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Lupus

Plaquenil for life?

09/25/1998

Question:

I was put on plaquenil for lupus.Does a pt. have to be on this medicine the rest of their life,or is it possible to come off..and does this drug cause the ANA count to come down?

Answer:

You do not have to take Plaquenil indefinitely. Lupus (Systemic Lupus Erythematosus) in some persons can go into remission naturally. In this event, the treatment can be discontinued. However, determining whether the absence of symptoms and physical findings is caused by a medication such as Plaquenil or is the result of spontaneous improvement can be very difficult. If the disease control is the result of Plaquenil stopping this drug can result in a reoccurrence of activity. Furthermore Plaquenil is slow acting and may require several months to become effective once restarting this drug.

The side effects of Plaquenil are minimal. Eye problems particularly retinal toxicity almost never occur on doses of 6.5 milligrams per kilogram of body weight or less. This means that anyone greater than 135 pounds is at almost no risk for this problem on the standard dose of two tablets daily. Skin rashes occasionally occur and can be severe but are reversible.

You and your physician have to consider the risk benefit ratio of any drug before deciding to discontinue it. The potential benefit of Plaquenil usually far outweighs the risk. One compromise is to lower the dose slightly and then closely monitor the disease activity.

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Response by:

Larry   Houk, MD Larry Houk, MD
Professor of Clinical Medicine and Rheumatology
College of Medicine
University of Cincinnati