Medicine HCQ 200mg Zydus prevention or treatment of acute malaria (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
The medication is indicated in the following cases:
hydroxychloroquine sulfate has anti -malarial and effective effect in the treatment of erythema lupus (system or chronic disk) and rheumatoid or chronic arthritis. The exact mechanism of action of the drug is not known.
malaria:
Like Chloroquine Sulfate, Hydroxychloroquine Sulfate works well on the red blood cells of P. Vivax, P. Malariae and most P. Falciparum strains (except for gametes).
Hydroxychloroquine sulfate does not prevent recurrence in malaria patients with P. Vivax, P. Malariae because it is not effective for the erythrocytes of the parasite as well as not preventing P. Vivax, P. Malariae when using backup. The drug 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 active De-Ethyl metabolites. About 50% of the dosage of the drug is 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 prevention or treatment of acute malaria (10 blisters x 10 tablets)
How to use
oral tablets. Take the tablet with a glass of water.
Dosage
one. Hydroxychloroquine sulfate 200 mg is equivalent to 155 mg of hydroxychloroquine bases.
malaria:
Preventive:
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 5mg (basic form)/kg body weight, but not exceeding adult dose.
If possible, start taking preventive medicine for 2 weeks before going into the area at risk.
However, if there is no conditions, adults may use double doses (attack dose) of 800mg (equivalent to 620 mg of bases), or children taking a dose of 10 mg of bases/kg body weight divided 2 times 6 hours apart. 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 bases). 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 way is more suitable for children and children. Total dose of 25mg/kg body weight in 3 days as follows:
lupus erythematosus:
Initially, the average dose for adults is 400 mg (equivalent to 310 mg of bases) once or twice daily. Can continue to use drugs for several weeks or 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:
The drug is accumulated gradually and it takes a few weeks to show the effect, while the mild side effects may occur relatively early. It may take a few months to achieve the 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 5-10 days), gradually increasing the dose to the optimal response, then unwanted effects often do not reappear.
Maintenance dose:
When the patient has a good response (usually in 4-12 weeks), 50% of the dose reduction and maintenance at a dose of 200 mg to 400 mg (equivalent to 155 mg to 310 mg of bases) per day, taking medication during meals or taking the same cup of milk. 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?
overdose
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 traceability, 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.
Treatment:
Symptomatic treatment, urgently need to cause vomiting or gastric lavage before taking the patient to the hospital. Use activated carbon after gastric lavage, within 30 minutes from the overdose of the drug, the drug can be prevented 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 has used. If convulsions appear, convulsions are required before gastric wash. If convulsions due to brain stimulation, Barbiturat can be used quickly, but if due to lack of oxygen, it is necessary to provide oxygen or artificial respiration.
In the case of a patient with hypotension, use blood pressure medications. Due to the importance of the airway support, sometimes it is necessary to apply the trachea opening measure, the trachea tube, then continue to apply the 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 (8g a day for adults, divided many times), used for a few days to acidify urine, support diuretic process.
In case of emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.
Side Effects
When using HCQ drug you may experience unwanted effects (ADR):
malaria:
When the dose is large enough to treat acute malaria, a mild and transient headache may occur, dizziness, digestive disorders (diarrhea, anorexia, nausea, abdominal muscles, and sometimes vomiting). Rarely occur cardiomyopathy when taking high doses of hydroxychloroquine daily.
lupus erythematosa and rheumatoid arthritis:
Not all the unwanted effects after all occur with all 4-aminoquinoline compounds 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, nerve deafness, convulsions, loss of air conditioning.
Neuromiasis: Bone muscle or musculoskeletal or musculoskeletal disease leads to muscle weakness and muscle atrophy that changes the sensation, inhibits the tendon reflexes and normal neurotransmitter.
Eye reaction:
- Mi: Adjustable disorders with blurred vision symptoms. This effect depends on the dose and often lost when stopping the drug. 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. Other changes in the bottom of the eye include weakness and atrophy of the optic nerves, thinning the artery in the retina, the pigmentation disorders in the retina. Morning, blurred vision, 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 stopping the treatment of malaria. No cases have occurred these side effects when using 4-aminoquinoline compounds lasting 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 drug, in some patients, early retinopathy (golden pigmentation sometimes accompanied by abnormal 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 regular eye exams; Eye market abnormalities also occur 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 mucosa, sensitive to light, skin rash (itching, measles, lick, lumpy, hemorrhage, centrifugal red rash, Stevens-Johnson syndrome, acute pustules and flaking skin inflammation).
Hematology: Different hematopoietic disorders such as proliferated anemia, granulocytosis, leukopenia, anemia, thrombocytopenia (hemolysis in patients with glucose-6-phosphate dehydrogenase (G-6-PD).
Digestive: Anorexia, nausea, vomiting, diarrhea, abdominal spasms. Some cases of special abnormalities of liver function and sudden liver failure.
Allergic reactions: itching, angioedema and bronchospasm have been reported.
Other unwanted effects: weight loss, fatigue, severe disorders of porphyrin metabolism and psoriasis are not sensitive to light.
Rarely occurs heart muscle disease when taking high doses of hydroxychloroquine daily.
Instructions on how to handle ADR:
Notify the physician with unwanted effects when using the drug.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
contraindicated
anti -contraindications in the following cases:
Be cautious when using
need to be very careful when taking the drug for patients in the following cases:
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 retinal lesions have been reported in some patients using high-dose 4-aminoquinoline 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 slot, eye -examination 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 retina) or any vision impaired symptoms (lightning or light streaks) not due to external causes or cornea, it is necessary to stop taking the drug immediately and the patient must continue monitoring the progression 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 and ankle reflection tests 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.
Caution:
Be cautious when taking anti -malarial drugs for patients with liver or alcoholism or use simultaneously with other drugs toxic to the liver.
Periodically check the blood formula in patients with prolonged drugs. If there is severe blood disorders not due to treatment, it is necessary to consider stopping the drug. Be careful when taking this medication for patients with G-6-PD deficiency (Glucose-6-phosphate dehydrogenase).
lupus erythematosa and rheumatoid arthritis:
Skin reactions with hydroxychloroquine sulfate may occur, so it is necessary to be cautious when taking this medication for patients at risk of drug dermatitis.
The recommended methods for early diagnosis "chloroquine" include (1) check the bottom of the eye to detect pigment disorders or lose retinal holes and (2) Check the center of the center in a small red object for testing around the center or near the center or determining the threshold of the retina with red. Any abnormal signs of vision must be considered and calculated that the possibility of retinal damage.
If severe poisoning occurs due to overdose or sensitivity, ammonium chloride (8 g per day for adults, divide many times), take 3 or 4 days per week for several months after stopping the drug due to urine acidification helps to increase the elimination of 4-aminoquinoline compound from 20-90%.
However, it is necessary to be careful for patients with renal impairment and/ or metabolic acidic infection.
The effect of the drug on the ability to drive and operate machinery
unknown effects of the drug.
Use drugs for women during pregnancy and lactation
Do not use this medication for pregnant women unless they have considered 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.
A small amount of medicine 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
Leave a cool place, avoid light, temperatures below 30⁰C.
To be out of reach of children, read the instructions carefully before use.
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