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How Does Hydroxychloroquine Help Rheumatoid Arthritis

What Are The Side Effects Of Plaquenil

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With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.

Contact your doctor immediately if you experience any of the following:

  • Irregular heartbeat
  • Changes in vision

The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.

Exploring New Uses For Hydroxychloroquine

In addition to halting the progression of autoimmune diseases, BRI is also testing hydroxychloroquine and other therapies to see if they can prevent these diseases from emerging in the first place. This includes a new study of type 1 diabetes , conducted through BRIs Diabetes Clinical Research Program and Type 1 Diabetes TrialNet.

T1D occurs when autoantibodies attack cells in the pancreas and, as a result, stop the body from properly regulating blood sugar. This happens over time: First, the body makes the autoantibodies . Later on it can take weeks, months or years they attack the pancreas and the patient has to take insulin injections to regulate their blood sugar.

With our T1D trial, were testing whether hydroxychloroquine can stop this disease at stage 1 when the risk is high, but before its causing harm, Dr. Buckner says.

People in the study will take hydroxychloroquine and see doctors for check-ups every few months to see whether their disease progresses. Similar studies are now also underway for RA and lupus.

This is the first time anyone has tested whether hydroxychloroquine can prevent T1D, and the RA trial is the first prevention study for that disease ever in the U.S., Dr. Buckner says. Im very excited to see what happens. Although hydroxychloroquine may not help fight COVID-19, it could very well lead to a breakthrough in the fight against autoimmune disease.

How To Manage Flares

Flares are periods when your symptoms and joint inflammation get worse. They can happen even when youâre doing everything you can to control your RA.

To manage a flare, try:

  • A few days of rest
  • Cool packs on painful joints
  • Gentle exercise, such as stretches and walks
  • Hot showers or baths

If your flares last longer than a few days, call your doctor. If they happen often, it might be time to try a different medication.

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What Rheumatology Patients On Hydroxychloroquine Should Do Now

Dr. Blazer says patients should be in contact with their physician over the phone or using a telehealth system to come up with a plan to source their medication.

Very importantly, do not ration your current supply, she says emphatically. This is not the kind of drug you can ration you need a steady-state dose in order for it to be effective. Dont take matters into your own hands.

The Global Healthy Living Foundation will be working with other advocacy groups and stakeholders to make sure these medications are available for rheumatology patients who need them. To ensure that people with lupus, RA, and other chronic conditions continue to have access to hydroxychloroquine, .

You can also report any drug shortages you are experiencing to the Food and Drug Administration.

What Else Should I Know

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Rarely, Hydroxychloroquine can cause vision problems. Your doctor may want you to have an eye exam before beginning this medication. You will then have an eye exam yearly with an ophthalmologist to check for any changes in the back of the eye. Notify your doctor if you experience any blurred vision or see black spots.

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Important Things To Remember

  • While taking hydroxychloroquine you should see your rheumatologist regularly to make sure the treatment is working and to minimise any possible side effects.
  • If you are concerned about any side effects you should contact your rheumatologist as soon as possible.
  • While taking hydroxychloroquine you should have your eyes tested regularly to identify any possible side effects.

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How Is Hydroxychloroquine Taken

Hydroxychloroquine is taken by mouth in tablet form. The usual dose is one tablet once or twice a day. Tablets can be taken altogether, once a day.

The dose may be reduced to a maintenance dose after a few months once a response is achieved. Occasionally it may be taken every second day.

It is best taken with food as it has a slightly bitter taste.

Hydroxychloroquine is not a pain killer and it should be taken continuously to be effective. Other medicines may be required to treat the pain.

Hydroxychloroquine may be used with other arthritis medicines including:

  • other DMARDs such as methotrexate
  • steroid medicines such as prednisolone or cortisone injections into the joint
  • anti-inflammatory medicines such as naproxen and ibuprofen
  • simple pain medicines such as paracetamol.

There are separate information sheets for the medicines mentioned above.

How long is treatment continued?

Treatment with hydroxychloroquine may be continued indefinitely as long as it is effective and no serious side effects occur.

If you stop hydroxychloroquine treatment for more than a few weeks there is a risk that your condition may worsen. Continue with your treatment unless advised by your doctor or unless side effects develop.

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Methotrexate Initially Not A Drug For Ra

Although methotrexate has been proven as a great treatment option for RA, that isnt why this drug was created. In fact, methotrexate was initially introduced in the 1940s as a cancer treatment drug. Doctors prescribed it to provide relief for patients with different types of cancers, such as non-hodgkin lymphoma and breast cancer.

Methotrexate works by interfering with cancer cells ability to absorb and use folate. Folate is a form of vitamin B thats necessary for cell survival, but methotrexate has the effect of partially inhibiting dihydrofolate reductase within the cancerous cells.

Then in the 1970s, the Food and Drug Administration approved methotrexate for psoriasis according to the National Psoriasis Foundation. Psoriasis afflicts roughly 7.5 million people and involves itchy, inflamed skin. Fortunately for its sufferers, numerous studies have backed using methotrexate as a suitable psoriasis treatment option. For example, one 26-year retrospective study found that low-dose MTX is an effective therapy for severe forms of psoriasis.

Not only is methotrexate beneficial for people with psoriasis, its also helpful for those diagnosed with psoriatic arthritis. This type of arthritis is different than RA in that psoriasis generally precedes issues in the joints. In some cases though, no psoriasis-type symptoms exist at all.

How Does It Work

Hydroxychloroquine And What It Does To Your Body
  • Hydroxychloroquine is available as a 200mg and 300mg tablet
  • The action of hydroxychloroquine is not fully understood and it is a cumulative effect over several weeks before any benefit is seen
  • Blood tests for hydroxychloroquine are checked before treatment starts and then as frequently as the specialist advises, usually at clinic visits. When it is prescribed alongside other DMARDs the frequency of blood tests may be more regular, depending on the recommendations for the other DMARD

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How Fast Does This Medication Work indicates that you can expect to see some results after a month or two of taking hydroxychloroquine, but in order to get the full benefits you will need to take the medication for at least six months. That can help you realize how much benefit youre going to actually get from the drug. Some people see a nearly complete remission of symptoms. Other people see only a slight improvement thats virtually nothing at all. For most people, there will be a difference in their symptoms that will be somewhere in the middle of these two extremes. Taking the medication for the full six months can help you make a decision about continuing it.

Methotrexates Possible Side Effects

So what are methotrexates possible side effects? The most common negative effects associated with this particular medication are gastrointestinal symptoms like nausea, vomiting, and ulcers . Some doctors have also reported that patients have developed mouth sores, fatigue, headache, dizziness, or shortness of breath. It may cause hair loss as well.

Though the risk is small, methotrexate therapy can also cause liver damage, so patients who take the medication on a regular basis as a form of RA treatment need to have routine blood tests taken by their doctor to make sure their liver remains healthy. To reduce any further risk of liver damage, patients taking methotrexate should also avoid drinking alcohol. If damage is suspected, your doctor may request a liver biopsy.

In a few rare cases, methotrexate has been known to cause lung inflammation or a decrease in white blood cells or platelets, a condition which can lead to bone marrow suppression. According to University of Pittsburg Medical Center , bone marrow suppression occurs when the marrow doesnt make the normal amount of blood cells.

Ultimately, this can instigate other medical conditions such as anemia, leukopenia, neutropenia, or thrombocytopenia says the UPMC. By limiting the likelihood of bone marrow suppression then, youre also reducing your risks of these other conditions. Fortunately, routine blood testing by your doctor can identify these potential issues so they can be stopped before they progress.

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When To Contact A Doctor

Plaquenil has few drug interactions. Nevertheless, people should tell a doctor about all the medications and supplements they are taking.

People should also notify an eye doctor if they are taking Plaquenil so that they can perform regular visual screening tests. In one study, five participants experienced retinopathy, which is a condition that damages the blood vessels at the back of the eye. By undergoing regular tests, people can lower their risk of eye problems.

Plaquenil is likely safe to take during pregnancy and while breastfeeding. That said, anyone who is pregnant, considering becoming pregnant, or lactating should check with a doctor before taking this medication.

People taking Plaquenil should also talk with a doctor if they experience any side effects, if their condition worsens, or if they do not notice any improvement in their condition after taking Plaquenil for several weeks.

What Benefit Can You Expect From Your Treatment

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About 60% of people treated with hydroxychloroquine experience improvement in their condition.

Hydroxychloroquine does not work straight away. It may take 8 to 12 weeks for symptoms to start to improve. The full effect of treatment may take up to 26 weeks.

Other medicines may be given to improve your symptoms while waiting for hydroxychloroquine to work.

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What Is Hydroxychloroquine And What Does It Do

According to the American College of Rheumatology, hydroxychloroquine , is a disease-modifying anti-rheumatic drug , meaning that it helps reduce the pain and swelling that come with arthritis. It can also reduce the incidence of joint damage, thus lessening the risk of developing a long-term disability from complications of RA. If you have rheumatoid arthritis, talking to your doctor about hydroxychloroquine may be the right choice for your needs. The medication is generally well-tolerated, and has even been found safe overall for women who are pregnant or breastfeeding.

Rheumatoid Drug No Help To Arthritis Patients

HealthDay Reporter

WEDNESDAY, Feb. 21, 2018 — A malaria drug that’s also shown effectiveness against rheumatoid arthritispain has failed to help people with the more common form of arthritis, new research shows.

The drug is called Plaquenil , explained one expert who wasn’t connected to the new study.

“Plaquenil was first used to treat malaria but was later found to also have beneficial effects in patients with inflammatory arthritis such as rheumatoid and lupus,” said Dr. Steven Beldner. He directs the New York Hand and Wrist Center at Lenox Hill Hospital in New York City.

“It is believed that it modulates some of the immune cells to reduce the body’s attack on joints,” Beldner added.

“There have been debates among physicians about whether was effective for the treatment of osteoarthritis, which is not an autoimmune condition,” he noted.

Osteoarthritis is the most common form of arthritic joint pain.

According to the researchers behind the new study, hand osteoarthritis affects up to 31 percent of people over 70 and up to 15 percent of those older than 60. The pain can be debilitating and there are few effective treatments.

Plaquenil has been used as an “off-label” treatment — meaning it’s approved for uses other than to treat osteoarthritic hand pain — but there’s been little evidence about its effectiveness.

This British study included 248 patients with hand osteoarthritis. They took either Plaquenil or a placebo for a year while receiving usual care.

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Frequently Asked Questions About Plaquenil

Can Plaquenil cure coronavirus ?

There is not enough medical data at this time to prove that hydroxychloroquine is effective in treating COVID-19. While some small studies suggest it may be helpful, other studies saw no difference.

Is there a shortage of Plaquenil ?

Plaquenil was added to the FDA shortage list on March 31, 2020. There has recently been an increase in demand as hospitals are testing it in patients with COVID-19.

How do I get Plaquenil ?

Plaquenil requires a prescription from your doctor. Many states have recently begun restricting pharmacists from dispensing it unless it is specifically being prescribed for an FDA-approved use.

What is the difference between hydroxychloroquine and chloroquine?

Hydroxychloroquine and chloroquine are similar in structure and were both first approved for malaria. Chloroquine tends to cause many more side effects than hydroxychloroquine. Because of that, hydroxychloroquine is more commonly used today. Hydroxychloroquine is also approved for rheumatoid arthritis and lupus, while chloroquine is not.

Can Plaquenil be used to treat sarcoidosis?

Yes, there are off-label uses of Plaquenil that include other autoimmune conditions such as skin and joint sarcoidosis, cutaneous dermatomyositis, porphyria cutanea tarda, primary Sjögren’s syndrome, and Q fever .

Is Hydroxychloroquine Safe For Autoimmune Diseases

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COVID-19 has put a therapy called hydroxychloroquine in the spotlight and, at the same time, shrouded it in confusion. Despite early hope from government officials and scientists that it would help fight the pandemic, the most recent reports suggest hydroxychloroquine is not necessarily effective in treating the new coronavirus and may have harmful consequences for some people.

But what does this mean for people who take hydroxychloroquine for other conditions including autoimmune diseases like lupus and rheumatoid arthritis ?

The short answer is: Hydroxychloroquine is both safe and effective for treating many autoimmune diseases, and people who have been prescribed the drug should feel very comfortable continuing with it, says Jane Buckner, MD, rheumatologist and president of Benaroya Research Institute at Virginia Mason . It has a long history of helping patients and were also exploring new ways to use it.

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What Are The Possible Side Effects Of Hydroxychloroquine

Common side effects associated with hydroxychloroquine include5:

  • headache
  • Have or have ever had liver disease, psoriasis, skin inflammation, or blood problems
  • Drink large amounts of alcohol5

Serious, irreversible eye damage has occurred, though rarely, for patients taking hydroxychloroquine. Risk factors include long-term high-dose use of the medication, pre-existing severe kidney disease, age over 60. If you are taking hydroxychloroquine over a long duration, it is important to take eye exams every 6 to 12 months.6 Do not take hydroxychloroquine if you experience vision symptoms, including problems seeing or reading, light sensitivity, blurred distance vision, or light flashes or streaks.5

Certain drugs do not mix well with hydroxychloroquine, so you should tell your doctor about any other medications or supplements you are taking, including vitamins and supplements.

Drugs that do not mix well include digoxin , iron-containing medications , isoniazid , methotrexate , niacin, and rifampin .v This is not a complete list of drugs that interact with hydroxychloroquine.

Hydroxychloroquine With Other Medicines

There are some significant potential drug interactions between hydroxychloroquine and some other medications and these risks can be minor or major. It is therefore particularly important that a full and complete medical history is given to the prescribing doctor.

Remember to take care when using any other medications or complementary therapies . Remember to check with a doctor, nurse or pharmacist that they are safe to take with hydroxychloroquine and any other medication taken.

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Are There Any Reasons I Won’t Be Prescribed Hydroxychloroquine

Before starting on hydroxychloroquine your doctor may take a blood test to check that your liver and kidneys are working normally, but you won’t need any regular blood tests during the treatment.

Your doctor will ask you about any problems with your eyesight and may suggest you have a vision test. Hydroxychloroquine won’t usually be prescribed if you have maculopathy, problems with the central part of the retina in the eye.

Pharmacist Tips For Plaquenil

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It can take Plaquenil several weeks to start working. Follow your doctor’s advice for how long you should take it even if you don’t feel any different.

Taking Plaquenil with food or milk can help reduce nausea. Do not break or crush the pills.

Plaquenil can make you more sensitive to sunlight. Wear sunglasses and use sunscreen if you’re outside. Wearing a long-sleeved shirt, long pants, and a hat can also help.

Plaquenil is broken down by your liver. Drinking alcohol in excess can increase your chances of liver problems.

Prices for Plaquenil start at just $13.41 with a GoodRx coupon. Theyre fast, easy-to-use and free!

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Are There Any Side Effects

You might experience side effects with your treatment. Tell your doctor if you are concerned about possible side effects. A reduction in dose may minimise side effects so that you can continue to take this treatment. Your doctor will advise on any dose changes that are necessary.

Most common possible side effects

  • About 10% of patients experience stomach and bowel side effects such as nausea , loss of appetite or diarrhoea. As the tablets are slightly bitter, these problems can often be reduced by taking the tablets with food or milk, or they may just improve with time.

Less common or rare possible side effects

  • Less common side effects include skin rashes and increased sensitivity to the sun. It is a good idea to wear sunscreen and a hat when in the sun. The medication may rarely worsen psoriasis rash.
  • Hydroxychloroquine may rarely cause increased skin pigmentation.
  • Very rarely hydroxychloroquine may cause temporary blurring of vision due to deposits in the front of the eye . This is fully reversible when the medicine is stopped. You should report to your doctor any visual disturbances, .
  • More serious eye problems involving the retina are extremely rare. These occur mainly in people taking a high dose for longer than 5 years, or in those who have liver or kidney problems. Your doctor will advise you about what eye testing is required.
  • Very rare effects include thinning of the hair, ringing in the ears, bleaching of the skinand/or hair, and weakness of the leg muscles.

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