Plaquenil... The Wonder Drug...

I love Plaquenil.

Also known as hydrochloroquine. It's a medicine that works wonders for a lot of my patients with lupus and rheumatoid arthritis. It can also help with Sjogren's syndrome, and even sarcoidosis. When it comes to treating autoimmune disease, there is no equal. It's a generic, it's time-tested, and effective.

It's an old anti-malarial medicine. The US Army gave it's precursor, Atabrine, to a few million GI's in the South Pacific to prevent malaria during World War II. A few of the Army doctors noticed that some of the men with autoimmune disorders got better... There wasn't much else to offer these patients, so they brought the medicine back to the states, and we've been using it ever since.

There are no drug interactions with plaquenil. It's very well tolerated, but does sometimes cause nausea, but that almost always gets better after you take it for a while. Most of my patients notice improvement in their fatigue within a couple of weeks. Then, over the next few months, many of my patients begin to feel their joints loosen up, their mouth sores clear, and their dryness improves... It's pretty unusual that it's the whole answer, but it's part of the treatment plan for a lot of my patients.

It's good stuff!!!

Which is why I can't, for the life of me, figure out why some clinicians don't at least try it!!!

I saw a new patient today, a nice girl who's been diagnosed with scleroderma at a young age. She developed some arthritis later, as well as Hashimoto's thyroiditis and interstitial cystitis. Throw in some mouth sores, rash, fatigue... She's a walking textbook of autoimmune illness. When she has a positive ANA last year her internist offered plaquenil. The patient called her rheumatologist, and he said 'no way, won't work...'

Huh?

How did he know? Why not try it? I've been shaking my head all evening over it.

I had another patient last month, with lupus, whose previous rheumatologist refused to write her for plaquenil even though she asked for it by name. He said he 'didn't have good luck with it'. Whatever. I started her on plaquenil and she's much better.

Sure, these are just a few patients. But my point is, if there's something out there that's low risk, effective, and can possibly help your patients, why not give it a try? Sure, there is the extremely small chance of eye problems with the medicine, but that's rare and with proper monitoring doesn't pose a long term risk.

 So, give it a try... You'll be glad you did...