Quinoric problems

I have just experienced more than 2 weeks of severe pain . My prescription was replaced by Quinoric instead of Plaquenil.

Doc thought I was flaring but after 10 years of Lupus I have never experienced pain for such a long duration. Increased steroid dose took a week to resolve the pain.

I saw the notice on the website about Quinoric. My GP has given me a prescription for

Plaquenil today. I guess it will take time to get quinoric out of my system.

12 Replies

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  • Oh poor you. I am supposed to be on plaquenil, but because quinoric is cheaper, I get this most of the tme now. I have only had plaquenil twice since May. On reading the leaflet the other day I noticed that you shouldn't drive whist on quinoric. Thats why I take it at bedtime! On waking it takes about 20 mins for my eyes to get with it. I know from this site that quinoric has adverse effects for some people. Keep well Liz

  • Oh my friend, I had a bad experiance with them, tummy upsets and teeth turning brown.

    Ask your Doctor to refer it to the Medical Council's watch dog so they can do something about it. Earlier this year there were pages and pages of us with the same problems.

    They have Not saved money now as they are having to dispence other medication to counteract the problems caused. I am on 1 x 2oo,mg morning and night. Good luck and hope we all can do something to help others.xx

  • My Plaquenil was changed a few months ago, luckily with no advere effects.

    My son's friend is a pharmacist and he said the main ingredient is the same, it is the rest of the ingredients that may cause problems.

    Iowicklady55, I did not realise that it says not to drive on Quinoric, I do and I am ok. I take mine in a morning as the Consultant said, and during the summer months when he says to take 2 daily, I was told to take them at the same time Hazel :/

    Oh well, as long as we cope with what we take and it works that is the main thing. xx

  • After reading many complaints about Quinoric I did some research and came up with the following. This information was originally posted on my own blog back in September but I thought I would share the material with Lupus UK today (in response to evans' post).

    Plaquenil and Quinoric 

    This week I read several posts on Lupus UK which addressed the question of whether Quinoric was as effective as Plaquenil in treating lupus. Several people on the site suggested that the only difference between the two drugs was in the “filler” added to the active ingredient, hydroxychloroquine. And several people added that their pharmacist, or doctor, had assured them the preparations were “identical”. Which suggests to me a larger issue: are generics and substitute formulations for established drugs truly “identical” in formulation and do they behave identically when consumed?

    In an effort to examine the interchangeability of generics for established drugs, I took a close look at Plaquenil and Quinoric. Are these two “identical”? Can one drug be substituted seamlessly for the other? I found a list of constituent ingredients for each of these drugs so I could make a comparison.

    Both drugs, I discovered, do contain the same active ingredient in equal quantity: 200 mgs of hydroxychloroquine. The differences between the drugs, as some people suspected, is in the “fillers”. So I looked at those “fillers”.

    Plaquenil (Manufacturer Sanofi)

    Calcium Phosphate, Dibasic, Anhydrous

    Hypromelloses

    Magnesium Stearate

    Polyethylene glycol 400

    Polysorbate 80

    Starch, Corn

    Titanium Dioxide

    Quinoric (Manufacturer Bristol Labs)

    Maize Starch

    Calcium Hydrogen Phosphate dihydrate

    Colloidal anhydrous silica

    Polysorbate 80

    Purified Tale

    Magnesium stearate

    Hypromellose

    Titanium dioxide

    Macrogol 6000

    While the two lists of constituent ingredients are similar, they certainly are not the same. But the question remains, do these differences matter? I took a look at one ingredient that appears to be almost identical.: PEG.

    On the Plaquenil list PEG (Polyethylene glycol) is described as Polyethylene glycol 400. On the Quinoric list PEG comes in a different formulation: Macrogol 6000. In industry, these two forms of PEG have different uses because they interact with environments differently. One, Macrogol 6000, is commonly used as a laxative, among other things. The other, Polyethylene glycol 400, has a lower molecular weight and is more liquid: this chemical is often used in printer ink, as well as in pharmaceuticl preparations. It's impossible for me to say if these two forms of PEG are processed identically in the human body.

    There's one “filler” included on the list for Quinoric which is not included on the list for Plaquenil: silica (Colloidal anydrous silica). Silica is abundant in the environment. This compound has been linked to a numboer of autoimmune diseases. Whether inhaled, absorbed through the skin or ingested orally, silica has a well-established association with lupus and rheumatoid arthritis, among other other inflammatory conditions. Silica is almost ubiquitous. It's in soaps, cleaning products, paints and other common household items.

    So, I ask,  what is silica doing in a preparation that's prescribed for people who have lupus?

    There is a pat response to this and other questions I raise in this essay: these substances are harmless, they are inactive and largely inert. They serve merely as vehicles for delivery of crucial medication.

    I going to refute these glib reassurances by turning to Dr. Phil Lieberman of the American Academy of Asthma, Allergy & Immunology. Dr. Lieberman is asked about an adverse reaction a patient had to one constituent ingredient in Quinoric: Macrolog 6000. The doctor responds: “..it is best to try and avoid polyethylene glycol as carefully as possible. This is a difficult task given the ubiquitous nature of these substances, but it is clearly the safest strategy to employ.”( see: aaaai.org/ask-the-expert/an... ).

    I' m not a chemist, pharmacist or doctor. But I do know what the word identical means. And I do know that when there is a change in formulation—say from PEG 400 to Macrolog 6000---it's because one formulation behaves differently from another. And if two substances are not the same, then they are not the same.

    Plaquenil and Quinoric are prescribed for a very particular population, a population of people who have heightened immune responses. Allergies, even rare allergies, are common in this population. Extreme caution should be taken when introducing any new element into the environment of someone with such a heightened and unpredictable response to potential antagonists.

    Plaquenil and Quinoric are not identical; they may not be absorbed the same into the bloodstream, or processed in exactly the same way by the digestive system. There may be constituent ingredients that are irritating in one and not the other.

  • I have had reactions to two generic brands of Olanzapine ( for bipolar) and suspected colloidal silica. An article in the lancet seems to add weight to this theory. I wrote about it here:

    healthunlocked.com/lupusuk/...

    I found your online blog very interesting as I have experienced many of the physical conditions that lupus sufferers share although I am officially only diagnosed with bipolar disorder. For me the cause of my physical and mental problems has been found to be a leaky gut causing many autoimmune responses. I now have a paleo diet excluding all grains, legumes and potatoes. My former health issues were muscle pain, frozen shoulder, vertigo, costochondritis (had a trip to A &E that ruled out heart problems but the machines confirmed that my blood pressure was erratic) , and chronic back pain for 25 years. I have no current health issues but the back pain took nearly 2 years, then it dawned on me it had gone. There are no quick fixes to serious conditions. I wish you well.

  • Three years later and this is still happening I am an ra sufferer and have been taking HDQ for over a year with methotrexate ....for some reason my Plaquenil was substituted with quinoric and now I am having servers stomach pains headaches and feeling generally dreadful I had been doing quite well before this happened how can they just change these drugs without letting us know about them we are already suffering from awful autoimmune illnesses only to be given more pain due to our medication being changed without us knowing if I had not joined health unlocked I would have had no idea why I have been feeling so ill the last two weeks I can only say thank you so much to you lupuswriter and to others who have taken the trouble to investigate These drugs I have been told to stop my quinoric to see if my very painful stomach and headaches subside and if they do

    I will have to somehow find some Plaquenil.

  • Hi Rodapies, look at lupusuk.plaquenil /availability I think that's right if not look on the Lupus website. The original company Sanifo, it's sister company Zentiva have now produced a generic with the PLAQUENIL formulation the site has all the details for what your GP is to put onto your prescription and also information for your Pharmacy to order it. I am in the throws of doing this as QUINORIC is a dreadful drug I too have had these symptoms with really bad stomach pains enough that I am being scanned next week, but it's definitely this drug. PLAQUENIL never gave me any real side-effects in fact I felt well on this and hope I will do again. Take care all Nx

  • Hi noonoo52 thanks for the info, I saw my gp and have now got the HDQ Zentiva brand from Boots the chemist my gp has added the info to my notes too ....for anyone out there who has had the same problems I would say that my stomach pains took about two weeks to clear after I had stopped the Quinoric I've been taking the Zentiva brand for 3 days now and all seems well Fingers crossed!

  • I am feeling really queasy today and I'm sure its the quinoric the chemist sent on my last prescription. I've read your post Lupuswriter and you mention a laxative in this drug. My symptoms are diarrhea, nausea and a general feeling of being unwell. I've had bouts of diarrhea over the last few days but today I dont feel well at all.

    I've decided not to take any more until I can speak to my gp. The surgery is closed this afternoon, it'll have to wait till tomorrow morning. I was on a tablet for sjogrens last year and had to come off it as that made me ill too, it was pilocarpine, didnt suit me one bit and my dentist stopped it straight away when she found out..We'll see what my gp has to say in the morning...

  • My gp changed my script back to Plaquenil with no hassle over the phone. Does anyone know how long it takes for symptoms to clear up??

  • I'm sorry to say weeks or months. I took Quinoric for 3 weeks and thought I was having a lupus flare (I had been on Plaquenil for years trouble free.) Quinoric is a vile drug. I reported on the yellow card system for adverse reactions to drugs. Best of luck. Insist on Plaquenil.

  • Well its 2 years, according to my last post, since this came up Evans and I'm fine.

    My gp put me back on Plaquenil straight away (in 2013) and the quinoric symptoms cleared up within a couple of days...been taking plaquenil ever since, my doctor made a note that it didn't suit me...Hope you're keeping well

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