Plaquenil side effects - kidney problems?

Symptoms & Treatments
1

Hello,

I was recently told by my internal medicine doctor, after years of cataloging symptoms, that she was going to begin treating me for Lupus. She started me on the generic version of Plaquenil at 200 mg. I have had a really hard time on this medicine. I have had extreme nausea, diarrhea, stomach cramps, and intense vertigo. I began taking it on Thanksgiving day and still experience these side effects. A week ago I asked if there was anything we could do and she stated that this was the only treatment pill option. She cut my dose in half (100 mg) and that has partially helped the symptoms. However, now my joints are hurting again (hard to walk around my house since it is in my ankles mainly) and I am having a new symptom - pain in my lower left back. I have looked up common side effects but don't see anything about kidneys. I have had back pain before but this doesn't feel muscular. I have access to urinalysis strips and found protein in my urine, indicating a possible kidney problem. Could it be the medicine? Has anyone ever heard of that?

I am so new to all of this and just do not know what to do right now. Any help from those who have dealt with this before would be greatly appreciated.

Daisy

2

Hello DaisyRose and welcome. I'm sorry that you're going through all of this, especially with your lupus medicine. I myself have fibro and think I might have lupus symptoms too. From what I understand (and believe me, my knowledge of lupus is extremely limited,) your kidneys can be affected by lupus itself. Here is a bit of info that I copied from Lupus Foundation of America:

How does lupus affect the renal (kidney) system?

Lupus is an autoimmune disease that can affect almost any part of your body, most often your joints, skin, kidneys, heart, lungs, blood, or brain. Your two kidneys are part of your renal system, which also includes two ureters, the bladder, and the urethra. As the primary organs of the renal system, your kidneys are responsible for:

  • Maintaining the correct amount and type of body fluids
  • Removing waste products and toxic substances
  • Regulating the hormones (chemical messengers) that help control blood pressure and blood volume

Lupus Nephritis

Inflammation of the nephrons, the structures within the kidneys that filter the blood, is called glomerulonephritis, or nephritis. Lupus nephritis is the term used when lupus causes inflammation in your kidneys, making them unable to properly remove waste from your blood or control the amount of fluids in your body.

Abnormal levels of waste can build up in the blood, and edema (swelling) can develop. Left untreated, nephritis can lead to scarring and permanent damage to the kidneys and possibly end-stage renal disease (ESRD). People with ESRD need regular filtering of their body’s waste done by a machine (dialysis) or a kidney transplant so that at least one kidney is working properly.

Lupus nephritis most often develops within the first five years after the symptoms of lupus start. It usually affects people between 20 and 40. In the early stages of lupus nephritis, there are very few signs that anything is wrong. Often the first symptoms of lupus nephritis are weight gain and puffiness in your feet, ankles, legs, hands, and/or eyelids. This swelling often becomes worse throughout the day. Also, your urine may be foamy or frothy, or have a red color. The first signs of lupus nephritis often show up in clinical laboratory tests on the urine.

There's more at that site, and I suggest that you look lupus up and find out what you can and can't expect from lupus.

Oh, and I just love your screen name, as that's my tiny chihuahua's name too!

Warmly,

Petunia

3

Thanks Petunia. To be honest I haven’t looked much up because it scares me too badly. It’s necessary I know - but I’m having a hard time coming to terms with it all. I’m just scared.

4

DaisyRose welcome.

I take a truck load of pills literally. I take a prescription dosage (300 mg) of Zantac (ranitadine). If I don't take that my stomach hurts, can have intestinal cramps and end up writhing on the floor. I take it 1/2 hour before I take my major pills in the morning and evening. I also have to eat lotsa food when I take the drugs.

The meds we take are chemicals and they are usually hard to tolerate. Might be that you need something like Zantac, (there are other acid reducers on the market) to help you get your medicine down. This might be something else for you to consider.

If you're dehydrated some protein can show up in your urine.

Hope this helps.

You got to hold on.

5

Dear DaisyRose,
Sorry for the problems lupus brought to you. I'll keep it very short, but I could try to answer additional questions, if you have some.
1. With extremly high probability Plaquenil has nothing NEGATIVE to do with your lower back pain and with protein in urine. On the contrary.I t is one of the most frequently used medications for lupus because studies show that it may prevent lupus flares and kidney damage.

2. Both symptoms could/should be a reason to have your MD check for (lupus) nephritis.

3. Any of the following, especially combined, could point to nephritis

  • Foamy Urine-
  • Blood in the Urine-
  • Pain in Your Mid-back or ‘Flank’
  • Swelling- Usually in the legs, feet, or ankles (edema)
  • Dark Urine
  • High Blood Pressure
  • Changes in Frequency of Urination
  • Vomiting
  • Water Retention/ Weight Gain

In summary: Plaquenil isn't causing tyour new problems. It probably caused only the nausea, diarrhea, stomach cramps, and intense vertigo.

BTW: 100 mg daily may reduce side effects, but this low dosage also greatly annihilates its positive effects. 100 mg are a drop (maybe two ...) on a hot stone

And finally:

You should always take your anti-malarial medications with MILK and/or with regular food to prevent stomach upset. If a stomachache does occur, it is usually temporary. However, if you experience stomach upset while taking generic hydroxychloroquine, ask your doctor about trying name-brand Plaquenil instead. While these medications contain the same active ingredient, the preparation of generic hydroxychloroquine can sometimes cause stomach irritation. This sort of upset usually does not occur with commercial Plaquenil. Your doctor can ensure that you receive this version of the medication by writing “do not substitute” on your script.

Lastly, remember that even though you may feel the benefits of anti-malarial therapy after about a month of treatment, it may take up to three months for the full benefits of the drug to manifest.

Kind regards

6

I couldn’t agree more with the above post! I am curious if you can also begin seeing a rheumatologist?

7

Yes, plaquenil is difficult to adjust first, but after the first year of treatment and side effects, the benefits outweigh the problems. So, stick with it. In my opinion, the plaque nil is keeping the immune system regulated and the pain and other symptoms described will reduce. Lupus is not an illness without pain or sacrifice, but, it’s worth it.

8

Hi Daisy Rose.

Sorry you are suffering with this wonderful disease we have.

I was getting diarrhea after staring plaquenil. My Gastro dr gave me VSL-3, its a probiotic. It is like a miracle drug to me. I haven't had diarrhea in a year. Maybe you can try that. It's over-the-counter . The pharamacist has t get it, it has to be refrigerated. I recently had to take an antibiotic which has a side effect, for my, of diarrhea. She told me to take 3 VSL-3 a day. Worked great.

Take care. Rest. Do what you can do when you can do it.

Cindy

9

Please get an appointment with a well regarded rheumetologist. They have been extensively trained to manage Lupus patients, and the medicines used to treat them. There are medication options avaiable, and you may find one that works well for you. Each Lupus patient manifests the disease differently.

10

I have also tested with protein in the urine the past year and was THOROUGHLY checked by a nephrologist. My kidneys are fine. No idea why I tested positive for protein

11

I have Lupus Nephritis and have had it for almost 12 years now. I strongly suggest you get tested for it because it sounds like that's what you may have, especially with protein in your urine. Better to be safe than sorry. I also take Plaquenil but it's stictly for my joints, all of my other medications are for my kidney function. Take care and I hope everything turns out ok!

12

Thank you all so much for replying. I truly appreciate your time and willingness to help me figure this out. I called for an appt with a rheumatologist today. It may take a couple of months but my doctor said we can start trying to figure out ways to treat the symptoms from the medicine until then. *fingers crossed it works*. :)

13

I agree with Mariso, I doubt the Plaquenil is causing your low back pain. It’s possible it’s part of the disease. You shouldn’t be on a dose no lower than 200mg and probably should be on 400 mg per day. If you can, I HIGHLY suggest you order the book The Lupus Encyclopedia by Dr Donald Thompson. You can find it on Amazon and he also has a fb page The Lupus Encyclopedia. Great Dr and great info. He makes Lupus and it’s suffers his pain priority. I hope you find the correct diagnosis and treatment in the near future!

14

http://http://www.mollysfund.org/2015/01/plaquenil/

15


Sorry correction...Dr. Thomas
Jamie Lyn said:

I agree with Mariso, I doubt the Plaquenil is causing your low back pain. It's possible it's part of the disease. You shouldn't be on a dose no lower than 200mg and probably should be on 400 mg per day. If you can, I HIGHLY suggest you order the book The Lupus Encyclopedia by Dr Donald Thompson. You can find it on Amazon and he also has a fb page The Lupus Encyclopedia. Great Dr and great info. He makes Lupus and it's suffers his pain priority. I hope you find the correct diagnosis and treatment in the near future!
16

I found taking the plaquenil at bedtime- and not on an empty stomach minimized the side effects

17

I think it took six weeks for nausea symptoms to go away. Still get light headed but not sure why. PlAQUENIL had really helped my lupus problems. I was in the middle of a four month flare up and two months of 200mg dose twice a day kicked in after eight weeks. So much better.

18

It,took,me,a,good,6months,to,get,used,to,plaquenil,now,if,I,go,off,it,My,symptoms,are,severe.

When,I,was,DX,22,years,ago,I,had,kidney,involvement.My,kidneys,are,now,in,remission,but,still,suffer,from,Lupus,symptoms

everyday.Please,talk,to,your,rhematologist.He,checks,for,protein,in,my,urine,every,3,months,and,you,need,to,get,this,

checked,out,soon!

Good,Luck,and,best,wishes

19

Thank you everyone for your advice and comments. I asked fr a referral to a rheumatologist now and am following up on my kidneys. Plaquenil sucks - but I guess it could always be worse.

20

The alternative for me was changing my plaquenil and I can't remember the other one but my reumy changed me to Dolobid and Aralan. I no longer have the symptoms you explain. You have received great advise from all the reply's so there is no need for me to say the same thing. I agree with all posts. I wish you well.