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PLAQUENIL (HYDROXYCHLOROQUINE SULFATE) TABLETS: DRUG INTERACTIONS

Digoxin

Concomitant Hydroxychloroquine Sulfate (Plaquenil) and digoxin therapy may result in increased serum digoxin levels: serum digoxin levels should be closely monitored in patients receiving combined therapy.

Insulin or antidiabetic drugs

As Plaquenil may enhance the effects of a hypoglycemic treatment, a decrease in doses of insulin or antidiabetic drugs may be required.

Drugs that prolong QT interval and other arrhythmogenic drugs

Hydroxychloroquine Sulfate (Plaquenil) tablets prolong the QT interval and should not be administered with other drugs that have the potential to induce cardiac arrhythmias. Also, there may be an increased risk of inducing ventricular arrhythmias if Plaquenil is used concomitantly with other arrhythmogenic drugs.

Mefloquine and other drugs known to lower the convulsive threshold

Plaquenil tablets can lower the convulsive threshold. Co-administration of this medication with other antimalarials known to lower the convulsion threshold (e.g., mefloquine) may increase the risk of convulsions.

Antiepileptics

The activity of antiepileptic drugs might be impaired if co-administered with Plaquenil.

Methotrexate

Combined use of methotrexate with Plaquenil (Hydroxychloroquine) has not been studied and may increase the incidence of adverse effects.

Cyclosporin

An increased plasma cyclosporin level was reported when cyclosporin and Plaquenil were co-administered.

The following interactions have been observed on treatment with the structurally related substance chloroquine phosphate, and therefore cannot be ruled out for hydroxychloroquine.

Praziquantel

Chloroquine has been reported to reduce the bioavailability of praziquantel.

Antacids and kaolin

Antacids and kaolin can reduce absorption of chloroquine; an interval of at least 4 hours between intake of these agents and chloroquine should be observed.

Cimetidine

Cimetidine can inhibit the metabolism of chloroquine, increasing its plasma level. Concomitant use of cimetidine should be avoided.

Ampicillin

In a study of healthy volunteers, chloroquine significantly reduced the bioavailability of ampicillin.

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