Quinacrine Atabrine is another alternative, but it is prescribed less often because it can sometimes cause a yellow discoloration of the skin. It is sometimes given in addition to hydroxychloroquine if the patient does not respond to Plaquenil alone.
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Quinacrine tablets are no longer manufactured and can only be obtained through a compounding pharmacist. Your doctor will advise you on how to obtain quinacrine if this becomes your advised method of treatment. Anti-malarial medications help to control lupus in several ways by modulating the immune system without predisposing you to infection.
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Anti-malarials can protect against UV light and sometimes even improve skin lesions that do not respond to treatment with topical therapy ointments. Anti-malarial medications may prevent activation of plasmacytoid dendritic cells, a component of the immune system that is responsible for making interferon. Yes, anti-malarials can be taken with other lupus medications, including corticosteroids e.
Anti-malarial drugs may be given in combination with prednisone to reduce the amount of steroid needed to control lupus symptoms and thus to alleviate some of the side effects of the steroid. In addition, since it usually takes about months for your anti-malarial medications to fully take effect, you may be given a steroid medication to act as a bridging medication and alleviate your symptoms during this interim. Anti-malarials are safe to use during pregnancy, but you should speak to your doctor if you are pregnant or may become pregnant to decide the course of treatment that will be best for you.
No fetal abnormalities are known to have occurred from taking hydroxychloroquine, and physicians at several major universities have used anti-malarial drugs for years to treat pregnant women with lupus without negative side effects on the fetus. Damage to the retina, the light sensitive portion of the inner eye, can occur with long-term use of Plaquenil or chloroquine Aralen.
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With Plaquenil, however, the most commonly prescribed anti-malarial, this sort of damage occurs only in 1 out of 5, people who take the drug for five years or more. For this reason though, it is important that you see an ophthalmologist for an exam before starting to take an anti-malarial medication for your lupus. Follow-up exams every 6 months or, annually at the very least are also advised. You can also monitor yourself between visits with a special grid called an Amsler grid, which can be obtained through your ophthalmologist.
Unfortunately, retinal damage caused by Aralen may be irreversible, but this medication is rarely prescribed anymore for lupus. Do not smoke while taking anti-malarial medications, since smoking actually reduces the benefits of these drugs. In fact, people with lupus should not smoke at all due to their increased risk of cardiovascular disease.
You should always take your anti-malarial medications with food to prevent stomach upset. If a stomachache does occur, it is usually temporary. However, if you experience stomach upset while taking generic hydroxychloroquine, ask your doctor about trying name-brand Plaquenil instead. While these medications contain the same active ingredient, the preparation of generic hydroxychloroquine can sometimes cause stomach irritation.
This sort of upset usually does not occur with commercial Plaquenil. Lastly, remember that even though you may feel the benefits of anti-malarial therapy after about a month of treatment, it may take up to three months for the full benefits of the drug to manifest. If you experience any serious adverse effects, notify your doctor. Long-term anti-malarial use is normally safe. However, if you stop taking your anti-malarial drugs, you may experience a lupus flare.
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Anti-malarial drugs may have additional health benefits for some people. Potential benefits include greater protection from UV light and lower cholesterol and blood glucose levels. These benefits may be especially helpful for people taking steroids. It may prevent joint damage and reduce the risk of long-term disability. Hydroxychloroquine is in a class of medications that was first used to prevent and treat malaria. Today, it is used to treat rheumatoid arthritis , some symptoms of lupus , childhood arthritis or juvenile idiopathic arthritis and other autoimmune diseases.
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It is not clear why hydroxychloroquine is effective at treating autoimmune diseases. It is believed that hydroxychloroquine interferes with the communication of cells in the immune system. Hydroxychloroquine comes in an oral tablet. Adult dosing ranges from mg or mg per day 6.
In some cases, higher doses can be used. It is recommended one tablet twice daily if taking more than one tablet.
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It is recommended to be taken with food. Symptoms can start to improve in one to two months, but it may take up to six months before the full benefits of this medication are experienced. Hydroxychloroquine typically is very well tolerated. Serious side effects are rare. The most common side effects are nausea and diarrhea, which often improve with time. Less common side effects include rash, changes in skin pigment such as darkening or dark spots , hair changes, and muscle weakness.
Rarely, hydroxychloroquine can lead to anemia in some individuals.