Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Hydroxychloroquine is classified as an
anti-malarial drug. It is similar to
chloroquine (Aralen) and is useful in
treating several forms of malaria as well as lupus erythematosus and rheumatoid
arthritis. Its mechanism of action is unknown. Malaria parasites invade human
red blood cells. Hydroxychloroquine may prevent malaria parasites from breaking
down (metabolizing) hemoglobin in human red blood cells. Hydroxychloroquine is
effective against the malarial parasites Plasmodium vivax, P. malariae, P.
ovale, and susceptible strains of P. falciparum. Hydroxychloroquine prevents
inflammation caused by lupus erythematosus and rheumatoid arthritis. The FDA
approved hydroxychloroquine in April 1955.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablet: 200 mg.
STORAGE: Hydroxychloroquine should be stored at room temperature up to
30 C (86 F) in a sealed, light resistant container.
PRESCRIBED FOR: Hydroxychloroquine is used for the treatment of
malaria due to Plasmodium vivax, P. malariae, P. ovale, and susceptible strains
of P. falciparum. It is also used for treating rheumatoid arthritis, and chronic
discoid and systemic lupus erythematosus when other therapies have failed. It
may prevent relapse and relieve skin inflammation, hair loss, mouth sores,
fatigue, and joint pain caused by systemic lupus erythematosus.
DOSING: The usual adult dose for treating malaria is 800 mg initially,
followed by 400 mg 6 hours later then 400 mg on days 2 and 3. The dose for
malaria prevention is 400 mg every week starting 1 or 2 weeks before exposure
and for 4 weeks after leaving the high risk area.
The recommended adult dose for
rheumatoid arthritis is 400-600 mg daily for 4-12 weeks followed by 200-400 mg
daily.
Systemic lupus erythematosus is treated with 400 mg once or twice daily
for several weeks then 200-400 mg daily. Hydroxychloroquine should be taken with
food or milk in order to reduce stomach upset.
DRUG INTERACTIONS: Administration of hydroxychloroquine with
penicillamine (Cuprimine,
Depen) may increase penicillamine levels, increasing the risk of
penicillamine side effects. The mechanism is unknown. Combining telbivudine (Tyzeka)
and hydroxychloroquine may increase the risk of unexplained muscle pain,
tenderness, or weakness because both drugs cause such side effects.
PREGNANCY: Hydroxychloroquine should only be used in
pregnant women
for malaria prophylaxis or treatment.
NURSING MOTHERS: Hydroxychloroquine may be secreted in
breast milk and
may cause side effects in the infant.
SIDE EFFECTS: Side effects include irritability, headache, weakness,
hair lightening or loss, stomach upset, nausea, dizziness, muscle pain, rash and
itching. Rarely, hydroxychloroquine can affect the bone marrow leading to
reduced white blood cells (leukopenia) or platelets (thrombocytopenia) and
abnormal red blood cells (anemia). Rare but potentially serious eye toxicity can
occur. This toxicity affects a part of the eye called the retina and can lead to
color blindness and even loss of vision. An ophthalmologist (eye specialist)
often can detect changes in the retina that suggest toxicity before serious
damage occurs. Therefore, regular eye examinations, even when there are no
symptoms, are mandatory. Patients who are genetically deficient in a certain
enzyme, called G6PD, can develop a severe
anemia resulting from the rupture of
red blood cells. This enzyme deficiency is more common in persons of African
descent and can be evaluated by blood testing. Hydroxychloroquine may worsen
psoriasis.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Sjögren's syndrome is an autoimmune disease involving the abnormal production of extra antibodies that attack the glands and connective tissue. Sjögren's syndrome with gland inflammation (resulting dry eyes and mouth, etc.) that is not associated with another connective tissue disease is referred to as primary Sjögren's syndrome. Sjögren's syndrome that is also associated with a connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma, is referred to as secondary Sjögren's syndrome. Though there is no cure for Sjögren's syndrome, the symptoms may be treated by using lubricating eye ointments, drinking plenty of water, humidifying the air, and using glycerin swabs. Medications are also available to treat dry eye and dry mouth.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Malaria is an infectious disease transmitted by the bite of an infected Anopheles mosquito. Symptoms of malaria include chills, pain, fever, and sweating. Though mild cases of malaria can be treated with oral medication, severe cases require intravenous drug treatment and fluids.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Sjögren's syndrome involves inflammation of glands
and other tissues of the body.
About 90% of Sjögren's syndrome patients are female.
Sjögren's syndrome can be complicated by infections
of the eyes, breathing passages, and mouth.
Sjögren's syndrome is typically associated with
antibodies against a variety of body tissues (autoantibodies).
Diagnosis of Sjögren's syndrome can be aided by a
saliva-gland biopsy.
Treatment of patients with Sjögren's syndrome is directed toward the particular areas of the body that are involved and complications, such
as infection.
What is Sjögren's syndrome?
Sjögren's syndrome is an autoimmune disease characterized by dryness of the
mouth and eyes. Autoimmune diseases feature the abnormal pr...
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