following, inform your doctor immediately:
skin rash
Itching and swelling (especially of the face, tongue, and throat)
dizziness
breathing problem
Contraindications of Hydroxychloroquine
Some medical problems can affect the side effects of this medicine. If any of the following applies to you, be sure to inform your doctor.
Blood or bone marrow problems
diabetes
vision problems
Muscular and nervous diseases
porphyria (blood disorder)
Psoriasis (skin disease)
Stomach and intestinal problems
Heart disease
Heart rhythm problems
Hypomagnesemia (decreased magnesium in the blood)
kidney disease
liver disease
Precautions of Hydroxychloroquine
Before taking hydroxychloroquine, tell your doctor or pharmacist if you are allergic to it.
Before using hydroxychloroquine, tell your doctor or pharmacist your medical history, especially if you have any of the following problems:
specific enzyme problem (glucose-6-phosphate dehydrogenase-G6PD deficiency)
Vision/eye problems
Hearing problems
kidney disease
liver disease
Regular use of alcohol
Skin problems (such as psoriasis)
specific blood disorder (porphyria)
convulsions
If you have diabetes, hydroxychloroquine may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you notice signs of low blood sugar (see Side Effects) Your doctor may need to adjust your diabetes medication, exercise program, or diet.
In case of changes in the heart rhythm, inform the doctor. If you develop blurred vision or other changes in your vision, be sure to inform your doctor. If you are using this medicine to treat or prevent malaria, take it until the end of the prescribed time. Stopping the drug early may cause infection or re-infection.
Be careful of the following when using hydroxychloroquine:
Hydroxychloroquine may make you more sensitive to the sun.
Stay in the sun less.
Avoid tanning booths and sun lamps.
Use sunscreen and wear protective clothing outdoors.
Tell your doctor right away if you get sunburned or have skin blisters or redness.
Before surgery, tell your doctor or dentist about all the products you use (including prescription drugs, over-the-counter drugs, and herbal products).
Hydroxychloroquine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation. Rarely, it can cause serious (rarely fatal) fast, irregular heartbeats and other symptoms (such as severe dizziness, fainting) that require immediate medical attention.
The risk of QT prolongation may increase if you have certain medical conditions or take other medications that may prolong the QT interval.
Before using hydroxychloroquine, be sure to tell your doctor if you have any of the following conditions:
Certain heart problems (heart failure, slow heart rate, QT prolongation on ECG), family history of certain heart problems (QT prolongation on ECG).
Low levels of potassium or magnesium in the blood may also increase the risk of QT prolongation. This risk may increase if you use certain medications (such as diuretics/”water pills”) or have conditions such as excessive sweating, diarrhea, or vomiting.
During pregnancy, hydroxychloroquine should be used only when clearly needed.
This drug is transferred to breast milk.
pregnancy
If you are pregnant or plan to become pregnant, tell your doctor before taking this medicine. Complete research on the harm of this pill to the fetus has not been done yet. But you should know that malaria can be very dangerous for the mother and the fetus. Malaria can cause serious illness or death in the mother. It also increases the possibility of miscarriage, stillbirth and premature birth.
breastfeeding
There is no accurate information about the transfer of this drug from breast milk to the baby. But the medicine may be transferred to the baby and cause side effects.
Drug interactions
Drug interactions may change how your medications work or increase your risk of serious side effects. Some medications may interact with hydroxychloroquine sulfate. Drug interactions may reduce the effectiveness of any drug or cause serious side effects in the body.
Keep a list of all the products you use (including over-the-counter drugs and herbal products) and share it with your doctor and pharmacist.
Do not start, stop, or change the dosage of medications without your doctor’s approval.
Some products that may interact with this drug include:
Penicillamine
Remdesivir
urothioglucose
jump
Cisapride
Levoctoconazole
Mesoridazine
pimozide
Piperaquine
Saquinavir
Sparfloxacin
Terfenadine
Thioridazine
Ziprasidone
Acarbose
Albiglutide
Alfuzosin
Allogyptin
amiodarone
Ami Sulpride
Amitriptyline
Anagrelid
Apomorphine
Aripiprazole
Aripiprazole Loroxyl
Arsenic trioxide
Asenapin
Astemizole
Atazanavir
Uranofin
Azithromycin
Badakilin
Buprenorphine
Chloroquine
Chlorpropamide
cimetidine
Ciprofloxacin
Citalopram
Clozapine
Disopyramide
Desipramine
Dolastrone
Doxepin
Eribulin
Encorefenib
Eribulin
Erythromycin
escitalopram
Famotidine
Fluconazole
Glimpride
Granistrone
Amy Pramin
Bovine insulin
Detmir insulin
Evabradine
Itraconazole
Leprolide
metformin
methadone
Pentamidine
Voriconazole
Many drugs besides Hydroxychloroquine may affect the heart rhythm (QT prolongation) such as:
amiodarone
Azithromycin
Disopyramide
Duran Daron
learn
quinidine
overdose of Hydroxychloroquine
Taking too much of this drug is dangerous and you should call the emergency room immediately. Usually, the overdose of hydroxychloroquine sulfate is associated with the following symptoms.
Drowsiness
dry mouth
thirst
loss of appetite
Mood changes
Decreased pulse and blood pressure
Numbness or tingling of the hands, feet or lips
fainting
Fast and irregular heartbeat
faint
Slow and shallow breathing
convulsions
Forgetting to take medicine
If you miss a dose, take it as soon as possible. But if it was close to the next turn, ignore the missed turn. Do not double the dose at the next time.
The latest research to investigate the effectiveness of hydroxychloroquine on Corona
One of the drugs used to treat corona in hospitals is hydroxychloroquine. According to a recent research, the use of this drug in people who were not ill did not reduce the rate of hospitalization. This medicine can prevent the spread of infection in the body to some extent. But studies show that other drugs can have a better effect than that.
Is hydroxychloroquine sulfate fattening?
Usually, hydroxychloroquine or placonil does not cause obesity and weight gain. Most people who have used this drug have reported weight loss. Patients who use this drug to treat lupus or rheumatoid arthritis should know that these two diseases can cause weight gain. In fact, the cause of weight gain is the disease, not the use of medicine.
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