Ophthalmologic examination: fundus endoscopy, perimetry (before therapy or within the first 12 m.), glucose-6-phosphate dehydrogenase activity at the faculty
Hydroxychlorquine sulphate (Plaquenil) 400 mg/d initial (max. 6 - 6.5 mg/kg bw/d), then 200 - 400 mg/d; Chlorquine sulphate (Nivaquine) 300 mg/d initial, then 150 mg/d
2 - 6 months
Renal insufficiency, liver insufficiency, intensive sun exposure (increased pigmentation disorders of the skin and hair), no simultaneous administration of MAO inhibitors, combination with digoxin, antieptileptics: Dose adjustment, Nivaquine: In long-term therapy > 3 years retinopathy frequent, switch from Nivaquine to Plaquenil 6 months before planned SS.
Existing retinopathy, myasthenia gravis, bone marrow disease (cytopenia), porphyria, glucose-6-phosphate dehydrogenase deficiency, severe liver disease (Child-Pugh class C), renal insufficiency for chloroquine therapy, plaquenil: haemolytic anaemia; SS and lactation (except in isolated cases such as disseminated SLE)
Gastrointestinal complaints -> dose reduction, possibly interruption. Hair loss, pigment shifts -> interruption. Pruritus, exanthema -> interruption, possible interruption. Exfoliative dermatitis -> interruption. Myopathy, neuropathy -> interruption, possibly abortion. Visual disturbances, retinopathy -> interruption for 6 months, possibly abortion Plaquenil. Agranulocytosis, aplastic anemia, thrombocytopenia, leukopenia -> abortion