In some cases, there may be no warning signs. Monitoring of the effects of your new treatment is important, particularly during the first 3 months of treatment. For your safety, you need regular blood tests for monitoring. If you develop rashes, facial swelling or shortness of breath after taking the medication, you could be allergic to the medication.
Please seek medical attention immediately. If you have any problem with your treatment, please contact your doctor, pharmacist or rheumatology nurse clinician. All rights reserved. All information correct as of August No part of this document may be reproduced, copied, reverse compiled, adapted, distributed, commercially exploited, displayed or stored in a database, retrieval system or transmitted in any form without prior permission of Tan Tock Seng Hospital.
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All information and material found in this document are for purposes of information only and are not meant to substitute any advice provided by your own physician or other medical professionals. This article was last reviewed on Sunday, April 15, All Rights Reserved. This drug, which is believed to interfere with the communication of various cells in the immune system, is particularly effective in treating skin and joint symptoms.
Hydroxychloroquine is also commonly used with other drugs to reduce inflammation and improve muscle or joint pain. Dosage and How to Use Hydroxychloroquine tablets should be taken with or after food to reduce stomach upset. A typical daily dose ranges from mg to mg. A recent study revealed that the number of Th17 cells is increased and that these cells are involved in the main pathogenic pathways in RA, SS, SLE, and GVHD 21 , 22 , and many studies have shown that the IL level is increased in the serum, saliva, and tears in SS patients 15 , 22 , 23 , BAFF is an essential homeostatic cytokine for B cells that regulates both innate and adaptive immunity The lack of tear production in SS subjects limited our selection of inflammatory parameters.
We evaluated the effect of HCQ on dry eye and systemic changes of inflammatory parameters. Serum and tear BAFF levels were not significantly changed. However, the patients of these two reports constantly took oral HCQ mediation for more than 2 years before enrollment. This could have introduced a bias in that only patients whose condition had improved after HCQ medication remained on HCQ medication at the time of enrollment.
ESR and serum IL-6 levels were not significantly changed, which was comparable with a previous study 9. Our patients were not allowed any other oral or topical anti-inflammatory medication, which may have caused the results in our study to differ from those of the other studies. HCQ showed no definite effect on Th17 cells, and the possible reasons are as mentioned above. In addition, the dosage of mg daily may not be sufficient to ameliorate inflammation such as that involving activated Th17 cells.
Regarding ocular changes, the Schirmer test score did not change significantly during follow-up after HCQ treatment and showed no difference between the groups, which suggests that the HCQ treatment did not affect tear production in this study. The presumed reasons for this finding are as follows: 1 HCQ actually has no clinically beneficial anti-inflammatory effect.
HCQ treatment may thus only affect tear production in younger individuals with early inflammation. The subjective symptoms represented by the OSDI score improved while taking the medication in the HCQ group, but the difference was insignificant between the groups.
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The small group size may explain the lack of significant difference between the two groups. Taken together, the present findings show that HCQ medication did not significantly improve pSS during the study period. However, we did not investigate all of the anti-inflammatory cytokines and inflammatory cells because of the small quantities of collected tears and blood. Therefore, we may have missed some other anti-inflammatory function of HCQ.
There were several limitations in this study. First, the appropriate sample size to obtain statistical significance could not be achieved. Many of the pSS patients were already taking oral medications such as HCQ, pilocarpine, steroids, or other immunosuppressants and were reluctant to stop these medications for a sufficient wash-out period. Furthermore, budget constraints prevented prolonging the study to achieve the targeted sample size. Second, the study schedule was short. Previous studies that reported significant positive results of HCQ in pSS ran for 12 months 7 , 9 , 10 or included cessation of 3 months after 48 months or more of treatment 8.
Third, the small number of enrolled patients may have prevented significant differences from being obtained. Fourth, symptoms OSDI and signs Schirmer test of patients in this study were milder than previous studies 8 , Selection bias can affect the results. Nevertheless, our study is important because it supports other reports and provides evidence that HCQ does not have a definite beneficial effect on dry eye or systemic inflammation.
Kyung Poong Pharma Co. Seoul, Korea kindly provided tablets of hydroxychloroquine and placebo. The authors would like to thank Editage www.
Receiving grant: Kim MK. Approval of final manuscript: all authors. National Center for Biotechnology Information , U. J Korean Med Sci. Published online Apr Find articles by Chang Ho Yoon. Find articles by Hyun Ju Lee. Find articles by Eun Young Lee.
Find articles by Eun Bong Lee. Find articles by Won-Woo Lee. Find articles by Mee Kum Kim. Find articles by Won Ryang Wee. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Dec 8; Accepted Mar This article has been cited by other articles in PMC.
Abstract The effect of hydroxychloroquine HCQ on dry eye has not been fully determined. Graphical Abstract. Open in a separate window. Treatment protocol All subjects underwent initial medical and ophthalmologic history taking and physical examination at the baseline visit week 0. Tear sample collection Tear fluid was obtained from the patients at the same time at baseline and at 6, 12, and 16 weeks. Measurement of tear and serum cytokine profiles ESR was measured by conventional methods in our hospital laboratory on the day of the patient visit.
Flow cytometric analysis for Th17 cells Flow cytometry was also performed on the same day as the patient visit. Statistical analysis Primary analyses of the data were based on the per-protocol population, which included all participants who took the week course of study medication. Ethics statement Written informed consent was obtained from all subjects, and the study was granted ethical approval by the institutional review board of Seoul National University Hospital IRB number: H Characteristics of the study population at baseline Of the 26 pSS subjects analyzed, 11 subjects were randomly assigned to receive HCQ and the remaining 15 subjects were randomly assigned to receive the placebo.
Hydroxychloroquine | Side-effects, uses, time to work
Table 1 Demographics and initial characteristics of the subjects. Changes in parameters Changes in parameters are shown in Table 2 and Figs. If you have urgent needs, please obtain from your local pharmacy. Plaquenil tablets mg are used to suppress and treat malaria, an infection caused by the protozoan single cell parasitic organism Plasmodium that is carried by mosquitoes.
Plasmodium is transmitted by a mosquito bite into the blood, where it migrates to the liver, grows and multiplies then released into the blood, where it and causes destruction of red blood cells.
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Malaria is a life-threatening disease with symptoms including, fever, shivering, headache, vomiting, muscle pain and joint pain. First symptoms usually appear 10 to 15 days after the mosquito bite; however, if left untreated, malaria can quickly become life-threatening, causing anaemia and brain damage and disrupting the blood supply to vital organs. The plasmodium parasite passes through several different stages in its life cycle and Plaquenil tablets mg kill the infective stage of the parasite in the blood erythrocytic forms , which breaks the life cycle of the plasmodium as well as preventing further destruction of red blood cells.
Plaquenil is effective against most common forms of plasmodium, including P. Plaquenil tablets mg are also used to slow down the progression of chronic rheumatic diseases, such as acute and chronic rheumatoid arthritis, mild systemic lupus erythematosus SLE and discoid lupus erythematosus DLE.
Plaquenil tablets mg contain hydroxychloroquine, the antimalarial and disease-modifying antirheumatic drug DMARD used to treat malaria and chronic rheumatic diseases. Acting as an antimalarial, hydroxychloroquine in Plaquenil tablets mg is active against the trophozoite stage of the plasmodium parasitic life cycle that infects red blood cells and causes their destruction.
Haemoglobin, the oxygen carrying protein of blood, is released when the red blood cells are destroyed. The plasmodium parasite digests haemoglobin forming the compound haem which is the non-protein component of haemoglobin and is toxic to cells. Haem is converted by a parasitic polymerase enzyme to the insoluble crystalline form haemozoin that is not toxic to plasmodium. Hydroxychloroquine in Plaquenil tablets mg is thought to act by inhibiting the formation of haemozoin which prevents the detoxification of haem inside the parasitic digestive system and thereby kills the parasite.
However, hydroxychloroquine is not effective against chloroquine-resistant strains of P. Antimalarials like hydroxychloroquine in Plaquenil tablets mg have also been found to have various immunomodulatory effects ability to influence and modify the immune system as well as antiinflamatory effects, and are classified as disease-modifying antirheumatic drug DMARD.
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There are several mechanisms by which hydroxychloroquine is thought to exert its beneficial effects as an antirheumatic drug. These include inhibition of inflammatory mediators such as interleukins and prostaglandins; also dampening down the immune response by interacting with immune cells that influence the immune response to autoantigens directed against self and by interfering with antigen-processing in antigen presenting cells like macrophages. These combined actions of hydroxychloroquine in Plaquenil tablets mg help slow down the progression of chronic rheumatic diseases, such as acute and chronic arthritis and mild systemic lupus erythematosus SLE and discoid lupus erythematosus DLE , which are thought to be autoimmune diseases when the immune system is directed against self , but it does not act as a cure.
Plaquenil contains the active ingredient hydroxychloroquine sulfate mg, the antimalarial and disease-modifying antirheumatic drug DMARD used to treat malaria, rheumatoid arthritis, systemic lupus erythematosus and discoid lupus erythematosus. They also contain: calcium hydrogen phosphate, maize starch, purified water, and magnesium stearate. The film coating contains small amounts of hypromellose, macrogol , titanium dioxide, polysorbate 80, carnauba wax, black ink Tekprint SBSD , and purified water. Plaquenil tablets mg are used to treat malaria, an infection caused by the protozoan single cell parasitic organism Plasmodium.
The most common forms of plasmodium are P. The parasite is carried by mosquitoes and is transmitted by a bite from an infected female mosquito when the first stage of the life cycle called the sporozoite is injected into the blood while the mosquito is feeding. It then migrates to the liver, where it matures into schizonts and multiplies.