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» LymeNet Flash » Questions and Discussion » Medical Questions » plaquenil questions

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Author Topic: plaquenil questions
cactus
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Hi all,

I will be adding Plaquenil to my regimen in a few days (Mepron, zith, omnicef, and soon to add artemisinin as well).

Has anyone else used Plaquenil in combination with Mepron for babs?

Or if you have any other experiences with Plaquenil I would be very interested in hearing your comments and reactions.

Feeling a bit anxious about being on both Mepron and Plaquenil, since both have potential effects on the liver.

'Course the anxiety might just be part of the Mepron effect...

Thanks in advance for any input,
Cactus

--------------------
Did you ever stop to think, and forget to start again? - A.A. Milne

Posts: 1987 | From No. VA | Registered: May 2005  |  IP: Logged | Report this post to a Moderator
gailsy
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I had plaquenil added to my regimen and did not like it at all. Tried it twice and stopped. Before you start you should have a field vision test (I did) because the plaquinil can affect your vision is and it can be permanent.

First time I used it I used the generic version and after four days was covered in a rash from head to toe. Had to get cortisone shots and increase my prednisone pills. Next time I took the real thing (not generic) and it was better but had too many stomach upsets.

Best of luck to you!.

Gailsy

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Beverly
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Hi cactus,

I used Plaquenil, Malarone and Zithromax for Babesia. It worked well for me and it also helped to keep inflamation down. That combo was the thing that finally took my spine pain away.
I didn't have any probelms with it, other than going to the eye doctor every six months.

I hope you have good luck with it alslo.

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Beverly
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Didn't see gailsy post....yeah it can cause stomach upset, it did for me as well.
Posts: 6626 | From Michigan | Registered: Jun 2001  |  IP: Logged | Report this post to a Moderator
cactus
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Thanks gailsy and Beverly.

I've heard it can cause vision problems and stomach upset - not sure what else, but others have mentioned they could not tolerate it and I've been wondering what the side effects might have been.

Beverly - what great news to hear that it worked so well for you! No more spine pain, what a relief that would be...

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Did you ever stop to think, and forget to start again? - A.A. Milne

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Beverly
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Hi again Cactus, [Wink]

Yes, it was such a relief to have it finally go away, it was so awful.

Keep us posted..


Here is some information previously posted by LymeBrat about Plaquenil, I hope it helps.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Posted by LymeBrat
"I have been on Plaquenil since April 1, 2002. I had just had an eye exam 2 months prior, so my LLMD and eye doc didn't feel another eye exam was necessary.

I do however have to go to the eye doc every 3 months for an eye exam. I have had 3 eye exams to date. My last one was just a few weeks ago, everything looks great.

I don't have to go back for another exam until June.

I also wanted to add that my Eye doc (consulted with my LLMD) has me taking Vitamin A & E. I also take Lutein. The eye doc said that they will help protect the eye from the Plaq.

Here is some information I found when I researched Plaq before I started to take it.

http://www.midwestarthritis.com/html/plaquenil.htm

The Plaquenil side-effect of greatest concern involves the eyes. The likelihood of developing Plaquenil eye problems depends upon the dose and duration of treatment. Eye problems are more common when very large doses are ingested and usually take months or years to occur. Eye side-effects from Plaquenil also may be more common in people over the age of 60.


Eye problems related to antimalarial drugs were more common years ago than what is experienced today. There are at least 3 reasons for this. First, Plaquenil seems safer than past antimalarial drugs. Second, larger doses of the antimalarial drugs were prescribed in the past than are currently recommended.

Third, there is a greater awareness of the potential for antimalarial eye problems. Thus, patients have thorough eye examinations more frequently now than was once the practice. With the currently recommended doses of Plaquenil, the risk of eye side-effects is about 3%.


In the past, it was believed that the eye side-effects of antimalarial drugs were irreversible and even progressive after the drug was discontinued. However, with the proper precautions, irreversible or progressive eye changes due to Plaquenil are extremely rare.


Symptoms of Plaquenil eye side-effects include: blurred vision, sensitivity of the eyes to sun light, decreased night or color vision, decreased ability to see objects at the edge of vision, black spots in the vision or light flashes or streaks.

If any of these visual changes occur, the Plaquenil should be immediately stopped and an eye specialist (ophthalmologist) consulted. Since early Plaquenil eye problems can occur without symptoms, regular examinations by an ophthalmologist are essential--even if vision is normal.

It is common to recommend eye examinations every 6 months. If the ophthalmologist detects possible eye toxicity, the Plaquenil should be immediately discontinued

http://www.medhelp.org/perl6/eyecare/archive/54.html

The management of patients on plaquenil has been a controversial subject. Alot of the concerns are related to the problems caused by chloroquine, the predecesor to hydroxychloroquine (Plaquenil).

It was much more toxic to the retina and much more likely to cause permanent visual problems. Hydroxychloroquine, on the other hand, is much less toxic to the retina and there have been fewer reported eye problems. In general, a baseline ophthalmic examination should be performed upon initiation of therapy. In addition, a central visual field test and color photographs of the retina are usually taken at that time.

There are differing opinions regarding subsequent follow-up exams. The most conservative opinion would include exams every 6 months with repeat visual fields every 6 to 12 months.

My general feeling is to perform annual exams with visual field testing. One study determined that the risk of retina toxicity when patients are taking less than 6.5 mg per kilograms per day is rare.

This means that a person weighing 150 lbs is likely to be safe if they are taking 200 mg twice daily. I calculate this number regularly and if the person is on more than 6.5 mg per kg per day than I will follow them more closely.

I have been on the Plaquenil for 10 months, and haven't had any side effects, other than an initial herx.


Hope this help some!!! "

~LymeBrat

Hydroxychloroquine (Plaquenil) http://www.midwestarthritis.com/html/plaquenil.htm


MEDLINEplus Drug Information Hydroxychloroquine (Plaquenil} http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202288.html

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docjen
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I took plaq with Alinia and Zith for about 4 months, and had to stop. It didn't cause any problems with vision, but the stomach issues and symptoms of neurotoxicity were too much for me to take. I know some people contribute their recovery to plaq, so it can work for some.
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sometimesdilly
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plaquenil has been the only med i've taken so far that i would refuse to take again.

in its favor- my llmd thinks significant problems with it are rare, and considers it a very important option in the toolbox.

the we are different thing-- i started having serious problems with my vision within a week of taking it (was also on zith and malarone). incressinglly blurry vision, could no longer see well enough to drive at night, loss of peripherial vision.

i stopped taking it about 1 1/2 weeks out. my vision was back to normal within a few days.

most people DON'T have that kind of experience with Plaq, especially not that quickly. trust your own body and experiences.

dilly

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sixgoofykids
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I take Plaquenil and have no problems with it at all. I also take Mepron, Biaxin, Minocycline, and Artemisia.

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sixgoofykids.blogspot.com

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Aniek
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I've been taking plaquenil for over 2 years. It reduces my inflammation and stiffness in my back and hands. I tried to cut down from 200 mg twice a day to once a day, and quickly noticed an increase in stiffness.

If you are going to be on it more than 6 months, you want to go to an eye doctor to get a field of vision test before or right after starting. Then you get one every 6 months.

This tests your peripheral vision so if the plaquenil does cause damage, it is caught before it has any noticeable impact on your vision.

If you have health insurance, it may pay for this because it is due to a medicine. Call your insurance and find out, and get a referral from a doctor if you need. The insurance might require you to go to a M.D. to get the test.

--------------------
"When there is pain, there are no words." - Toni Morrison

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cactus
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Thanks so much, all of you, this is excellent info. I will be sure to follow up on the initial eye exam.

Have any of you heard of anyone experiencing an allergic reaction to plaq?

This may be wrong, but I have one Lymie friend who seems to remember plaq is related to macrobid, and can cause a reaction in people who are allergic to macrobid or sulfa drugs?

Macrobid reactions have prompted 911 calls for me, so that's a scary proposition.

I haven't found any info that these 2 drugs are in the same class, though. Anyone else heard of this?

You guys are the best, thanks!

--------------------
Did you ever stop to think, and forget to start again? - A.A. Milne

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pamyla
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I've been on plaquenil for over a year now, and am currently taking mepron as well. I had a hard time initially adjusting to the plaquenil, but I do tend to be pretty drug sensitive. But now that I'm on it, it works great. A few months ago I tried to reduce the dosage and my neck pain came back with a vengence, so it's apparently helping me quite a bit with keeping the babs in check [Wink]

Also wanted to mention that I have an allergy to eggs and am supposed to be avoiding sulfa drugs, but was not taken off plaquenil.

Hope it works out for you!
Pam

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Aniek
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I forgot to mention, my LLMD makes sure I always get brand name of Plaquenil. I think that's actually because the brand works better on arthritis symptoms than the generic. But I'm not sure.

--------------------
"When there is pain, there are no words." - Toni Morrison

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gailsy
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As I mentioned in my earlier response I did have an allergic reaction to the plaquinil. I broke out in hives over my entire body (except for my face). It took one week on prednisone to finally clear up.

But I was on the generic version when that happened and my LLMD mentioned that another patient of hers also had a similar reaction when on the generic.

I then did the real thing and only had stomach problems but stopped after a couple of weeks because I didn't like how I was feeling. So for sure try to get the real Plaqunil and not the generic for starters.

Feel better.

Posts: 31 | From Bloomfield, New Jersey | Registered: Nov 2006  |  IP: Logged | Report this post to a Moderator
   

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