Quinoric now - what happened to Plaquenil?

I've just collected my latest prescription for Hydroxichloraquine from the pharmacy and find I've been given a different type of pill with a brand new name. I've experienced this many times with my Levothryoxine so I know it's quite usual for doctors to switch brands but am slightly alarmed this time because Plaquenil always make me a bit queasy for a few hours after taking them (not in the league of MTX mind) but this ref to Quinine takes me back to when I was young and went back packing round India with Quinine tablets for malaria deterrent. I realised quite early on that when I took them each week I would feel very sick for a few days afterwards and get a vile taste in my mouth and finally had to stop taking them as I got dysentry so couldn't hack the drug side effects too.

These ones are sugar coated and I'm not sure why I've been moved onto a new brand this time when I've had so much trouble with pills lately? Can anyone enlighten me about them and warn me as I have another day's worth of the Plaquenil to take still - so maybe anticipating trouble before it happens or imagining that it's a cost saving measure when in reality they might be better re the nausea (and I have told the GP I get a bit nauseous from Plaquenil too). Sorry but I'm feeling like a wimp about them because of the name! Tilda

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  • I found this on a Lupus site:

    Hydroxychloroquine Prescriptions

    It has come to our attention that some lupus patients have been receiving Quinoric® instead of their usual Plaquenil® and it has caused adverse effects on their health.

    Plaquenil® and Quinoric® both use the same active ingredient (Hydroxychloroquine) but they may have different fillers or dyes. It is these fillers/dyes that are probably what many people have a problem with.

    The reason Quinoric® is now being dispensed is that it is a cheaper alternative to Plaquenil®, which has come off its patent.

    If you have received Quinoric® and have noticed adverse effects then you should consult your GP. We have been informed that if they specifically write Plaquenil® on the prescription then the pharmacy will be able to supply you with the correct brand.

    But it does look from a lot of the other forum posts etc., like some people find it better, some find it worse, and others haven't noticed any difference! It sounds like a suck-it-and-see, I guess.

    Sara xx

  • Thanks Sara - I just looked too and found the same site. Then found a blog where some lass says she has been prescribed 400mg same as me and has sustained immediate and irreparable damage to her retina and is sueing her rheumy for this overdose (according to height/ weight she should have been on 350mg max). But then the same lass says she would never think about taking MTX for her RA as it is pure poison so I think it's time to stop reading!?

    I just phoned my surgery and the receptionist said that it's not down to gp who simply prescribes Hydroxy sulphate - it's the pharmacy who move from the generic to other brands according to what they have available. So if it makes me sick or feel strange I'll ask my GP to specify Plaquenil in subsequent prescriptions. Meanwhile I will suck it and see and let you know how I get on! TTx

  • I saw that blog too - never quite sure whether to believe horror stories like that, or take them with a pinch of salt!

    Good luck! xx

  • Pinch of salt or we'd never make any progress - especially if we read stuff online about Methotrexate! TTx

  • lol The internet is a wonderful source of information but it can be a dangerous place, I normally use uk/nhs based sites.

    I asked my pharmacist about this some time ago (giving different branded drugs), he said they are obliged by law to give the cheapest brand of any drug unless the doctor puts a particular brand-name on the prescription.

    Beth xx

  • Thanks Beth that's helpful to know - I will see how I get on with it and try to keep an open mind about the Quinoric. Maybe it will even make me feel less sick? The internet info I read was all UK based but I still take with pinch of salt! TTx

  • Generally GPs are supposed to prescribe the generic, as 9 times out of 10 it's identical and a fraction of the price. And generally I feel the same, as don't see why I should pay £4 for a branded painkiller that has exactly same content as generic 16p version from Morrisons. I was also moved onto Quinoric, for same reason, and have found it if anything slightly less queasy making. Px

  • That's cheering thanks Polly - I do get a little queasy after Plaquenil as I've said so hopefully it will work same way for me as you. I don't pay for prescriptions as this is Scotland so I wouldn't know about the cost but take your point entirely. TTx

  • Hi, I was changed from one to the other, and I think it is better than Plaquenil, as that one used to keep me awake if I took it too late!

    They are called antimalarials which always used to puzzle me. But lots of stuff concerning RA puzzles me.

    I have wondered if I could ditch all my tablets and drink Tonic water instead, as that's made of quinine. But with a small Gin as well, obviously!

    I bet you won't notice the difference in the end. Can you do a blind test? Get your OH to give you them, but not say which is which? Just a thought!

  • Hi Tilda

    I think I mentioned my Plaquenil experiences on the site but not sure where!

    Some horror stories are true. I was on 200mg of Plaquenil every other day for two years and it did affect my macular. I had a fixed grey blob in my central vision in my right eye.My opthalmologist diagnosed it (I have high eye pressures) after examining my right eye. HEe told me to stop the Plaquenil and after two months the blob disappeared. My opthalmologist said I was extremely lucky as often stopping the medication makes no difference.

    I did take a product called Macushield duing those months and wonder whether that helped.

    None of the rheumatologists seemed to want to believe what happened. They kept telling me it was extremely rare and almost didn't think it was true even though it was an opthalmologist who diagnosed it and the blob went after stopping the medication! My optician also saw the damage on the back of the retina when I went to get new glasses after going to the hospital.

    It may be rare what happened to me but I would be very cautious and read up on what to look out for just in case it affects you. You can't replace your sight. x

  • I'm an artist so my sight is more or less everything to me KJay. I told my GP that I'd already had problems with my hands so the last thing I needed was my eyesight being affected so he wrote to my optician and did a basic eyetest himself before I started. My rheumy explained that it's about body mass/ weight and dosage and the toxicity can build up so it's really people who are taking 600mg per day or those who have been on it for 5 or 6 years who are most at risk he explained. However I am short and am losing weight slowly but surely so I will double check with my GP that 400mg is appropriate.

    If I felt anything happening to my eyesight I wouldn't hesitate to ask for a check and stop taking it. I think the main test is the peripheral vision test which I had shortly before I started on it. I've been taking it for over 3 months now and I think it might be responsible for some of the improvement in my joints but it's hard to know being on MTX too of course?

    I will try a blind test tomorrow as you suggest Phoebe and monitor results as I have one lot of Plaquenil left. The Quinoric are sugar coated so it might be hard not to notice even with eyes shut! TTx

  • Hi Scouser - haven't seen you about for ages how are you? I will see how I go over next few days and if I don't like the new stuff I'll ask GP on Wednesday. TTx

  • Hi

    I get prescribed quinoric from gp (as it's cheaper), & the consultant gives me plaquenil. I prefer plaquenil, but can take both. It's the same with cocodomols. Solpadols and I get the cheaper zapin. Solpadols are capsules which I find works quicker where as zapin is a solid caplet that takes longer to be broken down hence is not as quick to relief the pain as solpadols. Once the gp's have to prescribe drugs routinely, they prescribe the cheapest version. That is the case of my gp as I have asked for the brand names on numerous occasion and when I request refils, but I still get the cheaper alternatives stated above.

    It is recognised that some peps cannot take the quinoric or other versions and if you are in this category, then gp will prescribe the branded plaquenil, at the higher cost!

    Cheers Jx

  • Yes, cimzia is in addition to the drugs I am on.

    x Joanne

  • There was a lot of discussion the the NRAS members forum. Apparently there is a national shortage of the plaquinal brand so a lot of people have been changed on to other brands.

    Beckyb

  • Ah that would explain it then. Thanks - Tilda

  • Hi Tilda, I've been given quinoric as well.

    I never thought about there being a difference until you posted this question, so I guess I must be ok with it.

    One thing though. I was on 400mg for 3 months, and was told to reduce to 200mg thereafter.

    I noticed within a few days that my joints were more painful, so I rang the doc to see if it was ok to go back up to 400mg.

    He told me that I would never be allowed to go back up to 400mg because of the side effects, and to give the mtx more time to take effect...I've been on 20mg for a couple of months.

    I didn't realize that it was all about weight.

    So, in light of that, and the fact that you have lost loads of weight, I think a review with your doc or rheumy is in order.

    I had an eye test last week and they told me that the inflammation behind my eyes has reduced since May, so something is working, but it does worry me about my eyes. There is macular degeneration on both sides of my family.

    I think in view of the possible damage to eyes, we should have free eye checks every 3 months.

  • Well I took my 2 tablets of Quinoric earlier and seems much the same as Plaquenil for me. I feel tired and a little nauseous but then ive just been walking round the County Agricultural show in the blazing sunshine for hours sp that's probably done for me more than anything although not complaining!

    Yes I will ask my GP about the 400mg although I'm still 2 stone overweight despite losing 4 stone in a year so he might well say that it's not yet an issue for me! They did weigh me at my last rheumy clinic a few weeks ago too. I was told initially that I would qualify for free yearly NHS eye test on Hydroxy but my rheumy then said every 2 years would be fine as the risks of eye damage are so low in first few years on this dose. I'm a bit worried now though so will double check with GP. TTx

  • Hi Tilda, I take 400mgs of Quinoric / Plaquenil per day and I was told by my consultant that I should take it twice a day as opposed to all in one dose. I

    've never had any side effects with taking it this way. Maybe that's why you are nauseous etc after taking it. Just a thought.

    I seem to be given either of these drugs when I collect my prescription, but haven't noticed any discernible difference between them.

    Carolyn x

  • Thanks Carolyn - can you tell me if you are of a small build or large? I asked this question to begin with regarding brand v generic but seeing some replies I am now also concerned that I might be taking too much Hydroxy for my frame as someone who is only 5'2". I am a bit wider than I should be of course but still it concerns me as others have these stories about their retinas etc. I don't think I'm reacting any differently to the Quinoric but I am still feeling queasy and have a foul taste in my mouth so maybe slightly less favorable on the Quinoric. I wish I didn't have such a stupidly oversensitive tummy! I will try splitting the dose tomorrow and see how I get on. TTx

  • Hi Tilda, just looked and I also have quinoric. I take 400mg split into 2 doses. I am also 5'2'' and a bit overweight(although attempting to lose it) I haven't had any problem taking it. I hadn't been told anything about the amount and body size. Nobody has mentioned eyes to me either, unless they assume I will be checked as I am under an opthamologist because of my scleritis, although he hasn't mentioned anything either.

    Lottie xx

  • Yes Tilda I'm 5ft 7ins and a couple of stone overweight so I think I'm quite a bit larger than yourself!!

    See if it does make a difference splitting the dose.

    carolyn x

  • Thanks Lottie that's comforting - everything is fine really just having a little panic - need to get back to life and stop fretting really! Tilda xx

  • Hi Tilda

    I'm sure it goes without saying, but obviously you need to check with your rheumatology team before taking it differently to how they told you to. A lot of people do split the doses of their medication, but this should always be done under guidance from your rheumatology team.

    If they are happy for you to split the dose I hope that helps to control the nausea that you are experiencing.

    Kind regards

    Victoria

    (NRAS Helpline)

  • Thanks Victoria. It actually doesn't specify how the dose should be taken over a day - just that 2 should be taken with food daily so that could mean one in the morning and one in the evening as long as it's with food.

    I tried splitting it into a morning and evening dose yesterday and found that the nasty taste it leaves me with lasted all day so am back to taking two with food at lunch time. And if anything the Quinoric is less queasy making and less foul taste than the Plaquenil for me so that's good.

    This question wasn't actually about the nausea or dosage just about brand v generic but I take your point about clarifying advice I've been given. Tilda

  • Hi Tilda

    Not a problem. I know this wasn't the original question, but I noticed that during the course of these threads someone suggested you split the dose, and while it may not specify on the tablets how they should be taken, the person that prescribed them would usually tell you how they wanted you to take them, and it is just important that they are aware of any change to this.

    Pleased to hear that the Quinoric makes you feel less queezy and has less of a foul taste. I've had the side-effect of having a nasty taste on the tongue with medication before (luckily for me it wasn't something I had to take long-term) so I know how horible it is.

    Kind regards

    Victoria

  • Thanks Victoria. That's interesting but that's not quite what I'm describing actually. As I've said here when I was in India many moons ago I took this medicine as an anti-malarial and it was the taste that used to linger and make me feel dreadful as it repeated on me. But these are coated tablets and I haven't had a bitter taste with them at all. But following Sulphasalazine, MTX and Plaquenil I have been getting a horrible rotten taste that dominates everything though for a day or more. However now with the Quinoric and the lower dose of MTX it's receded I'm delighted to say - so I'll get there in the end! Tilda

  • PS I've never brushed my teeth so much as I have over the last 8 months so my dentist should be impressed at least!

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