Plaquinal

[hihannula]

Good Morning to Everyone

I have a question for anyone taking Plaquinal. Is it more effective to split the dose? If it doesn't matter, when is the best time of the day.

Thank you😁 Have a wonderful day.

[lupus-support1 Administrator]

It is better to split doses, whether it is Plaquenil or steroids. This is to try and even out throughout the day, rather than all at once. If, therefore, you are taking 2 tablets a day, I take one in the morning; and one later in the day. I would not take it at bed time, unless they are specific drugs to be taken then. It's always advisable to take medication after food, unless directed otherwise.

I was advised to do this by Prof. Hughes, but I don't think there are any "rules!" In any doubt, always refer to your own specialist!

With good wishes,

Ros

[KellyInTexas Administrator in reply to lupus-support1]

Can you elaborate on the plaquinil, specifically Ros? For example if a patient has been prescribed 200 mg plaquinil, should the patient take 100 mg with breakfast and the remaking 100mg with dinner?

Even with the titrations, this would certainly be fine. I titrated very slowly, and this was fine. Each patient must titrations as tolerated. I started with 50 mg per day. My Rheumatoligist said even if I had to try 50 mg for a month before bumping up that was ok.

It never occurred to me to split the dose.

I supposed could have tried 25mg with breakfast and 25 mg with dinner keeping with Professor Hughes’ method of dosing?

( and I will say- you are right- my Rheumatoligist also thinks there are really,” no rules...”)

[lupus-support1 Administrator in reply to KellyInTexas]

Plaquenil comes in 200mgs tablet. Obviously, if you are prescribed one tablet, you take the 1 tablet am. IF you are prescribed 400 mgs ie 2 tablets, they can be split into am & pm.

[KellyInTexas Administrator in reply to lupus-support1]

No, what I’m saying is it’s not that obvious.

I was splitting the 200 mg tablet into quarters. I was taking 1/4 tablet at dinner.

I should have, per Dr Hughes, cut that quarter again.

I could have Split that 1/4 😉

twice daily. ( 1/8th am and 1/8th pm to to total 50 mg daily.) during titration schedule.

I might try this because so far I’ve been unable to tolerate Plaquinil. ( even excipient free.)

I’m so glad you mentioned this.

[hihannula in reply to KellyInTexas]

Thanks Kelly. I'm going to split up my plaquinal as well. I think it's the plaquinal that causes my nausea in the morning when I take all at once.

[KellyInTexas Administrator in reply to hihannula]

Same thing happened to me.

[lupus-support1 Administrator in reply to KellyInTexas]

I was never advised to literally split one tablet. Therefore, I can't comment other than to ask your doctor. I am not sensitive to Plaquenil.

As an aside: those taking Plaquenil MUST see an ophthalmologist (specialist eye doctor), not an optician, every year. Ideally, they should be seen BEFORE taking Plaquenil, so there is a base line.

It is also advisable to begin with 1 tablet & then increase the dosage as necessary. In SOME patients, going straight to 2+ tablets per day can affect the eye muscle & cause blurry vision. THIS IS NOT SERIOUS & STOPPING PLAQUENIL ENDS THE EYE MUSCLE PROBLEM! This doesn't happen IF the dose begins with 1 tablet & then increased.

Plaquenil, an antimalarial, has been used successfully for many years for patients with SLE. It has a mild blood thinning property.

[hihannula in reply to lupus-support1]

Thank you. I'll do that! I think the large dose of plaquinal at once is what causes nausea soon after I take them with my breakfast. I can never eat lunch, I feel off until mid afternoon. Thanks again.

[hihannula in reply to lupus-support1]

Thank you. I didn't know about splitting the prednisone as well. I think that makes sense to keep it even in the body. About4-6 months ago, I had an adrenaline test done because I complained to my GP, I feel energetic in the morning but by 2:30-3:00 pm I'm literally crashing.

He ordered an adrenal function test. It was a 2 part test done the same day. 8 am and 4 pm. 8 am was normal, but the 4 pm reading was only 1/4 of what the 8 am reading was. He said, no wonder I feel like crashing so I'm going to the endroconologist in Sept. in the meantime, I'll split my prednisone dose in 2 and see if that balances my energy level.

Thank you for the answer. Much appreciated. Cheers

[lupus-support1 Administrator in reply to hihannula]

I do this with sulfasalazine. I do this for baby aspirin: x2 75mgs because I require that dose else the headaches return!

I do NOT do this for MTX (injection) nor would I do this for the tablet form MTX.

[MaryF Administrator]

HI My daughter is on Plaquenil and when on the highest dose she had to split it between morning and evening. Usually after a meal, as she has been on it for years now. MaryF

[hihannula in reply to MaryF]

Hi Mary. I've been taking my plaquinal with a meal. Does it work best after a meal? If so, how long afterwards do I take it? Thanks!!

[MaryF Administrator in reply to hihannula]

It is what we were told to do by the Paediatrician at the time, so just kept to that, after dinner, she is now on half the dose at the moment, so just the evening. MaryF

[hihannula in reply to MaryF]

ok Thank you Have a good evening. Cheers

[milkwoman]

Since day 1, I have been instructed to split dose my Plaquenil. I take 200mg with breakfast and 100mg in late afternoon with a snack.

[MsPacman]

New here. I've been taking Plaquenil for 18 yrs. Started on 800mg/day for 3 mos, lowered to 400mg/day for approx 10 yrs and 200mg/day for the last 8 yrs. I previously split the dose evenly but on only 200mg I take it at night so I don't get any stomach upset with coffee in the morning.

Plaquenil is quickly absorbed into the bloodstream and has a half life of 3 mos so I wouldn't worry too much about when you take it.

[hihannula]

Thank you. I now know why I’m nauseated in the morning. Good info. Cheers. Holly