Side Effects of Plaquenil
Antimalarial medications are typically well tolerated. Nearly 90% of people will not experience any side effects from these types of medications.
Call your doctor right away if you notice any of these side effects:
- Blurred vision or changes in your vision
- Convulsions, seizures, or other neurological symptoms (these are very rare)
- Muscle aches or weakness
- Nervousness or anxiety
If you notice these less serious side effects, talk with your doctor:
- Dry skin
- Loss of appetite
- Upset stomach or cramps
- Bleaching of hair or hair loss
- Blue-back discoloration of skin, fingernails, or inside of the mouth
A full list of known side effects can be found here.
Plaquenil is sold in 200mg tablets.
The recommended adult dosage for a person with lupus is 200 to 400 mg daily. It can be taken in two doses or at one time. Doses above 400 mg/day are not recommended.
It is possible to overdose on Plaquenil as it is rapidly and completely ignored upon ingestion. Toxic symptoms may occur within 30 minutes. Symptoms of overdose include:
- visual disturbances
- cardiovascular collapse
- respiratory and/or cardiac arrest
Drug interactions with Plaquenil
A total of 226 drugs are known to interact with Plaquenil, including 8 major drug interactions. For a full list that can be easily searched, visit drugs.com
You should avoid taking antacids or Kaopectate within 4 hours of taking Plaquenil. Some antacids may make it harder for your body to absorb the medication.
Some of the medications that may interact with Plaquenil include:
- Arava (lefunomide)
- Aurolate (gold sodium thiomalate)
Benlysta is a relatively inexpensive medication that is likely covered, at least in part, by insurance.
Using GoodRx, the estimates for 60 200mg tablets are:
Generic hydroxychloroquine: $54
Brand name Plaquenil: $400
Lupus and Plaquenil research
While Plaquenil was not created with the explicit purpose of helping people minimize the disease activity of lupus, a number of clinical trials have been conducted to examine the clinical impact of the medication.
One such study found that Plaquenil “has a protective effect on survival” which is evident even when considering for other treatment variables. Additionally, the study confirmed that the medication was well tolerated by the participants.
This study examined people that were part of the LUMINA cohort. LUMINA stands for: LUpus in MInorities: NAture vs nurture. As the name suggests, this cohort is made up of people of various ethnicities.
There were 608 participants in the trial. The ethnic breakdown was:
- 117 Hispanics from Texas
- 101 Hispanics from Puerto Rico
- 220 African-Americans
- 170 Caucasians
An additional finding of the study was that patients treated with Plaquenil tended to have less severe disease activity.
Because previous studies have found strong connections between Plaquenil and decreased lupus flares, the amount of damage to the body, and the favorable impact on survival, the researchers deemed it to be unethical to conduct a double-blind, placebo study. Instead, the researchers used statistical models to create two groups based on the likelihood of a patient being prescribed Plaquenil after accounting for disease severity and socio-demographic factors.
It is by comparing these two groups that the researchers could conclude that Plaquenil provided a statistically beneficial protective effect on survival both on its own and in conjunction with other lupus medications. The researchers made this determination using odds ratios — these are a measure of the association between an exposure (in this case, taking Plaquenil) and an outcome (here, survival).
The researchers concluded that these positive outcomes, and the limited side effects, make Plaquenil a powerful force in the fight against lupus. The researchers suggest that Plaquenil, “should be considered as a therapeutic option in all patients with SLE and should be administered using established guidelines so that the proper dose is prescribed (not exceeding 6.5 mg/kg of (ideal) body weight) and adequate ophthalmological monitoring is performed.”