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Plaquenil (Hydroxychloroquine)
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Plaquenil

Plaquenil is an expensive drug used to treat rheumatoid arthritis and systemic lupus erythematosus. It is also used to treat malaria. It is more popular than comparable drugs. It is available in generic and brand versions.

Other names for this medication:
Hydroxychloroquine, Rutor, Zhquine

Similar Products:
Azulfidine, Aceon, Ceclor, Estrace, Alprostadil, Aurogra

Also known as: Hydroxychloroquine

Description

Plaquenil (hydroxychloroquine) is used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Hydroxychloroquine is not effective against all strains of malaria, or against malaria in areas where the infection has been resistant to a similar drug called chloroquine.

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

Dosage

Usual Adult Dose of Plaquenil for Malaria Prophylaxis:

400 mg salt (310 mg base) orally once a week Weight-based dosing: 6.5 mg/kg salt (5 mg/kg base) orally once a week -Maximum dose: 400 mg salt (310 mg base)/dose Comments: -This drug should be administered on the same day of each week. -Suppressive therapy should begin 2 weeks prior to exposure and should continue for 4 weeks after leaving the endemic area. Use: For the prophylaxis of malaria in geographic areas where chloroquine resistance is not reported US CDC Recommendations: 310 mg base (400 mg salt) orally once a week Comments: -An alternative to chloroquine for prophylaxis only in areas with chloroquine-sensitive malaria -Prophylaxis should start 1 to 2 weeks before travel to malarious areas; should continue weekly (same day each week) while in malarious areas and for 4 weeks after leaving such areas -If malaria develops while using this drug for chemoprophylaxis, it should not be used as part of the treatment regimen. -Current guidelines should be consulted for additional information.

Usual Adult Dose of Plaquenil for Malaria:

800 mg salt (620 mg base) orally as an initial dose, followed by 400 mg salt (310 mg base) at 6, 24, and 48 hours after the initial dose Total dose: 2000 mg salt (1550 mg base) Weight-based dosing: -First dose: 13 mg/kg salt (10 mg/kg base) orally -Second dose (6 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally -Third dose (24 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally -Fourth dose (48 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Maximum Dose: -First dose: 800 mg salt (620 mg base)/dose -Second, third, and fourth dose: 400 mg salt (310 mg base)/dose Comments: -Concomitant therapy with an 8-aminoquinoline compound is necessary for radical cure of Plasmodium vivax and P ovale infections. Use: For the treatment of uncomplicated malaria due to P falciparum, P malariae, P ovale, and P vivax US CDC Recommendations: 620 mg base (800 mg salt) orally at once, followed by 310 mg base (400 mg salt) orally at 6, 24, and 48 hours Total dose: 1550 mg base (2000 mg salt) Comments: -Recommended for uncomplicated malaria (P falciparum or species not identified) in regions with chloroquine sensitivity -Recommended for uncomplicated malaria (P malariae, P knowlesi, P vivax [unless chloroquine-resistant P vivax suspected], or P ovale) in all regions; if treating P vivax or P ovale infections, concomitant treatment with primaquine (after quantitative testing to rule out glucose-6-phosphate dehydrogenase [G6PD] deficiency) is recommended. -Recommended for uncomplicated malaria treatment for pregnant women in regions with chloroquine sensitivity -Current guidelines should be consulted for additional information.

Usual Adult Dose of Plaquenil for Systemic Lupus Erythematosus:

200 to 400 mg salt (155 to 310 mg base)/day orally divided in 1 or 2 doses Comments: -Doses above 400 mg/day are not recommended. -Higher incidence of retinopathy reported when this maintenance dose is exceeded. Uses: For the treatment of chronic discoid lupus erythematosus and systemic lupus erythematosus

Usual Adult Dose of Plaquenil or Rheumatoid Arthritis:

Initial dose: 400 to 600 mg salt (310 to 465 mg base)/day orally divided in 1 or 2 doses Maintenance dose: 200 to 400 mg salt (155 to 310 mg base)/day orally divided in 1 or 2 doses Maximum dose: 600 mg salt (465 mg base)/day or 6.5 mg/kg salt (5 mg/kg base)/day, whichever is lower Comments: -The action of this drug is cumulative and may require weeks to months to achieve the maximum therapeutic effect. -When a good response is obtained, the initial dose may be reduced by 50% and continued at a maintenance dose. -Higher incidence of retinopathy reported when this maintenance dose is exceeded; 600 mg salt (465 mg base) or 6.5 mg/kg salt (5 mg/kg base), whichever is lower, should not be exceed per day. -Corticosteroids and salicylates may be used with this drug, and they can generally be decreased gradually in dosage or eliminated after a maintenance dose of this drug has been achieved. Use: For the treatment of acute and chronic rheumatoid arthritis

Usual Pediatric Dose of Plaquenil for Malaria Prophylaxis:

6.5 mg/kg salt (5 mg/kg base) orally once a week Maximum dose: 400 mg salt (310 mg base)/dose Comments: -This drug should be administered on the same day of each week. -Suppressive therapy should begin 2 weeks prior to exposure and should continue for 4 weeks after leaving the endemic area. Use: For the prophylaxis of malaria in geographic areas where chloroquine resistance is not reported US CDC Recommendations: 5 mg/kg base (6.5 mg/kg salt) orally once a week Maximum dose: 310 mg base (400 mg salt)/dose Comments: -An alternative to chloroquine for prophylaxis only in areas with chloroquine-sensitive malaria -Prophylaxis should start 1 to 2 weeks before travel to malarious areas; should continue weekly (same day each week) while in malarious areas and for 4 weeks after leaving such areas -If malaria develops while using this drug for chemoprophylaxis, it should not be used as part of the treatment regimen. -Current guidelines should be consulted for additional information.

Usual Pediatric Dose of Plaquenil for Malaria:

First dose: 13 mg/kg salt (10 mg/kg base) orally Second dose (6 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Third dose (24 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Fourth dose (48 hours after first dose): 6.5 mg/kg salt (5 mg/kg base) orally Maximum Dose: -First dose: 800 mg salt (620 mg base)/dose -Second, third, and fourth dose: 400 mg salt (310 mg base)/dose Comments: -Concomitant therapy with an 8-aminoquinoline compound is necessary for radical cure of P vivax and P ovale infections. Use: For the treatment of uncomplicated malaria due to P falciparum, P malariae, P ovale, and P vivax US CDC Recommendations: 10 mg/kg base orally at once, followed by 5 mg/kg base orally at 6, 24, and 48 hours Total dose: 25 mg/kg base Comments: -Pediatric dose should never exceed adult dose. -Recommended for uncomplicated malaria (P falciparum or species not identified) in regions with chloroquine sensitivity -Recommended for uncomplicated malaria (P malariae, P knowlesi, P vivax [unless chloroquine-resistant P vivax suspected], or P ovale) in all regions; if treating P vivax or P ovale infections, concomitant treatment with primaquine (after quantitative testing to rule out G6PD deficiency) is recommended. -Current guidelines should be consulted for additional information.

Detailed Plaquenil dosage information

Overdose

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of hydroxychloroquine can be fatal, and must be treated quickly.

Overdose symptoms may include drowsiness, vision changes, seizure, slow heart rate, weak pulse, pounding heartbeats, sudden dizziness, fainting, shortness of breath, or slow breathing (breathing may stop).

Keep this medicine out of the reach of children. A hydroxychloroquine overdose can be fatal to a child who accidentally swallows this medicine.

Storage

Store at room temperature below 30 degrees C (86 degrees F) away from moisture, light and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Plaquenil are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

You should not use Plaquenil if you are allergic to hydroxychloroquine or chloroquine.

High doses or long-term use of Plaquenil may cause irreversible damage to your retina (the membrane layer inside your eye that helps produce vision). This could progress to permanent vision problems. The risk of retinal damage is higher in people with pre-existing eye problems, kidney disease, or people who also take tamoxifen.

To make sure Plaquenil is safe for you, tell your doctor if you have ever had:

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; porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Tell your doctor if you are pregnant or plan to become pregnant. Malaria is more likely to cause serious illness or death in a pregnant woman. Having malaria during pregnancy may also increase the risk of miscarriage, stillbirth, premature delivery, and low birth weight.

It is not known whether hydroxychloroquine will harm an unborn baby. If you are pregnant, ask your doctor about the risks of traveling to areas where malaria is common (such as Africa, South America, and Southern Asia).

It may not be safe to breastfeed while using Plaquenil. Ask your doctor about any risk.

Plaquenil is not approved for treating lupus or rheumatoid arthritis in anyone younger than 18 years old.

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Two hundred micrograms of DNA was injected into the tibialis anterior muscle four times at weekly intervals. Biorelevant dissolution media as a predictive tool for glyburide a class II drug. Styrax decreased the spontaneous locomotor movements at 100 mg/kg during 5-60 min interval after oral administration. An evaluation of two respite models for older people and their informal caregivers. The incidence of stereotyped sniffing produced by both apomorphine and LY171555 was increased in the adrenalectomized group and decreased following replacement therapy and in intact rats treated with chronic corticosterone, compared with sham-operated animals and saline-treated controls, respectively. Our previous studies have shown the role of hydrogen-bond donor and acceptor groups of cytosine and guanine in the CpG motif and identified synthetic immunostimulatory motifs. The present study aims to elucidate the pathophysiology of PTTM. Examples illustrate a variety of approaches and a breadth of contexts in which quality-based payment has been implemented.

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Abstracts: Genetic mechanisms in carcinogenesis and tumor progression. Macroscopic and ultrasound findings revealed that lymphoedema adipose tissue had larger lobules of adipose tissue, with these lobules surrounded by thick collagen fibres and interstitial lymphatic fluid. Plasma free GH was measured in the supernatant after polyethylene glycol precipitation. In yeast cells, the levels of both ZOD1- and ETC5-specific transcripts were dramatically enhanced upon nucleosome depletion. Prognostic significance of baseline positron emission tomography and importance of clinical complete response in patients with esophageal or gastroesophageal junction cancer treated with definitive chemoradiotherapy.

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The effect of sulfur containing amino acids on L-tryptophan biosynthesis from anthranilic acid by yeasts and their accumulation in the biomass. In Experiment 1, adults, 11-year-olds, and 8-year-olds rated how well individual test tones continued fragments of melodies. We used data from the Botswana Family Health Needs Study (2002), a sample of 1033 working adults with caregiving responsibilities who used public services, to assess whether households with orphan-care responsibilities encountered financial and other difficulties. Comparative Analysis of the Neurochemical Profile and MAO Inhibition Properties of N-(Furan-2-ylmethyl)-N-methylprop-2-yn-1-amine. However, the efficacy of WPI as a bioavailable source of these vitamins in the elderly with low vitamin B12 was not previously tested. We conclude that the pressor response to A II has a direct contractile effect and a catecholamine dependent component in aortic rings of Bufo arenarum toad.

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Fibrinolytic activity of the cerebrospinal fluid after subarachnoid haemorrhage. Varying the presence and absence of nest shavings in the correct and incorrect arms of a T-maze in Experiment 1 revealed that nest shavings had both nondirective facilitation and approach-eliciting properties. Increased memory load also led to a growth of theta-band coherence in the left hemisphere and its decrease in the right hemisphere. The substructure is then expanded to the full structure by maximum-likelihood phasing with SHARP and density modification with the program DM. We argue that learning how to manage errors effectively would enable trainee practitioners to improve patient care, reduce the burden on an overstretched health care system and engage in dynamic as opposed to defensive practice. The number of vasectomies performed/day at Pro-Pater clinics increased from 11 to 20 during the publicity campaign and fell after the ads stopped but continued at higher levels. In this study, we hypothesized that an imbalance in the MMP-TIMP system may be an intra-ovarian component that contributes to the pathogenesis of cystic ovarian disease (COD) in cows. Factors that increase the risk of developing cancer are early onset of the disease, widespread disease, and a duration of over 10 years. Sox8 and Sox10 are two closely related transcription factors of the Sox protein family with overlapping expression patterns during development.

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In 13 of the 15 patients with mild pleural thickening, the 1-3-mm-thick pleura was separable from the underlying normal intercostal muscle by a layer of extrapleural fat. In this article, we review evidence which implicates 14-3-3 proteins in responses to environmental, metabolic and nutritional stresses, as well as in defence responses to wounding and pathogen attack. By indirect immunofluorescence we detected laminin in cultures of Pam cells ( a mouse keratinocyte cell line) and normal human epidermal cells. Intermittent medication cessation may reduce the risk of exposure to these side effects. Studies of the phylogeny and ontogeny of the specialized lymphatic tissue venules. These results were extended to a series of phenols, thereby demonstrating that the microfluidic peroxidase reactor may have application in high-throughput screening of phenolic polymerization reactions for use in phenolic resin synthesis. In this way, hormonal signals from the gut may be translated into the subjective sensation of satiety.

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Pharmacokinetic and dosimetric characteristics of new radiopharmaceutical based on complexes of 103Pd and albumin microspheres. The aim of this study was to determine whether handling of Prestige oil-contaminated birds during autopsies and cleaning may is xanax a brand name or generic have resulted in genotoxic damage. Histological alterations in the testicular tissue induced by sildenafil overdoses. Psoriasis is the disease of abnormal keratinocyte differentiation and apoptosis. Further information is needed on the baroreflex control of various efferents in hypertension. The fluorescence immunoassay using plane surface solid phases (FIAPS). The presented strategy is effective not only for designing non-peptidic ligands from a peptide ligand but also for the rational optimization of these ligands based on the plausible target-binding conformation without requiring the three- dimensional structural information of the target and its peptide ligands. Fifteen patients with cutaneous DM were assessed using the CDASI and the Physician Global Assessment (PGA) by five dermatologists, five rheumatologists and five neurologists. Congenital ophthalmoplegia, floppy baby syndrome, myopathy, and aminoaciduria. Renal biopsy showed membranoproliferative glomerulonephritis-like lesions with azan-red-stained thrombi in the glomerular capillary lumen.

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Technique to facilitate graft passage in posterolateral reconstructions of the knee. Contraceptive action can only be sought if the gametes carry specific antigens, so that other physiological functions will not be disturbed, and if the antigens play a determining role in fertilization. Expression of Xenopus suppressor of cytokine signaling 3 (xSOCS3) is induced by epithelial wounding. Cancer in Belgium: an exploratory analysis of morbidity and suggestions for improved registration. In horses age 6 months-4 years, the collagen network of all 3 layers within the joint has already attained a mature biochemical composition, but the mineral composition of both subchondral and trabecular bone continues to develop until approximately age 4 years.

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Differential diagnosis usually includes a combination of clinical examination, biochemical testing, ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), transhepatic cholangiography, computed tomography (CT), nuclear magnetic resonance (NMR) and endoscopic ultrasonography (EUS). Living donor transplantation in the USA: are there any lessons for Europe?. Changes in the basement membrane composition could induce changes in endothelial cell modifying their interactions with leukocytes. Sequential roles for Mash1 and Ngn2 in the generation of dorsal spinal cord interneurons. We determined soluble ions (chloride, nitrate, sulfate, ammonium, sodium, potassium), ionizable transition metals (Zn, Fe, Ti, Pb, Mn, V, Ni, Cr, Cu) and soluble protein. Repair of transposition of the great arteries in 123 pediatric patients: early and long-term results. The respective ED50 values for the inhibition of the antiseizure action of lamotrigine were 40.9 and 0.2 mg/kg. Comparison of levels of various substances obtained at this site with levels obtained in fresh bottom ash in other studies suggests that these results may be applicable to exposures from other municipal incinerator bottom ash landfills. The concept of individual reproductive success was investigated in a rural Trinidadian village by analyzing arcoxia 60 mg pret genealogical, economic and demographic data.

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The Castle Hill lunatic asylum (1811-1826) and the origins of eclectic pragmatism in Australian psychiatry. The findings suggest the value of using genetic data in helping to classify the categories of this heterogeneous disease. Juvenile hormone, 20-hydroxyecdysone and dopamine interaction in Drosophila virilis reproduction under normal and nutritional stress conditions. Up-regulation of Flot-2 protein is related to lymph node metastasis and poor prognosis in human solid tumors. Germination and fermentation inhibiting effect of byssochlamic acid. Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system that may result in a wide range of neurological symptoms and accumulating disability. Update on current care guidelines: physical activity and exercise training for adults in sickness and in health. The uptake by cells having asialoglycoprotein receptors (ASGPr) on their plasma membrane was decreased by the addition of free AF, indicating that AF-lipoplexes were taken up specifically by cells via ASGPr-mediated endocytosis. This can be achieved by incorporating specific lipid-based proenhancers or prodestabilisers into the liposome carrier, which automatically becomes activated by PLA(2) only at the diseased target sites, such as inflamed or cancerous tissue.

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Attempt to evaluation of the microbiological purity of dish table subjected to mechanical washing process. The organisation of the symptoms of depakote overdose statocyst hair cells and auditory evoked potentials (AEPs) generated by the afferents in three body size classes of prawn (Palaemon serratus) have been studied using a combination of anatomical, electron microscopic and electrophysiological approaches. Low conscience level and oculoclonic movements may form part of the subtle clinic of the occipital seizures, that may be the main manifestation of PLS in children who are following immunosupressor treatment. Exercise therapy in convalescence from acute myocardial infarction. Descending projections from the basal forebrain to the orexin neurons in mice.

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Culture of 2 mammary glands from each sow revealed no strict anaerobes. sHLA-G effectively blocked NK lysis of target cells via fracticide killing of NK cells by apoptosis. The specific work-related demands of ankle joints did not improve all components of functional ankle stability in professional dancers. An analysis of the spatial distribution of the main religious groups in India para que sirve el glucophage 500 mg is presented for political divisions and for rural and urban areas. Temperature-sensitive regulation system of prophage lambda induction. However, there were some doubly positive multinucleated cells, suggesting that they belonged to the mononuclear phagocyte system. Aerobic exercise decreases TG in overweight/obese children and adolescents. Prodigiozan also lowered development of local infection caused by Proteus vulgaris in the recipients treated with the combination of prednisolone and azathioprin.

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Dynamics of the cytoskeleton of epidermal cells in situ and in culture. On January 1, 2004, Intermountain Healthcare Health Plans implemented a polypharmacy edit and reduced the quantity limits of triptans to minimize the risks associated with triptan polypharmacy. 30 females with purgative anorexia nervosa, 33 females with purgative bulimia nervosa and 31 controls were included. Primary endpoint was in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) stratified by kidney function and age. P2X7 receptor cell surface expression and cytolytic pore formation are regulated by a distal C-terminal region. The average time between diagnosis and operative intervention was 42 months. Hereditary forms, notably those with SDHB mutation, seem to have a poor prognosis.

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The miniaturized SAW ionization unit requires only a modest operating power of 3 to 4 W and, therefore, provides a viable and efficient ionization platform for the real-time analysis of a wide range of compounds. Finally, ODI from single-shell NODDI analysis, but not NDI, was found to reproduce the group differences from the multi-shell analysis. Abnormalities in vascular constriction and dilatation are associated with early diabetes and contribute to diabetic vascular complications. Role of membrane integrity on G protein-coupled receptors: Rhodopsin stability and function. Blood and saliva samples were obtained to examine if there is a correlation between saliva glycated protein and blood glycated protein. Association of Tear Film Stability and Corneal Surface Temperature in Pudong Patients.

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