Hydroxychloroquine is a 4-aminoquinoline derivativeAntimalarial drugThe action and mechanism are similar to chloroquine, but the toxicity is only half of chloroquine.This product also has anti-inflammatory, immune regulation, anti infection, light filtering, anticoagulant and other effects.
Antimalarial drugs;Antipyretic, analgesic, anti-inflammatory, anti rheumatic drugs[2-4]
Action category
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Antimalarial drugs;Antipyretic, analgesic, anti-inflammatory, anti rheumatic drugs.[2-4]
indication
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It is suitable for malaria, allergic and autoimmune diseases.
Specifications
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Tablets: 0.1g, 0.2g.[2-3]
Adverse reactions
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1. Retinal changes
Retinal pigmentation changes and visual field defects can occur, but rarely.These lesions are reversible after early discontinuation of the product.In case of further development, there is still an increased risk even after stopping the product.Patients with retinopathy may have no symptoms at the early stage, or may be accompanied by paracentral scotoma, pericentral annular defect, temporal defect and abnormal color vision.
2. Corneal changes
Reports of corneal changes include corneal edema and opacity, which may cause no conscious symptoms or may cause such as halo, blurred vision or photophobia.These symptoms may be temporary or reversed after drug withdrawal.The blurred vision caused by abnormal regulatory function is dose dependent and may be reversible.
matters needing attention
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1. Before starting the treatment with this product, all patients should undergo ophthalmic examination.Examination includes visual acuity, ophthalmic microscopy, central visual field and color vision.Thereafter, it shall be inspected at least once a year.
2. Retinopathy has a great correlation with drug dosage. The risk of retinal damage is low when the maximum daily dose does not exceed 6.5mg/kg body weight.But exceeding the recommended daily dose will greatly increase the risk of retinal toxicity.The frequency of ophthalmic examination should be increased for patients with the following conditions:
(1) The daily dose exceeds 6.5 mg/kg ideal body weight.Taking the absolute weight as the medication guidance for obese patients will lead to drug overdose.
(2) Renal insufficiency;
(3) The cumulative dosage exceeds 200g;
(4) Elderly;
(5) Impaired visual sensitivity;In case of visual impairment (visual sensitivity, color vision, etc.), the drug should be stopped immediately and the progress of the patient's abnormal situation should be closely observed.Even after stopping treatment, retinopathy (and visual impairment) may still develop further. Patients who are taking drugs that may cause eye or skin adverse reactions should use this product with caution.This product should also be used with caution in patients with liver or kidney diseases, or those who are taking drugs that are known to affect these organs, as well as patients with severe gastrointestinal, neurological and blood abnormalities.The plasma level of hydroxychloroquine should be estimated in patients with severe impairment of liver and kidney functions in order to adjust the dose used.
Although the risk of myelosuppression is very low, because anemia, aplastic anemia, granulocytopenia, leukopenia and thrombocytopenia have been reported, it is recommended to conduct regular blood cell counts, and discontinue the product in case of abnormalities.Patients who are sensitive to quinine, patients with glucose-6-phosphate dehydrogenase deficiency, patients who take hydroxychloroquine to exacerbate delayed porphyria, and patients with psoriasis should also use this product with caution as it seems to increase the risk of adverse skin reactions.Patients with rare genetic diseases such as galactose intolerance, Lapp lactase deficiency or glucose galactose malabsorption should not take this product.
Children are particularly sensitive to the toxic effects of 4-aminoquinoline;Therefore, the patient is warned to keep the product out of the reach of children.All patients undergoing long-term treatment should have their skeletal muscle function and tendon reflex checked regularly.If skeletal muscle function and tendon reflex decrease, the drug should be stopped.
There were reports of impaired vision adjustment shortly after starting treatment.Relevant personnel driving and operating the machine shall be reminded.If the symptoms cannot be self limited, the dosage shall be reduced or the treatment shall be stopped.Malaria: Hydroxychloroquine is not effective in the treatment of falciparum malaria resistant to chloroquine, nor is it effective in the treatment of plasmodium vivax, plasmodium ovale and plasmodium vivax outside the red blood cells. Therefore, neither infection nor relapse can be prevented.
(Note: The above contents are only for introduction. Drug use must be carried out by a regular hospital under the guidance of a doctor.)
clinical application
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Tablets are given orally.The first dose for adults (including the elderly) is 400mg per day, taken in batches.When the curative effect is no longer further improved, the dose can be reduced to 200mg for maintenance.If the therapeutic response is weakened, the maintenance dose should be increased to 400mg per day.The minimum effective dose should be used and should not exceed 6.5mg/kg/day (calculated from the ideal body weight rather than the actual body weight) or 400mg/day, or even less.Children should use the minimum effective dose, which should not exceed 6.5 mg/kg/day (calculated according to the ideal weight) or 400 mg/day, or even less.It is forbidden for children under 6 years old, and 200mg tablet is not suitable for children whose weight is less than 35kg.Take food or drink milk at the same time every time you take medicine.
Hydroxychloroquine has a cumulative effect, which takes several weeks to play its beneficial role, and minor adverse reactions may occur relatively early.If the rheumatic disease does not improve after 6 months of treatment, the treatment should be terminated.In the case of light sensitive diseases, treatment should only be given in the maximum exposure to sunlight.
