Medicine HCQ 200mg Zydus Cadila treats acute malaria, lupus erythematosus (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Hydroxychloroquine sulfate

Ingredient

Composition information	Content
Hydroxychloroquine sulfate	200mg

Uses

indications

Medicine of HCQ 200mg is indicated in the following cases:

Hydroxychloroquine Sulfate is used to prevent or treat acute malaria due to Plasmodium vivax, P. Malariae, P. Ovale and P. Falciparum sensitive to drugs. Learning

The exact mechanism of action of HCQ 200mg is not known.

malaria

Like Chloroquine Sulfate, Hydroxychloroquine Sulfate has a good effect on the red blood cells of P. Vivax, P. Malariae and most P. Falciparum strains (except for gametes). Hydroxychloroquine Sulfate does not prevent relapse in patients with malaria caused by P. Vivax, P. Malariae because it is not effective for the erythrocytes of the parasites as well as the prevention of P. Vivax, P. Malariae when using backup.

HCQ 200mg is effective as a prophylactic drug for patients at the end of the acute malaria period caused by P. Vivax, P. Malariae and has a significant effect on the period of recurrence. For patients with malaria due to P. Falciparum, the drug has the effect of treating acute malaria, prevention and recurrence except for some P. Falciparum strains.

Dynamic pharmacology

hydroxychloroquine is quickly absorbed from the digestive tract. The time to reach the peak concentration in serum is 1-3 hours. Hydroxychloroquine is concentrated in the liver, spleen, kidney, heart, lungs and brain. The drug is partially metabolized through the liver into the De-Ethyl metabolites that are active.

There are about 50% of the dosage of the drug eliminated in the urine in the form of unprocessed substances. The drug is eliminated very slowly through the urine and may last up to monthly or year after stopping the drug. Elimination of the kidneys increases when the urine is acidified and decreases when the urine is alkaline. The sale time of the drug is approximately 32 days.

Before taking Medicine HCQ 200mg Zydus Cadila treats acute malaria, lupus erythematosus (10 blisters x 10 tablets)

How to use

HCQ 200mg Take oral use.

Dosage

A hydroxychloroquine sulfate 200 mg tablet is equivalent to 155 mg of hydroxychloroquine bases.

malaria

Prevention

Adults use 400 mg (equivalent to 310 mg of bases), used on a fixed day every week.

For children and young children, the weekly dose is 5 mg (basic form)/kg body weight, but not exceeding the adult dose.

If possible, start taking medicine for 2 weeks before going into the area at risk. However, if there is no conditions, adults can use double doses (attack dose) of 800 mg (equivalent to 620 mg of bases), or children taking a dose of 10 mg of bases/kg body weight divided 2 times apart 6 hours. Should continue to take preventive drugs for 8 weeks after leaving the area at risk.

Treatment of acute malaria

Adults: The initial dose of 800 mg (equivalent to 620 mg of bases), followed by 400 mg (equivalent to 310 mg of bases) for 6-8 hours and 400 mg (equivalent to 310 mg of bases) per day for the next 2 days (a total of 2 g of hydroxychloroquine sulfate or 1.55 g of base). A single dose of 800 mg can also be used (equivalent to 620 mg of bases).

Dosage for adults can also be calculated based on body weight, this calculation is more suitable for children and children. Total dose of 25 mg/kg body weight in 3 days as follows:

Initial dose: 10 mg of bases/kg body weight (but not exceeding the single dose of 620 mg of bases).

The second dose: 5 mg of bases/kg body weight (but not exceeding the single dose of 310 mg of bases), taking after the first dose 6 hours.

3rd dose: 5 mg of bases/kg body weight, taken after the second dose 18 hours.

4th dose: 5 mg of bases/kg body weight, taken after the third dose 24 hours.

To thoroughly treat malaria due to P Vivax and P. Malariae, it is necessary to use in combination with compound 8- Aminoquinoline.

lupus erythematosa

Initially, the average dose for adults is 400mg (equivalent to 310 mg of bases) or twice a day. Can continue to use the medicine HCQ 200mg for a few weeks or a few months depending on the response of the patient. In long -term maintenance treatment, smaller doses, from 200 mg to 400 mg (equivalent to 155 mg to 310 mg of bases) per day often effective.

The frequency of retinal disease increases when the dose is higher than this maintenance.

rheumatoid arthritis

HTQ 200mg drugs are gradually accumulated and it takes a few weeks to show the effects, while lightweight side effects may occur relatively early. It may take a few months to achieve maximum treatment effect. If treatment goals (such as reducing joint swelling, increasing motor ability) is not achieved after 6 months of treatment, it is necessary to stop taking the drug. Safety when using this drug to treat rheumatoid arthritis in adolescents has not been determined.

attack dose

Adults: Use a dose of 400 mg to 600 mg (equivalent to 310 mg to 465 mg of bases) per day, taking the drug in meals or taking the same milk cup. In a small percentage of patients, some unwanted effects may appear, then the initial attack dose must be reduced. Then (usually from 5 to 10 days), gradually increasing the dose to the optimal response, then the unwanted effects often do not reappear.

Maintenance dose

When the patient has a good response (usually in 4-12 weeks), 50% reduction and maintenance at a dose of 200 mg to 400 mg (equivalent to 155 mg to 310 mg of bases) per day, taking the drug in meals or taking the same milk cup. The frequency of retinal disease increases when the dose is higher than this maintenance dose.

If the disease recurs after stopping the drug, may continue to take the drug with interrupt treatment if there is no contraindication to the eye.

Can take this drug in combination with corticosteroids and salicylate, and generally can gradually reduce the dose or stop using these drugs after a few weeks of taking the drug. When the indications gradually reduce the dose of steroids, reduce 5 mg to 15 mg of cortisone; 5 mg to 10 mg hydrocortisone; 1 mg to 2.5 mg Prednisolone and Prednisone; 1 mg to 2 mg methylprednisolone and triamcinolone; and 0.25 mg to 0.5 mg dexamethasone every 4-5 days.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

4-aminoquinoline compounds are absorbed very quickly and completely after use, in case of overdose, or a few cases of lower doses in sensitive patients, poisoning symptoms may occur within 30 minutes. Overdose symptoms include headache, dizziness, visual disorders, cardiovascular collapse, convulsions, then cardiac arrest, sudden apnea. Electrolyte may show atrial -hearted - ventricular pacification, prolonged interior transmission time, slow heart rate that leads to ventricular vibration or cardiac arrest.

Handling

Symptomatic treatment, urgently need to cause vomiting or gastric lavage before taking the patient to the hospital. Use activated carbon after gastric lavage for 30 minutes from the overdose of the drug that can prevent the drug from being absorbed from the digestive tract. To achieve efficiency, the amount of activated carbon at least 5 times the amount of hydroxychloroquine the patient used.

If convulsions appear, convulsions need to be controlled before gastric lavage. If convulsions are stimulated by brain, the barbiturate can be used quickly, but if due to lack of oxygen, it is necessary to provide oxygen or artificial respiration. In the case of patients with hypotension, use of blood pressure.

Due to the importance of the airway support, sometimes it is necessary to apply the trachea open, place the trachea, and then continue to apply gastric lavage if necessary. Hematoma has been applied to reduce blood levels in the blood.

Patients with acute attacks and no symptoms still need closely monitoring at least 6 hours. In case of overdose and sensitivity, transmitting a lot of fluid and using enough ammonium chloride (8 g of adults daily, dividing many times), used for a few days to acidify urine, support diuretic process.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using the 200mg HCQ, you may experience unwanted effects (ADR).

Lupus erythematosa and rheumatoid arthritis

Not all unwanted effects after all occur with all compounds 4-aminoquinoline when taking the drug for a long time, but these side effects have been reported to occur with one or several 4-aminoquinoline compounds and must always remember this when using 4-aminoquinoline compounds. The unwanted effects of each different drug vary by type and frequency.

Central nervous system: stimulating, restlessness, mental change, nightmares, mental disorders, headaches, dizziness, dizziness, tinnitus, eye shock, nervous deafness, convulsions, loss of air conditioning. Usually.

Sticky eyelashes: adjustable disorders with blurred vision symptoms. This effect depends on the dose and often lost when stopping the drug.

cornea: transient edema, opaque, reducing sensitivity. The change of cornea may have or have no symptoms (blurred vision, halo around, fear of light) but can recover. Side effects in the cornea may appear early, within 3 weeks from the beginning of treatment. The frequency of unwanted effects in the cornea of hydroxychloroquine is lower than chloroquine.

retina: yellow point: edema, atrophy, color disorders, loss of retinal hole reflexes, increasing recovery time after lighting (testing with light), increasing threshold with red light, abnormal surrounding and peripheral retina. Other changes in the bottom of the eye include weakness and atrophy of the optic nerves, thinning the artery in the retina, the disorders of the pigmentation in the retina.

affect the eye market: haunting the point or near the center, the center of the center with vision impairment, rarely causing eye market, color blindness.

The most common symptoms due to retinal damage are: difficult to see and difficult to read (words, letters), fear of light, fuzzy view, not seeing the central or peripheral area of the eye market, blinking or light streaks.

Lateal damage is related to the dose and occurs after a few months (rarely) to a few years when taking the daily drug; A few cases are reported after a few years of stopping treatment for malaria. No cases have occurred these side effects when using compound 4 - Aminoquinoline lasted with a weekly dosage mode to prevent malaria.

Patients with retinal damage may have or have no symptoms (whether or not have no market abnormalities). Rarely market abnormalities occur without clear retinal damage.

Retinal damage can occur even after stopping the medication. In some patients, early retinopathy (golden pigmentation sometimes accompanied by abnormalities in the center of the market) reduced or completely lost after stopping the drug. Early retinopathy manifests early decline in retinal function and often recovered when stopping the drug.

Small number of patients with retinal abnormalities that are reported in patients only use hydroxychloroquine. These changes are usually changes in retinal pigments detected through periodic eye exams, an unusual eye market also occurs in some patients. There has been a report on a case of late retinopathy with an vision loss that begins after a year of stopping hydroxychloroquine.

Skin: silver hair, bald, itching, skin pigmentation appears on the skin and mucous membranes, sensitive to light, skin rash (itching, measles, liken, burning, hemorrhage, centrifugal redness, Stevens-Johnson syndrome, acute pustules and flaking dermatitis). Platelet reduction (hemolysis in patients with glucose-6-phosphate dehydrogenase (G-6-PD). Want to another: weight loss, fatigue, severe disorders of porphyrin metabolism and psoriasis are not sensitive to light.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Medicine of HCQ 200mg Contraindicated in the following cases:

Patients with retinal abnormalities or eye market caused by 4-aminoquinoline compound.

Patients with hypersensitivity to 4-aminoquinoline compounds

Prolonged treatment in children.

Caution when using

General warning

Hydroxychloroquine sulfate is ineffective for P. Falciparum strains resistance chloroquine.

Children are particularly sensitive to 4-aminoquinoline compounds. There has been a report on death after accidentally using chloroquine, sometimes at relatively low doses (0.75 g or 1 g for 1 3 -year -old children). Patients should be warned to preserve this drug outside the reach of children.

Use hydroxychloroquine sulfate in patients with psoriasis can cause an exacerbat outbreak of psoriasis. Using this medication for patients with porphyrin metabolic disorders can worsen the disease. Hydroxychloroquine sulfate should not be used in these cases unless it is considered the benefits of treatment and possible risk.

malaria

In recent years, some P. Falciparum has been discovered resistant to 4-aminoquinoline compounds (including hydroxychloroquine) that have been shown by the fact that with the usual dosage, the drug has no prevention or treatment of malaria. Patients infected with resistance parasites should be treated with quinine or other specific drugs.

Lupus erythematosa and rheumatoid arthritis

The doctor must master all the information stated in this user manual before prescribing hydroxychloroquine sulfate for patients.

Unresponsive retinopathy lesions have been reported in some patients using high-dose 4-aminoquinoiine compounds or prolonged in the treatment of disc-red-shaped lupus, systemic erythema lupus and rheumatoid arthritis. Retinal disease is recorded depending on the dose.

When planning to use any anti -malarial drugs for a long time, it is necessary to check the visual function at the beginning of treatment and periodically (every 3 months) including: vision measurement, eye exam with light slots, eye -catching eye and market testing.

If there is any signs of vision abnormalities, the market of the eye or the retinal gold spot (such as changing the color, losing the reflex of the retinal hole) or any vision impairment (lightning or light streaks) is not due to external causes or corneal opaque, it is necessary to stop taking the drug immediately. In addition, patients must continue monitoring the progress of these abnormalities. Retinal abnormalities (and vision disorders) may continue to occur even after the drug stopped.

Patients with long -term treatment with this medication should be regularly examined including knee reflections and ankles to detect the likelihood of muscle weakness. If muscle weakness occurs, need to stop taking the drug.

In the treatment of rheumatoid arthritis, if the treatment goals (such as reducing joint swelling, increasing motor ability) is not achieved after 6 months of treatment, it is necessary to stop taking the drug. Safety when using this drug to treat rheumatoid arthritis in adolescents has not been determined.

The ability to drive and operate machinery

No report on the effect of drugs on driving and operating machinery.

pregnancy

should not be used for pregnant women unless they consider the benefits of prevention or treatment of malaria and the risk may occur. It should be noted that when intravenous injection for pregnant mice, chloroquine is marked quickly through the placenta. The drug is accumulated selected in the melanin structure of the fetal eye and maintained in the eye tissue 5 months after the drug in other parts of the body has been eliminated.

The period of breastfeeding

A small amount of drugs is secreted into breast milk. Do not use this medication for breastfeeding women. Women who need this medication should stop breastfeeding.

Interactive drug

There is no report on the interaction of this drug and other drugs.

Storage

Store at temperatures below 30 ° C.

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