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Plaquenil (hydroxychloroquine) is an anti-malarial drug used for both prevention and treatment of certain types of malaria infections. The medication has also been found helpful in relieving symptoms of autoimmune diseases, such as rheumatoid arthritis, systemic lupus, discoid lupus, and the skin disorder known as porphyria cutanea tarda.

In all cases the medication is administered by tablet. In all cases tablets should be taken with food or milk. To retain potency tablets should kept out of direct light and not exposed to excessive heat for long periods. The medication can be used in children, but dosage adjustments will be required.

Plaquenil for Malaria

Individuals planning to travel to areas where malaria is known to be present should begin treatment two weeks before arriving. 400 mg of Plaquenil should be taken as a single dose once per week, on the same day every week, throughout the visit and for an additional 8 weeks after leaving the area.

If treatment was not started prior to arriving in the endemic area, treatment should begin with two 400 mg doses taken 6 hours apart, for a total of 800 mg on the first day. After that the usual 400 mg once per week schedule may be followed.

If malaria has been contracted emergency medical attention should be sought. Treatment with Plaquenil typically consists of a large 800 mg dose, followed by another 400 mg in 6 hours. A 400 mg dose should be taken on the following two days as well.

How Plaquenil works in combating malaria is not completely understood. It is thought that the medication prevents the parasites from obtaining adequate nutrition from the blood of their host.

Other Uses

In systemic lupus, discoid lupus, and rheumatoid arthritis Plaquenil helps alleviate or prevent symptoms caused by the body's inflammatory response, such as swelling and pain.

For these conditions Plaquenil is usually taken once or twice per day, ideally at the same times each day. Patients are typically started on smaller doses, which are increased if needed and no adverse effects develop.

Treatment may be for just a few weeks but more commonly spans months, if not longer. Most patients find 200 to 400 mg per day to be sufficient, though more rarely some individuals require 600 to 800 mg per day. If taking long-term, the lowest effective dose is desirable to reduce the likelihood of side effects.

It may take several weeks of regular treatment for full benefit to be felt, particularly in arthritis.

Precautions & Side Effects

While most people take Plaquenil without any issues, it can produce an odd assortment of side effects in some patients, particularly if taken long-term:

• Irritability
• Vertigo
• Skin irritation
• Headache
• Thinning hair
• Digestive disturbances
• Muscle aches

A rare but potentially serious eye issue, retinopathy, is associated with Plaquenil. The condition, which involves deterioration of the retina, can develop without symptoms until damage has been done. Those taking Plaquenil should receive regular eye examinations.

Another rare complication, the result of an enzymatic genetic deficiency known as G6PD, can cause severe anemia from the destruction of red blood cells. This condition can be screened for by a physician. Individuals of African lineage at at increased risk.

Plaquenil may increase the symptoms of those with psoriasis.

This product should never be taken with the drug penicillamine. Other antimalarial medications should also be avoided unless explicitly instructed to take them by a doctor. Other medications are less concerning but can produce complications if taken with Plaquenil; double-check with a doctor or pharmacist before mixing medications.