Hydroxychloroquine (Hydroxychlorochinum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Antiparasitic agents

Immunosuppressive drugs

Included in the formulation
  • Hydroxychloroquine
    pills inwards 
    New Farm Inc.    
  • Hydroxychloroquine
    pills inwards 
    BIOKOM, CJSC     Russia
  • Immard
    pills inwards 
    Ipka Laboratories Ltd.     India
  • Plaquenil
    pills inwards 
    Sanofi-Synthelabo Co., Ltd.     United Kingdom
    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    VED

    АТХ:

    P.01.B.A.02   Hydroxychloroquine

    Pharmacodynamics:

    The 4-aminoquinoline derivative interacts with ferriprotoporphyrin IX, a specific degradation product of parasites within the erythrocytes. Has selective toxicity with respect to plasmodium infection in the erythrocyte phase. It binds to nucleic acids, interrupting the synthesis of DNA, which leads to the death of parasites that cause malaria, as well as tissue forms of amoebae.

    Has immunosuppressive and anti-inflammatory action in autoimmune processes. It binds free radicals, stabilizes the membranes of lysosomes, inhibits the activity of enzymes in the inflammatory focus, reduces chemotaxis of leukocytes.

    Pharmacokinetics:

    After oral administration, up to 98% is absorbed in the gastrointestinal tract. The maximum concentration in the blood plasma is achieved in 1-2 hours. The connection with plasma proteins is 55%.

    Penetrates through the blood-brain and placental barrier, is found in breast milk. Metabolism in the liver.

    The half-life is 5-6 days. Elimination by the kidneys, up to 70% unchanged.

    Indications:

    It is used for the prevention and treatment of malaria, systemic lupus erythematosus, porphyria, amoebiasis. It is part of the combined therapy of systemic lupus erythematosus, scleroderma, rheumatoid arthritis and photodermatosis.

    ICD-10

    I.B50-B64.B52   Malaria caused by Plasmodium malariae

    I.B50-B64.B51   Malaria caused by Plasmodium vivax

    I.B50-B64.B50   Malaria caused by Plasmodium falciparum

    XII.L80-L99.L93.0   Discoid lupus erythematosus

    XIII.M05-M14.M05   Seropositive rheumatoid arthritis

    XIII.M05-M14.M08   Juvenile [juvenile] arthritis

    XIII.M30-M36.M32   Systemic lupus erythematosus

    I.A00-A09.A06.4   Amoebic liver abscess

    I.A00-A09.A06.9   Amebiasis, unspecified

    I.B50-B64.B54   Malaria, unspecified

    IV.E70-E90.E80   Disorders of porphyrin and bilirubin metabolism

    XII.L55-L59.L56   Other acute skin changes caused by ultraviolet radiation

    XIII.M05-M14.M06.9   Rheumatoid arthritis, unspecified

    XIII.M30-M36.M34   Systemic sclerosis

    Contraindications:

    Inhibition of cerebral circulation, renal and hepatic insufficiency, psoriasis, neutropenia, cardiac rhythm disturbances, individual intolerance, children under 3 years old.

    Carefully:

    Epilepsy, deficiency of glucose-6-phosphate dehydrogenase, retinopathy, myasthenia gravis, maculopathy,diseases of the gastrointestinal tract, hypersensitivity.

    Pregnancy and lactation:

    Recommendations for FDA - Category C. It is used with caution during pregnancy and lactation in cases where the intended benefit exceeds the risk to the fetus and newborn.

    Dosing and Administration:

    Use in children

    The daily dose for children is 6.5 mg / kg.

    Adults

    Inside. For treatment of malaria: 1 day - 800 mg in the morning, after 6-8 hours - 400 mg, for 2-3 days - 400 mg once a day.

    For the treatment of connective tissue diseases: 400 mg per day.

    The highest daily dose: 1600 mg.

    The highest single dose: 800 mg.

    Side effects:

    Central and peripheral nervous system: dizziness, headache, convulsive attacks, sleep disorders, acute psychosis.

    Hemopoietic system: thrombocytopenia, agranulocytosis, leukopenia.

    The cardiovascular system: arterial hypotension, toxic myocarditis.

    Digestive system: anorexia, gastralgia, nausea, vomiting.

    Musculoskeletal system: arthralgia, muscle weakness, myalgia, muscle spasms.

    Dermatological reactions: itching, hyperpigmentation of mucous membranes and skin, dermatitis, hair color change (depigmentation).

    Sense organs: ringing in the ears, hearing impairment, retinal damage, corneal opacity, visual impairment.

    Allergic reactions.

    Overdose:

    Nausea and vomiting, a sharp drop in blood pressure, quickly turning into a coma and apnea.

    Treatment is symptomatic.

    Interaction:

    Increases glycoside intoxication of cardiac glycosides.

    With simultaneous use with penicillamine, gold preparations, levamisole, phenylbutazone and cytostatics, neurotoxicity increases.

    Ethanol increases hepatotoxicity.

    When used simultaneously with glucocorticoids, the risk increases development of cardiomyopathy and myopathy.

    Cimetidine increases the concentration of hydroxychloroquine in the blood plasma.

    Antacids reduce absorption.

    Monoamine oxidase inhibitors increase toxicity.

    Special instructions:

    Monitoring the cellular composition of the blood.

    In the treatment it is necessary to observe patients with an oculist.

    In the treatment it is not recommended to drive vehicles and work with moving mechanisms.

    Instructions
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