|
Quinacrine (Atabrine)
Available:
100 mg
Dose:
100 mg daily
Cost:
Variable, requires compounding at a special pharmacy
Common To All Antimalarials
Indications:
Treating longstanding inflammation
associated with rheumatoid arthritis, lupus, and a number of
other autoimmune disorders
Side
effects: The most serious side effect is damage to the
retina in the back of the eye, occurring in 1 in 1,000 treated
patients. This is generally reversible if caught early but
could lead to loss of vision, especially color vision, if not
properly monitored. The optometrist or ophthalmologist can
pick up these changes in the eye before the patient
experiences any symptoms. Stomach upset and changes in the
skin pigment (most common with quinacrine) are less serious
side effects. Patients with certain enzyme deficiencies may
experience anemia after starting quinacrine.
Monitoring:
An eye exam is recommended upon initiation of therapy,
then every 6-12 months thereafter while taking this
medication. Blood counts are recommended every 3-6 months on
amodiaquine or quinacrine. Testing the level of an enzyme
known as G6PD is prudent before starting quinacrine.
Important
points to know: Notify the eye doctor concerning any
changes in vision. Taking the medication with food may
decrease stomach upset. Protective clothing should be worn to
minimize sensitivity to the sunlight. These drugs may take
3-6 months to demonstrate significant effects on joint
inflammation but may reduce skin manifestations of lupus
within 1 or 2 months.
|
