consists of a portfolio of branded products and authorized generic contracts, including branded products such as Nilandron, for the treatment of metastatic prostate cancer; Dibenzyline, for the treatment of pheochromocytoma; Lanoxin, for the treatment of mild-to-moderate heart failure and atrial fibrillation; Plaquenil
, for the treatment of lupus and rheumatoid arthritis, Donnatal for the treatment of irritable bowel syndrome and Zonegran (zonisamide) for treatment of partial seizures in adults with epilepsy.
I remember when I was a fellow a paper was published saying Plaquenil
[hydroxychloroquine] is safer than aspirin, it lowers lipids, and everyone should be taking it," recalled Dr.
The patient was diagnosed with SLE and started on a regimen of colchicum dispert tablet and Plaquenil
200 mg tablet twice daily.
She was on Plaquenil
for the last 23 years 200 mg b.
200 mg twice daily and prednisone 4 mg daily were prescribed.
Those using Plaquenil
and steroids experienced the most side effects.
Patients who use plaquenil
are generally advised to have dilated eye exams at least yearly to monitor for this problem, and the drug is discontinued if there are any signs of toxicity such as pigmentary abnormalities in the macula forming a bull's-eye pattern, a classic characteristic of late-stage macular toxicity.
The factors accounting for the preservation of the fovea in atrophic disorders are not well understood, but foveal preservation is also present in a number of other conditions, including Stargardt disease, cone dystrophy, central areolar choroidal dystrophy, and plaquenil
toxicity (Gass, 1997).
Several possibilities existed in the differential diagnosis of this case including steroid psychosis, Plaquenil
psychosis, adolescent adjustment reaction, neuropsychiatric lupus, and psychosis induced by illicit drug use.