Page 10 - N&V Winter 2019

Hydroxychloroquine Prescriptions

This information is intended to explain the difference between brands of hydroxychloroquine
tablets in the UK and what you need to do if you are unable to obtain the one you need.

why was I prescribed have varied presentations of symptoms and adverse effects when they take certain
hydroxychloroquine? react to medications differently. It is brands, most commonly Quinoric®. If you
Hydroxychloroquine is generally the first important to find a version that suits you suspect that your side effects could be
line of treatment for someone who has personally. linked to the brand of hydroxychloroquine
been diagnosed with lupus. It is used for why can i no longer get you take, you may want to consider
skin and joint involvement, muscle inflam- plaquenil®? discussing this with your doctor.
mation, fever, fatigue, pleurisy, to reduce If you have experienced side effects from
the development of renal (kidney) disease Plaquenil® was the original brand of your hydroxychloroquine then you should
and chronic damage, and for its steroid- hydroxychloroquine and was previously the report them using the Yellow Card Scheme.
sparing properties. It is one of the few most commonly supplied by pharmacies in It is important to specify which company’s
licensed drugs for lupus and there is good the UK. In summer 2015 Sanofi-Aventis version of hydroxychloroquine you
evidence for its efficacy and safety. Medicine (the manufacturers of Plaquenil®) experienced the adverse reaction to,
‘de-branded’ the drug to generic. This
When you were prescribed hydroxy- meant that Plaquenil® branded hydroxy- especially if a change of version has
chloroquine your consultant will have chloroquine was no longer available but reversed these effects for you. You can
arranged an eye examination with your the Zentiva generic version is made lodge a report online at
ophthalmologist and this should be identically to the original Plaquenil®. www.yellowcard.mhra.gov.uk/yellowcar
ds/reportmediator/
Any prescriptions that stated ‘hydroxy-
chloroquine sulphate 200mg (Plaquenil)’ or If you previously received Plaquenil® and
‘hydroxychloroquine sulphate 200mg’ can know that you can tolerate it, the generic
be supplied by whichever version the with the same formulation is Zentiva. Other
pharmacist has available as Plaquenil® is alternatives that you could try are
no longer available by that name. Blackrock or Teva as they have different
fillers to Quinoric® or generic Bristol
we’ve heard some people react hydroxychloroquine tablets. Please always
badly to Quinoric®? bear in mind that people with lupus
There is evidence indicating that that many respond to drugs differently – these brands
may not necessarily be more suitable for
repeated annually after five years of experiences of adverse effects are related any given individual.
consecutive treatment. This screening is to to the Quinoric® branded hydroxy-
mitigate a very low risk of retinopathy. chloroquine tablets which was published in what if my pharmacist cannot
The Journal of Rheumatology - obtain my preferred brand of
which brand/version is best? www.jrheum.org/content/44/3/398.1. The hydroxychloroquine?
most frequently reported adverse effect
Hydroxychloroquine is the name of the from Quinoric® is gastrointestinal upset but We have received a lot of reports from
drug but there are a few different versions nausea or general flare symptoms have people with lupus recently that their
available in the UK. Plaquenil® was the also been mentioned by some people. pharmacist has been unable to dispense
original brand or trade name for hydroxy- either the Zentiva or Blackrock versions. In
chloroquine that was patented. The only It should be noted that this is not the many cases it has been suggested that this
other branded product is Quinoric® experience of all lupus patients taking this is the result of manufacturing or supply
(produced by Bristol Laboratories). Generic particular brand of hydroxychloroquine. If problems. There are currently no
versions are non-branded products you take the Quinoric® brand and manufacturing or supply issues for these
(produced off patent and cheaper than the experience no adverse effects then there is versions in the UK. We will publish
originals) that have been produced by a no reason to request a change to another additional advice if/when a manufacturing
variety of companies since the patents for brand. or supply issue occurs.
these two brand expired. Every version You can provide the information below to
(with a brand name or generic version) will what should I do if I experience your pharmacist to help them obtain the
include the same quantity of the active side effects from taking hydroxy- version of hydroxychloroquine that you
ingredient hydroxychloroquine, but the chloroquine? need;
formulations differ in terms of the ‘fillers’. It is important to mention any unexpected
The generic versions are sometimes know symptoms or side effects to your doctor or Zentiva
by the company that produces them: pharmacist as soon as possible. Some side
Zentiva (produced by Zentiva), Blackrock effects go away over time as your body If your pharmacist has any difficulty
(produced by Blackrock Pharmaceuticals, gets used to a new drug, so your doctor obtaining generic hydroxychloroquine
Teva (produced by Teva UK Ltd) and Bristol may recommend you stick with your current produced by Zentiva, the product
(a generic version of Quinoric produced by plan for a little longer. In other cases, they description is: "HYDROXYCHLOROQUINE
Bristol Laboratories). advise you to lower your dose or try a SULPHATE (ZENTIVA) 200MG FILM
different drug. COATED" and the 'PIP number' (product
There isn’t a particular brand of hydroxy- code) is 1201730. If for any reason they
chloroquine tablet that will be best for Each brand of hydroxychloroquine cannot find the product on their system they
every individual with lupus. It must be available has a slightly different can ring the customer service line on
268C
remembered that all people with lupus formulation. Some people with lupus report 0800 854 431.
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luPus uK NEWS & VIEWS SUMMER 2019