Hydroxychloroquine

Hydroxychloroquine

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  • Hydroxychloroquine tablets (brand name Plaquenil) are used to treat or prevent malaria, a disease caused by parasites that enter the body through a mosquito bite.
  • For the treatment of patients with COVID-19, several medications are used, the ability of which to affect various links of the infectious process has been shown during experimental or limited clinical studies. These drugs include Hydroxychloroquine, which, due to its anti-inflammatory effect and effect on the immune system, has been used for decades to treat malaria, rheumatoid arthritis, and systemic lupus erythematosus.
    Recommendations for the use of Hydroxychloroquine in COVID-19 are based on the results of numerous studies that have confirmed the effectiveness of the drug against an infectious agent in vitro (in an experiment), and then during clinical trials, as well as expert opinions.
  • These data, supported by the experience of using Hydroxychloroquine in real practice around the world, were the basis for its inclusion in a number of national and international clinical guidelines, including the FDA in the US.

Active ingredient: Hydroxychloroquine
  • Brand(s):Plaquenil / Imulast / HCQS / Hydroquin
  • Manufacturer: Cipla / IPCA / Sun Pharmaceutical Industries Ltd.
  • Disease(s):Malaria / Rheumatoid Arthritis / Discoid Or Systemic Lupus Erythematosus / COVID-19

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Buy Hydroxychloroquine 200mg, 400mg 

Hydroxychloroquine 200/400 mg (hydroxychloroquine sulfate) is an antimalarial drug that is useful in the treatment of autoimmune diseases such as discoid and systemic lupus erythematosus (SLE and SLE), rheumatoid arthritis (including juvenile arthritis), Sjogren’s syndrome and cutaneous vasculitis.

One of the most widely discussed methods of treating patients with COVID-19, especially in the first months of studying the infection, when there were frightening mortality figures, was the use of the drug Hydroxychloroquine. The first small and non-randomized studies have shown the ability of Hydroxychloroquine and its combination with azithromycin to accelerate the elimination of the virus and remove patients from the acute phase of the disease.

With the drug Hydroxychloroquine is more often bought:

Use of the drug Hydroxychloroquine

  • Hydroxychloroquine is an antimalarial drug that has proven useful in the treatment of autoimmune diseases such as discoid and systemic lupus erythematosus (SLE and SLE), rheumatoid arthritis (including juvenile arthritis), Sjogren’s syndrome and cutaneous vasculitis.
  • The drug Hydroxychloroquine, which is believed to interfere with the interaction of various cells of the immune system, is especially effective in the treatment of skin and joint symptoms.
  • A significant array of published research results, as well as experience, indicates the validity of the use of Hydroxychloroquine when it is prescribed in certain groups of patients with COVID-19 in low doses, to a lesser extent associated with cardiac arrhythmias.
  • Hydroxychloroquine tablets are also commonly used with other medications to reduce inflammation and relieve muscle or joint pain.

Pharmacological action of Hydroxychloroquine

  • Antiprotozoal action – inhibit the vital activity of protozoa that cause infectious diseases; first of all, this applies to malaria pathogens, therefore, the main effect of the drug is antimalarial;
  • Immunosuppressive effect – suppresses an overly pronounced reaction of the immune system, including an allergy to the patient’s own body tissues;
  • Anti-inflammatory effect – suppresses inflammatory reactions.

How does Hydroxychloroquine work?

Hydroxychloroquine belongs to the group of antimalarial and immunosuppressive drugs from the group of 4-aminoquinoline derivatives. The mechanism of its action has not been studied enough, but it is believed that it is associated with the following properties of the drug Hydroxychloroquine:

  • The ability to suppress the action of toxic free radicals formed during metabolism (antioxidant effect).
  • The ability to suppress the action of enzymes that cause the breakdown of cartilage tissue.
  • The ability to suppress the synthesis of prostaglandins – biologically active substances involved in inflammatory processes.
  • The ability to concentrate in leukocytes and strengthen the shells of lysosomes – cell structures containing enzymes that can break down food substances entering the cell. Lysosomes are also involved in the digestion of bacteria captured by leukocytes.
  • The ability to suppress the synthesis of those types of cytokines (hormone-like proteins synthesized by cells to affect other cells) that activate the immune system. It also contributes to the reduction of autoimmune processes (destruction of the body’s own tissues by immune processes).
  • The ability to suppress the activity of lymphocytes involved in immune reactions.
  • The ability to suppress the formation of rheumatoid factor – immunoglobulins (antibodies) that perceive the body’s own tissues as foreign structures (antigens) and destroy them.
  • Antimalarial properties of Hydroxychloroquine consists in suppressing the vital activity of pathogens of three-day malaria, four-day malaria, ovale malaria, as well as forms of pathogens of tropical malaria that are sensitive to it (most pathogens of tropical malaria are insensitive to Hydroxychloroquine).

After taking the Hydroxychloroquine tablet, its active substance is rapidly and almost completely absorbed and enters the blood, and then accumulates in high concentrations in various organs and tissues. The maximum concentration of the active substance in the blood plasma is reached within about 100 minutes. The drug decomposes in the liver into active and inactive metabolic products (metabolites) and is excreted in the urine, but partially with feces. The active substance Hydroxychloroquine penetrates through the placenta and is excreted in female milk. The drug is excreted slowly, it disappears from the blood plasma no earlier than a month later.

Usage dosage of Hydroxychloroquine

Hydroxychloroquine tablets should be taken during or after meals to reduce stomach upset. A typical daily dose ranges from 200 mg to 400 mg. The dosage may vary depending on the patient’s weight and reaction to the disease.

This medicine does not work immediately. It may take up to 12 weeks or more before you notice the benefits. Thus, it is important that you take medications regularly, otherwise you may not get any benefit from them at all. If you miss a dose, take the missed dose as soon as you remember. If it’s almost time for the next dose, skip the missed dose and continue taking the usual dose.

Do not double the dose to compensate for the missed dose.

Dose for adults

Oral:

800 mg (2 tablets Hydroxychloroquine 400mg or 4 tablets Hydroxychloroquine 200mg) orally as an initial dose, then 400 mg 6, 24 and 48 hours after the initial dose. Total dose: 2000 mg

The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the applied dosage form of a particular drug with the indications for use and the dosage regimen

Dose depending on body weight

Oral:

  • First dose: 13 mg/kg;
  • Second dose (6 hours after the first dose): 6.5 mg / kg;
  • Third dose (24 hours after the first dose): 6.5 mg/kg;
  • Fourth dose (48 hours after the first dose): 6.5 mg / kg.

The use of Hydroxychloroquine during pregnancy and lactation

Hydroxychloroquine is contraindicated during pregnancy. If necessary, use during lactation should carefully assess the balance between the expected benefits of treatment for the mother and the potential risk for the baby, taking into account the indications for use and duration of treatment.

The use of Hydroxychloroquine in liver diseases

Hydroxychloroquine is used with caution in hepatic insufficiency, hepatitis, simultaneous administration of drugs that can negatively affect liver function (in severe hepatic insufficiency, the dose should be selected under the control of the concentration of hydroxychloroquine in plasma).

The use of Hydroxychloroquine in kidney diseases

With caution, it is used for renal insufficiency, while taking drugs that can negatively affect kidney function (in severe renal insufficiency, the dose should be selected under the control of concentrations of hydroxychloroquine in plasma).

The use of Hydroxychloroquine in children

Hydroxychloroquine is contraindicated in children if long-term treatment is necessary (children have an increased risk of developing toxic effects). Contraindicated in children under 6 years of age (200 mg tablets are not intended for children with a body weight of less than 31 kg).

The use of Hydroxychloroquine in elderly patients

It is used in elderly patients according to indications.

Hydroxychloroquine side effects

In case of any visual disorders, including color perception disorders, patients should be advised to immediately stop taking the drug Hydroxychloroquine and consult a doctor.

Hydroxychloroquine should be used with caution to treat patients taking medications that may cause adverse reactions from the organs of vision or skin.

From the side of the organ of vision:

Retinopathy with pigmentation changes and defects in the visual fields may develop, although rarely. In an early form, these phenomena are usually reversible after discontinuation of hydroxychloroquine. If the condition remains undiagnosed and retinal lesions continue to develop further, then there may be a risk of their progression even after discontinuation of the drug. Retinal changes may initially be asymptomatic, or manifest as paracentral or pericentral scotomas, transient scotomas and color vision disorders. Corneal changes may occur, including swelling and clouding. They may be asymptomatic or cause visual disturbances such as the appearance of halos, blurred vision or photophobia. Upon discontinuation of treatment, these changes may reverse. Visual disturbances associated with accommodation disorders, which are dose-dependent and reversible, may also occur.

From the skin:

Sometimes there are skin rashes; itching, changes in pigmentation of the skin and mucous membranes, hair discoloration and alopecia are also described. These changes usually pass quickly after discontinuation of treatment. Bullous rash has been reported, including very rare cases of erythema multiforme and Stevens-Johnson syndrome, photosensitivity and isolated cases of exfoliative dermatitis. Very rare cases of acute generalized exanthematous pustulosis (OGEP) must be distinguished from psoriasis, although Hydroxychloroquine can also provoke an exacerbation of psoriasis. OGEP may be accompanied by an increase in temperature and hyperleukocytosis. After discontinuation of the drug, the outcome is usually favorable.

From the gastrointestinal tract:

  • Nausea,
  • diarrhea,
  • anorexia,
  • abdominal pain,
  • rarely vomiting.

These symptoms usually go away immediately after dose reduction or withdrawal of the drug.

From the side of the hepatobiliary system:

with prolonged use in large doses, the development of hepatotoxic action is possible. There are reports of isolated cases of liver dysfunction and several cases of sudden liver failure.

From the Central nervous System:

Infrequently – dizziness, tinnitus, hearing loss, headache, irritability, emotional instability, psychosis, convulsions, muscle weakness, ataxia.

From the peripheral nervous system and muscles:

Cases of skeletal muscle myopathy or neuromyopathy leading to progressive weakness and atrophy of proximal muscle groups have been noted. Myopathy may be reversible after discontinuation of the drug, but it may take several months to fully recover. At the same time, there may be weak sensory changes, suppression of tendon reflexes and a decrease in nerve conduction.

From the cardiovascular system:

There are rare reports of the development of cardiomyopathy. Chronic cardiac toxicity may be suspected when conduction disorders are detected (blockage of the legs of the Gis bundle / violation of AV conduction) or hypertrophy of both ventricles. With the cancellation of the drug, the reverse development of these changes is possible.

From the hematopoietic organs:

  • Cases of suppression of bone marrow hematopoiesis were rarely observed.
  • Rare cases of anemia, including aplastic, agranulocytosis, leukopenia and thrombocytopenia have been reported.
  • Hydroxychloroquine can provoke or cause an exacerbation of porphyria.

From the immune system:

  • Urticaria,
  • angioedema,
  • bronchospasm.

Hydroxychloroquine drug interactions

  • Hydroxychloroquine can cause an increase in the level of digoxin in the blood plasma, therefore, patients receiving combination therapy should regularly monitor the level of digoxin in the blood serum.
  • Hydroxychloroquine can enter into some of the known chloroquine interactions, even if there are no publications about it. These include: strengthening of the direct blocking effect of aminoglycoside antibiotics on the neuromuscular synapse inhibition of its metabolism under the influence of cimetidine, which leads to an increase in the concentration of antimalarial drug in blood plasma antagonism of the action of neostigmine and pyridostigmine decrease in the formation of antibodies in response to primary immunization with intradermal human diploid-cell rabies vaccine.
  • As in the case of chloroquine, taking antacids can reduce the absorption of hydroxychloroquine, so the interval between taking Hydroxychloroquine and antacids should be at least 4:00.
  • Since hydroxychloroquine can enhance the effect of hypoglycemic agents, it may be necessary to reduce the dose of insulin or antidiabetic drugs.
  • Halofantrin prolongs the QT interval and should not be prescribed together with other medications that may contribute to the occurrence of cardiac arrhythmias, including hydroxychloroquine. In addition, the risk of inducing ventricular arrhythmias may increase if hydroxychloroquine is used simultaneously with other arrhythmogenic drugs, such as amiodarone and moxifloxacin.
  • An increase in the level of cyclosporine in blood plasma has been reported with the simultaneous use of cyclosporine and Hydroxychloroquine.
  • Hydroxychloroquine can lower the seizure threshold. The simultaneous use of hydroxychloroquine and other antimalarial drugs for which the effect of lowering the seizure threshold is known (for example, mefloquine) may increase the risk of seizures.
  • In addition, there may be a decrease in the effectiveness of antiepileptic drugs when they are used simultaneously with Hydroxychloroquine.
  • In a study on drug interaction with a single use of the test agent, chloroquine reduced the bioavailability of praziquantel. It is not yet known whether a similar effect will be observed with the simultaneous use of hydroxychloroquine and praziquantel. Extrapolating these data, taking into account the similarity of the structure and pharmacokinetic parameters in hydroxychloroquine and chloroquine, we can expect the development of a similar effect for Hydroxychloroquine.

Hydroxychloroquine for coronavirus COVID

In 2020, the President of the United States of America announced that Hydroxychloroquine could be used to treat Covid 19. The FDA authorized the emergency use of Hydroxychloroquine in March 2020. Infectious disease researchers from New Jersey have published a study. Researchers studied 255 patients at St. Barnabas Medical Center in Livingston, New Jersey, during the first months of the pandemic. They concluded that the combination of Hydroxychloroquine and Azithromycin at certain levels leads to a survival rate 2.9 times higher than in other patients.

FAQs

Which countries use Hydroxychloroquine?

Hydroxychloroquine is used in countries where malaria is prevalent. These include regions such as Africa, South America and South Asia. 90% of biomedical science in the world is the science that is done in Western Europe, in the United States, in Japan, in Australia. There is the main expertise, purely in quantitative terms.

The initial use of Hydroxychloroquine had a positive effect, patients began to recover. Therefore, Chinese therapy schemes began to be used in the USA, Italy and Spain.

What time of Day should I take Hydroxychloroquine?

Hydroxychloroquine should be taken at any time with a meal, or washed down with 200 ml of fresh milk. This ensures better absorption of the active substance.

The therapeutic effect is cumulative and manifests itself no earlier than after 28 days of daily pill intake, in connection with which a long-term therapy regimen with this drug is practiced.

Does Hydroxychloroquine make you gain weight?

Hydroxychloroquine has not yet found wide distribution and is rarely prescribed, so reviews of patients who have taken the drug can be found infrequently. Those who have been treated with this drug willingly share their own experience, which allows us to draw conclusions about the effectiveness and safety of Hydroxychloroquine therapy. Yes, it is very possible to gain weight, but this is more likely due to water retention, the contents of the bladder or stomach, or some other factor.

What are the advantages of the drug Hydroxychloroquine?

  • Hydroxychloroquine is a drug produced in the form of tablets. The drug has a wide spectrum of action. Many experts appreciate it for its antiprotozoal properties.
  • Tablets are able to cure a person of malaria in a short time. Hydroxychloroquine is also prescribed to stop a powerful inflammatory process in the body.
  • A little less often, tablets are prescribed to patients to restore the functioning of the immune system, which prevents the development of allergies to their own tissues.
  • The main advantage of the drug is its versatility. The active ingredients rapidly penetrate into the blood, thereby spreading throughout the body. This contributes to a complex effect.

What is Hydroxychloroquine what is it use to treat?

  • Hydroxychloroquine is a drug with a powerful antimalarial effect. When ingested, the drug has a powerful anti-inflammatory and immunosuppressive effect. It is prescribed for the treatment of discoid and systemic lupus erythematosus, often relieving patients from acute and chronic rheumatoid arthritis. It should be borne in mind that specialists cannot fully study why Hydroxychloroquine is able to rid a person of systemic lupus erythematosus and rheumatoid arthritis.
  • The effectiveness of Hydroxychloroquine tablets is explained by the unique composition. The basis of the drug is hydroxychlorine sulfate. This component has a powerful immunomodulatory effect, due to which the body’s production of rheumatoid factor or other components that cause the acute phase of this disease is reduced.
  • The active components accumulate in leukocytes, which normalizes the work of the cell membrane. This prevents the spread of pathogenic enzymes throughout the body, due to which the cartilage retains its integrity and strength.

Storage

Keep away from light & moisture. Store below 30°C. Keep out of the reach of the children.

 

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