Top 300 Pharmacy Drug Cards

HYDROXYCHLOROQUINE: Plaquenil, Various

Class: Aminoquinoline

Dosage Forms. Tablet: 200 mg

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Common FDA Label Indication, Dosing, and Titration.

1. Lupus erythematosus: maintenance: 200-400 mg po daily

2. Malaria: suppression: Adults: 400 mg po q week on the same day; Children: 5 mg base/kg (200 mg hydroxychloroquine sulfate = 155 mg hydroxychloroquine base) begin 2 wk prior to entering an endemic area and continue for 8 wk after leaving the endemic area

3. Rheumatoid arthritis: maintenance: 200-400 mg po daily

Off-Label Uses. None

MOA. The mechanism of action of hydroxychloroquine is unknown. It is effective in treating Plasmodium vivaxPlasmodium malariae, and susceptible strains of Plasmodium falciparum.

Drug Characteristics: Hydroxychloroquine

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Medication Safety Issues: Hydroxychloroquine

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Drug Interactions: Hydroxychloroquine

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Adverse Reactions: Hydroxychloroquine

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Efficacy Monitoring Parameters. Rheumatoid arthritis: decreased pain and improved range of motion. Lupus: decreased joint pain, decrease in butterfly rash, improved energy. Malaria: avoidance of malaria.

Toxicity Monitoring Parameters. Seek medical attention if signs/symptoms heart palpitations, severe rash, unusual bruising or bleeding, or difficulty seeing or changes in visual fields. Baseline and periodic eye exams.

Key Patient Counseling Points. If taking weekly, take on same day each week. Take with food or milk.

Clinical Pearls. One tablet of 200 mg of hydroxychloroquine sulfate is equivalent to 155 mg base. If serious toxic symptoms occur, ammonium chloride (8 g daily in divided doses for adults) administered 3-4 d a week for several months may increase the renal excretion of hydroxychloroquine.