What is Hydroxychloroquine SULFATE

Indications: There are several indications of Hydroxychloroquine Sulphate, which are as follows:

• Malaria
• Lupus Erythematosus
• Rheumatoid Arthritis

Malaria: Hydroxychloroquine indicated for the treatment of uncomplicated malaria due to P. falciparum, P. malariae, P. ovale, and P. vivax.
Also, indicated for the prophylaxis of malaria in geographic areas where chloroquine 
resistance is not reported.

Lupus Erythematosus: Hydroxychloroquine indicated for the treatment of chronic discoid lupus erythematosus and systemic lupus erythematosus in adults.
Rheumatoid Arthritis: Hydroxychloroquine indicated for the treatment of acute and chronic rheumatoid arthritis in adults.

This medication, frequently sold as a sulfate salt known as hydroxychloroquine sulfate.
Hydroxychloroquine 200 mg of the sulfate salt is equal to 155 mg of the base.
There are various existing brand names of hydroxychloroquine include, Hydroquin, Plaquenil, Axemal, Dolquine, Quinoric, and Quensyl. 

Contraindications: Use of Hydroxychloroquine is contraindicated in patients with known hypersensitivity to 4­ aminoquinoline compounds.

Side Effects of Hydroxychloroquine:

Following adverse reactions have been identified during post-approval use of Hydroxychloroquine or other 4-aminoquinoline compounds. 

• Gastrointestinal disorders: Nausea, vomiting, diarrhea, and abdominal pain. 
• General disorders and administration site conditions: Fatigue. 
• Immune system disorders: Urticaria, angioedema, bronchospasm. 
• Nutrition and Metabolism and disorders: Decreased appetite, hypoglycemia, porphyria, weight decreased. 
• Nervous system disorders: Headache, dizziness, seizure, ataxia and extrapyramidal disorders such as dystonia, dyskinesia, and tremor have been reported with this class of drugs. 
• Psychiatric disorders: Emotional lability, nervousness, irritability, nightmares, 
• psychosis and suicidal behavior. 
• Skin and subcutaneous tissue disorders: Rash, pigmentation disorders in skin and mucous membranes, hair color changes and Stevens-Johnson syndrome. 

Mechanism of Action:

Hydroxychloroquine increases lysosomal pH in antigen-presenting cells. In conditions such as inflammatory, it blocks toll-like receptors on plasmacytoid dendritic cells (PDCs). TLR-9, which recognizes DNA-containing immune complexes, leads to the production of interferon and causes the dendritic cells to mature and present antigen to T cells. Hydroxychloroquine decreased the TLR signaling, and also reduced the activation of dendritic cells and the inflammatory process.

In the year 2003, a novel mechanism was described wherein hydroxychloroquine inhibits stimulation of the toll-like receptor (TLR) 9 family receptors. Toll-like receptors work as cellular receptors for microbial products that induce inflammatory responses through activation of the innate immune system.

General Precautions:

Antimalarial compounds need to be used with more caution in patients with alcoholism/hepatic disease/or in conjunction with known hepatotoxic drugs. 
Periodic blood cell counts should be made if patients are given prolonged therapy.
If any kind of blood disorder occurs which is not attributable to the disease under the treatment, discontinue the drug. 
Medication should be administered with caution in patients with glucose-6-phosphate dehydrogenase deficiency.

Storage and Stability:

Hydroxychloroquine Sulfate, an anti-malaria medicine should be stored at room temperature (15C -30C). Keep this medication in a safe place out of reach of children.

Availability of Dosage Form:

This anti-malaria medication comes in the form of tablets, containing the strength of 200 mg which is equivalent to 155 mg base. 

Missed Dose: If you forget to take a dose, take it as soon as you remember. But if it’s within twelve hours of your next dose, skip the one you missed and take only the regularly scheduled dose. Never take a double dose. 
 

Read: uses of Oseltamivir Phosphate