Rheumatoid Arthritis Medicine Plaquenil

Rheumatoid arthritis is a serious inflammatory autoimmune disease in which the body attacks its own tissue, in this case the joints. Therapy is aimed at reducing the immune response and decreasing the inflammation that causes often irreversible joint damage, pain, and loss of function.

Many different types of medications are used for dealing with the symptoms of rheumatoid arthritis (RA) and they act in different ways. Some are purely analgesics to relieve pain while others act directly on the inflammation. The latter includes both steroid drugs and NSAIDS, or non-steroidal anti-inflammatory drugs, which includes aspirin as well as other prescription and over the counter (OTC) medications. Steroids and other drugs such as methotrexate act to turn the immune system down to decrease that attack on joint tissues.

Plaquenil is the brand name for hydroxychloroquine, originally prescribed to prevent or treat malaria. It is also sold under the brand name Quineprox. It is part of a class of drugs called DMARDs, which stands for “disease modifying anti rheumatic drugs.” No one is quite sure how the drug works to fight arthritis, but speculation is that it somehow interferes with messages being sent from one part of the immune system to another.

When new DMARDs such as methotrexate and minocycline came into use about ten years ago, most rheumatologists thought that the use of Plaquenil would fade away, but this proved not to be true. The drug is still useful for patients who cannot tolerate the newer drugs or for whom they have proven ineffective.

While Plaquenil can be very effective in some patients in controlling symptoms of RA it does have several side effects and contraindications. One of the most serious complications, although rare, is damage to vision from the drug. Long term and high dose use can cause a kind of retinopathy and some patients are higher risk than others.

All patients should have an exam by an ophthalmologist before starting the drug and will need regular exams while on it, sometimes as often as every six months. Patients should immediately report any changes in vision to their doctors.

More common side effects are gastrointestinal complaints such as loss of appetite, abdominal cramps, nausea, stomach pain, and diarrhea. Some patients experience dizziness when starting this medication so caution is needed in standing up suddenly and in other hazardous activities. Some people also report mood changes and an increased heart rate.

Whenever these or any other symptoms occur, the physician should be notified, but a patient should not stop or change their dose except on instructions of the doctor. The usual dose for Plaquenil in adults is about 200mg to 600mg per day given in one or two doses. Patients and doctors should discuss all the possible risks and benefits as well before starting therapy. Plaquenil also interacts with other medications, so patients need to discuss all medications and supplements before using them, prescription or not.

Resources:

For more complete drug information on Plaquenil:

www.webmd.com/drugs/

www.rxlist.com/cgi/generic/hquine_ad.htm

www.drugs.com/pdr/plaquenil.html

Drug chart comparing DMARDs from the Arthritis Foundation:

www.arthritis.org/drug-chart.php

Ten things you should know about Plaquenil from the arthritis pages of About.com:

arthritis.about.com/od/plaquenil/a/plaquenil.htm