pharmachologic effect

Plakvenil has antimalarial properties, and also has anti-inflammatory and immunosuppressive effects in chronic discoid or systemic lupus erythematosus (SLE), acute and chronic rheumatoid arthritis. The mechanism of its action for malaria, SLE and rheumatoid arthritis is not fully known.

Hydroxychloroquine has the properties of a moderate immunosuppressant, suppressing the synthesis of the rheumatoid factor and the components of the acute phase reaction. It also accumulates in leukocytes, stabilizing the lysosomal membranes, and inhibits the activity of many enzymes, including. collagenase and proteases, which cause the decay of cartilage.

Efficacy in SLE and rheumatoid arthritis is associated with the following anti-inflammatory and immunomodulating effects of hydroxychloroquine:

- Increase in intracellular pH leads to a slowing of the antigenic response and decreases the binding of peptides of the main histocompatibility complex (MHC) receptors; a smaller number of antigen-MHC receptors reaches the cell surface, which leads to a decrease in the autoimmune response;

- decrease in activity of phospholipase A2 at high concentrations, lysosomal enzymes;

- a decrease in the concentrations of IL-1 and IL-6 cytokines, leading to a decrease in the clinical and laboratory parameters of the autoimmune response; since there is no violation of the synthesis of interferon gamma, these effects can be associated with a selective effect on cytokines;

- inhibition of pre- and / or posttranscriptional DNA and RNA.

The drug actively suppresses asexual erythrocyte forms, as well as gametes of Plasmodium vivax and Plasmodium malariae, which disappear from the blood almost simultaneously with asexual forms. Plaquenyl does not affect the gametes of Plasmodium falciparum. It is not effective against chloroquine resistant strains of Plasmodium falciparum, and is also not active against the extraerythrocyte forms of Plasmodium vivax, Plasmodium malariae and Plasmodium ovale and therefore can not prevent infection by these microorganisms when prescribing for preventive purposes, nor is it able to prevent the relapse of the disease caused by these pathogens.

Indications
- rheumatoid arthritis;

Juvenile rheumatoid arthritis;

- systemic lupus erythematosus;

Discoid lupus erythematosus.

Malaria (with the exception of chloroquine-resistant strains of Plasmodium falciparum):

- for the prevention and treatment of acute attacks of malaria caused by Plasmodium vivax, Plasmodium ovale and Plasmodium malariae, and by sensitive strains of Plasmodium falciparum;

- for the radical treatment of malaria caused by sensitive strains of Plasmodium falciparum.