Leitura clínica
Comentário
Antimalárico usado como anti-inflamatório e agente imunológico em colagenoses como artrite ou lúpus sistêmico ou discóide, artrite reumatoide, porfiria cutânea tarda, sarcoidose e outras doenças cutâneas. Utiliza-se também na profilaxia do tromboembolismo venoso. Sua eficácia foi ensaiada no tratamento da COVID-19 (Elavarasi 2020, SEFH 2020). Administração oral. Excreta-se no leite materno em quantidade clinicamente não significativa, muito inferior à dose utilizada em bebês que mamam (Peng 2019, Liu 2016, Cissoko 2010, Costedoat 2002, Ostensen 1985, Nation 1984). Não foram observados problemas clínicos nem de desenvolvimento nem de visão ou audição em bebês que mamam cujas mães a tomavam (Peng 2019, Motta 2005 e 2002, Cimaz 2004, Tincani 2001). Quando a mãe toma 400 mg ao dia, aparecem 1 mg em cada litro de leite, quantidade que não seria perigosa para o bebê que mama, pois a dose preventiva para malária em bebês que mamam é 5 mg por quilo de peso por semana. Diversas sociedades médicas, especialistas e consensos de especialistas consideram compatível o uso desta medicação durante a amamentação (Hale, Sammaritano 2020, Briggs 2017, Flint 2016, Götestam 2016, Kavanaugh 2015, Schaefer 2015). Academia Americana de Pediatria: medicação usualmente compatível com a amamentação (AAP 2001). Pode consultar abaixo a informação destes produtos relacionados: Artrite Reumatoide (AR) Materna (Bastante seguro. Efeitos adversos leves ou pouco prováveis. Compatível em determinadas circunstâncias. Acompanhamento recomendado. Leia o Comentário.) Lúpus (Bastante seguro. Efeitos adversos leves ou pouco prováveis. Compatível em determinadas circunstâncias. Acompanhamento recomendado. Leia o Comentário.)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 4
- Υδροξυχλωροκίνη θειϊκή
- Гидроксихлорохина Сульфат
- 硫酸ヒドロキシクロロキン
- P01BA02
Marcas comerciais na fonte 20
- Axokine
- Dolquine
- Ercoquin
- Evoquin
- Fen Le (纷乐)
- HCQS
- Hydroquin
- Ilinol
- Immard (Иммард)
- Metirel
- Narbon
- Parenquil
- Plaquenil
- Plaquenil (Плаквенил)
- Plaquenil (赛能)
- Plaquinol
- Polirreumin
- Quensyl
- Reumazine
- Reuquinol
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 74 | % |
| Peso Molecular | 434 | daltons |
| Unión proteínas | 63 | % |
| Vd | 580 - 815 | l/Kg |
| Tmax | 1 - 2 | horas |
| T½ | 768 - 1200 | horas |
| Índice L/P | 5,5 | - |
| Dosis Teórica | 0,06 - 0,2 | mg/Kg/d |
| Dosis Relativa | 0,9 - 3 | % |
| Dosis Rel. Ped. | 0,4 - 6,6 | % |
Rastreabilidade
Bibliografia
- Elavarasi A, Prasad M, Seth T, Sahoo RK, Madan K, Nischal N, Soneja M, Sharma A, Maulik SK, Shalimar, Garg P. Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: a Systematic Review and Meta-analysis. J Gen Intern Med. 2020 Nov;35(11):3308-3314. Consultado el 30 de Noviembre de 2020 Resumen
- Pluma A, Hamroun S, Rüegg L, Cecchi I, Kramer M, Perez-Garcia LF, Rivero T, Finckh A, Meissner Y, Förger F. Antirheumatic drugs in reproduction, pregnancy, and lactation: a systematic literature review informing the 2024 update of the EULAR recommendations. Ann Rheum Dis. 2025 Sep;84(9):1561-1590. Resumen Texto completo (enlace a fuente original)
- Ikram N, Eudy A, Clowse MEB. Breastfeeding in women with rheumatic diseases. Lupus Sci Med. 2021 Apr;8(1). pii: e000491. Resumen Texto completo (enlace a fuente original)
- SEFH - Sociedad Española de Farmacia Hospitalaria. Procedimientos de farmacia hospitalaria para la gestión del tratamiento con antivirales en la enfermedad por el nuevo coronavirus sars-cov-2 (COVID-19). Recomendaciones de la Sociedad Española de Farmacia Hospitalaria. None 2020 Texto completo (en nuestros servidores)
- Sammaritano LR, Bermas BL, Chakravarty EE, Chambers C, Clowse MEB, Lockshin MD, Marder W, Guyatt G, Branch DW, Buyon J, Christopher-Stine L, Crow-Hercher R, Cush J, Druzin M, Kavanaugh A, Laskin CA, Plante L, Salmon J, Simard J, Somers EC, Steen V, Tedeschi SK, et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol. 2020 Apr;72(4):529-556. Resumen Texto completo (enlace a fuente original)
- Peng W, Liu R, Zhang L, Fu Q, Mei D, Du X. Breast milk concentration of hydroxychloroquine in Chinese lactating women with connective tissue diseases. Eur J Clin Pharmacol. 2019 Nov;75(11):1547-1553. Resumen
- Bitencourt N, Bermas BL. Pharmacological Approach to Managing Childhood-Onset Systemic Lupus Erythematosus During Conception, Pregnancy and Breastfeeding. Paediatr Drugs. 2018 Dec;20(6):511-521. Resumen
- Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016 Aug;25(9):973-9. Resumen
- Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016 May;75(5):795-810. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Flint J, Panchal S, Hurrell A, van de Venne M, Gayed M, Schreiber K, Arthanari S, Cunningham J, Flanders L, Moore L, Crossley A, Purushotham N, Desai A, Piper M, Nisar M, Khamashta M, Williams D, Gordon C, Giles I; BSR and BHPR Standards, Guidelines and Audit Working Group. BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford). 2016 Sep;55(9):1693-7. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Levy RA, de Jesús GR, de Jesús NR, Klumb EM. Critical review of the current recommendations for the treatment of systemic inflammatory rheumatic diseases during pregnancy and lactation. Autoimmun Rev. 2016 Resumen
- Kavanaugh A, Cush JJ, Ahmed MS, Bermas BL, Chakravarty E, Chambers C, Clowse M, Curtis JR, Dao K, Hankins GD, Koren G, Kim SC, Lapteva L, Mahadevan U, Moore T, Nolan M, Ren Z, Sammaritano LR, Seymour S, Weisman MH. Proceedings from the American College of Rheumatology Reproductive Health Summit: the management of fertility, pregnancy, and lactation in women with autoimmune and systemic inflammatory diseases. Arthritis Care Res (Hoboken). 2015 Mar;67(3):313-25. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Costedoat-Chalumeau N, Dunogué B, Morel N, Le Guern V, Guettrot-Imbert G. Hydroxychloroquine: a multifaceted treatment in lupus. Presse Med. 2014 Resumen
- Sammaritano LR, Bermas BL. Rheumatoid arthritis medications and lactation. Curr Opin Rheumatol. 2014 Resumen
- Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Resumen
- Jain V, Gordon C. Managing pregnancy in inflammatory rheumatological diseases. Arthritis Res Ther. 2011 Resumen Texto completo (enlace a fuente original)
- Zrour-Hassen S, Jguirim M, Aouam K, Korbaa W, Younes M, Bejia I, Touzi M, Bergaoui N. [Safety of rheumatic disease drugs at childbearing age]. Therapie. 2010 Resumen
- Mathieu O, Masson F, Thompson MA, Leplay M, Mazurier E, Hillaire-Buys D. (Abstracts of the 14th Annual Meeting of French Society of Pharmacology and Therapeutics, 77th Annual Meeting of Society of Physiology, 31th Pharmacovigilance Meeting, 11th APNET Seminar and 8th CHU CIC Meeting, 23-25 March 2010, Bordeaux, France). Case report: in utero exposure and safe breastfeeding in two premature twins of a chronically treated mother with high doses of zopiclone. Fundam Clin Pharmacol 2010;24 (Suppl. S1), 88. abst424. doi:10.1111/j.1472-8206.2010.00819.x
- Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Resumen Texto completo (en nuestros servidores)
- Cissoko H, Rouger J, Zahr N, Darrouzaina F, Jonville-Beraa AP, Autret-Lecaa E. Breast milk concentrations of hydroxychloroquine. 2010;24 (Suppl. 1):87. Abstract 420. doi:10.1111/j.1472-8206.2010.00819.x.
- Weber JC, Kuhnert C. Traitements de fond des affections inflammatoires systémiques au cours de l’allaitement. [Breastfeeding and drug management in connective tissue and rheumatic diseases]. Rev Med Interne. 2008 Dec;29(12):1017-23. Resumen
- Østensen M, Motta M. Therapy insight: the use of antirheumatic drugs during nursing. Nat Clin Pract Rheumatol. 2007 Resumen
- Østensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H, Doria A, Rai R, Meroni P, Cetin I, Derksen R, Branch W, Motta M, Gordon C, Ruiz-Irastorza G, Spinillo A, Friedman D, Cimaz R, Czeizel A, Piette JC, Cervera R, Levy RA, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Costedoat-Chalumeau N, Amoura Z, Huong DL, Lechat P, Piette JC. Safety of hydroxychloroquine in pregnant patients with connective tissue diseases. Review of the literature. Autoimmun Rev. 2005 Resumen
- Costedoat-Chalumeau N, Amoura Z, Le Thi Huong D, Wechsler B, Piette JC. [Pleading to maintain hydroxychloroquine throughout Lupus pregnancies]. Rev Med Interne. 2005 Resumen
- Motta M, Tincani A, Faden D, Zinzini E, Lojacono A, Marchesi A, Frassi M, Biasini C, Zatti S, Chirico G. Follow-up of infants exposed to hydroxychloroquine given to mothers during pregnancy and lactation. J Perinatol. 2005 Feb;25(2):86-9. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Temprano KK, Bandlamudi R, Moore TL. Antirheumatic drugs in pregnancy and lactation. Semin Arthritis Rheum. 2005 Resumen
- Cimaz R, Brucato A, Meregalli E, Muscará M, Sergi P. Electroretinograms of children born to mothers treated with hydroxychloroquine during pregnancy and breast-feeding: comment on the article by Costedoat-Chalumeau et al. Arthritis Rheum. 2004 Sep;50(9):3056-7; author reply 3057-8. No abstract available. Resumen Texto completo (en nuestros servidores)
- Motta M, Tincani A, Faden D, Zinzini E, Chirico G. Antimalarial agents in pregnancy. Lancet. 2002 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Al-Herz A, Schulzer M, Esdaile JM. Survey of antimalarial use in lupus pregnancy and lactation. J Rheumatol. 2002 Resumen
- Costedoat-Chalumeau N, Amoura Z, Aymard G, Le TH, Wechsler B, Vauthier D, Dermer ME, Darbois Y, Piette JC. Evidence of transplacental passage of hydroxychloroquine in humans. Arthritis Rheum. 2002 Apr;46(4):1123-4. No abstract available. Resumen
- Tincani A, Faden D, Lojacono A, Zatti S, Palai N, Biasini C, Frassi M, Taglietti M, Gorla R, Balestrieri G, Vescovi F, Doria A, Gerosa M, Trespidi L, Meroni PL, Castellino G, Brucato A, Chirico G, Motta M. Hydroxychloroquine in pregnant patients with rheumatic disease. Arthritis Rheum. 2001;44 (Suppl 9):S397. Abstract 2065. 2001 Texto completo (en nuestros servidores)
- AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Canadian rheumatology association. Canadian Consensus Conference on hydroxychloroquine. J Rheumatol. 2000 Resumen
- Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Resumen
- Ostensen M, Brown ND, Chiang PK, Aarbakke J. Hydroxychloroquine in human breast milk. Eur J Clin Pharmacol. 1985;28(3):357. Resumen
- Nation RL, Hackett LP, Dusci LJ, Ilett KF. Excretion of hydroxychloroquine in human milk. Br J Clin Pharmacol. 1984 Mar;17(3):368-9. No abstract available. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)