MEPACRINE
What are the aims of
this leaflet?
This
leaflet has been written to help you understand more about mepacrine. It tells
you what it is, how it works, how it is used to treat skin conditions, and
where you can find out more about it.
What is mepacrine and
how does it work?
Mepacrine
(an unlicensed drug in the UK) was introduced as a treatment for malaria and
for certain other tropical infections. It is one of several antimalarial drugs
that have been found also to have anti-inflammatory properties, which can help
some skin conditions.
What does
“unlicensed” mean in relation to a drug?
An
unlicensed drug is one that has not been awarded a Market Authorisation from
the UK Medicines Healthcare Products Regulatory Agency (MHRA). A drug may be
licensed in other countries, but not in the UK. Drug licenses in the UK are
awarded following a rigorous process of evaluation by the MHRA following an
application by a pharmaceutical company. Once awarded, the licensed drug can
then be marketed and sold in the UK.
In
the absence of a license, the drug may still be prescribed in the UK, provided
there is funding available locally to pay for it. Additionally, there must be a
clear body of evidence to confirm that the drug is effective for the condition
in question and that safety concerns have been adequately addressed. Even after
such evidence has been supplied it is still a matter for the local formulary
group (a multidisciplinary group who make decisions on the prescribing of
medicinal drugs at a local level) to make a final decision on a case-by-case
basis.
Mepacrine is widely used for lupus in many countries including
the UK and North America but remains unlicensed and has to be obtained from a
TAJ
PHARMA INDIA, Taj Pharma Group (India), P.O. Box No. 12002, Azad Nagar Post
office,
Andheri
(w), Mumbai - 400 053. India. (+91) -22-2637 4592 (IST) (+91) -22-2637 4593
Fax: (+91) - (0)22-2634-1274
‘Specials’ pharmaceutical
manufacturer. It is listed as a treatment for discoid lupus erythematosus in
the British National Formulary.
Which skin conditions
are treated with mepacrine?
Mepacrine
is used particularly to treat discoid
lupus erythematosus and for subacute
cutaneous lupus erythematosus. Mepacrine has also been used in the treatment
of erythema multiforme, sarcoidosis and dermatomyositis (please see
the relevant BAD Patient Information Leaflets).
What dose of
mepacrine should I take?
Your doctor will advise you about this. For
skin conditions, the dose may be as small as 50 mg (half a 100 mg tablet) taken
three times a week. A maximum dose would be 100 mg, taken three times a day.
The dose for children is 2 mg per kg bodyweight, given as a split dosage three
times a day (to a maximum of 300 mg daily). It may take several weeks to reach
its full effect.
What are the possible
side effects of mepacrine?
Mepacrine is well tolerated at the low doses
used in dermatology. However, it can have some undesirable side effects:
Yellow discoloration of the skin and urine
may occur during long-term treatment or with large doses. This is common but
quite harmless, and should not be a cause for concern as it goes away when you
stop the drug. Similarly, the palate, nails and eyes may be discoloured blue or
black, which also resolve when you stop taking the drug.
Mepacrine can cause dizziness, particularly
when you get up from sitting or lying down. Getting up slowly should help to
reduce this side effect.
Other possible side effects include stomach
upsets, headaches, nausea and vomiting, rashes (occasionally severe), and
changes in mood or behaviour. Fits may occur with overdosing. Liver
inflammation and alterations in the blood count can occur but are rare.
Mepacrine should be
used with caution in:
patients
with porphyria elderly patients
the presence of liver disease
TAJ
PHARMA INDIA, Taj Pharma Group (India), P.O. Box No. 12002, Azad Nagar Post
office,
Andheri
(w), Mumbai - 400 053. India. (+91) -22-2637 4592 (IST) (+91) -22-2637 4593
Fax: (+91) - (0)22-2634-1274
Mepacrine
is best avoided by patients with psoriasis as it can make this condition worse.
It should also be avoided in myasthenia gravis and by patients with a history
of the severe forms of mental illness called psychoses.
How will I be
monitored for the side effects of mepacrine treatment?
Blood tests are usually performed twice a
year to check your blood count and liver function.
Can I have
vaccinations while I am on mepacrine?
Yes. This should not be a problem. If you are
travelling to a place where malaria occurs, mepacrine alone will not provide
adequate protection against it and you must see your GP to be prescribed
additional antimalarial treatment which may be taken at the same time as
mepacrine.
Does mepacrine affect
fertility or pregnancy?
There are no data on
the use of this drug in pregnancy and breastfeeding.
Consequently, it is recommended that you
should avoid taking it if you are pregnant or planning a pregnancy, or if you
are breast feeding.
May I drink alcohol
while I am taking mepacrine?
Mepacrine has been reported to produce a mild
flushing reaction when taken with alcohol. There may be symptoms such as a
racing heartbeat, dizziness, headache, shortness of breath, and sickness. If
you experience these symptoms it is advisable to avoid alcohol.
Can I take other
medicines at the same time as mepacrine?
Mepacrine is often used in conjunction
with hydroxychloroquine
for additional benefits. This is safe, however, some drugs do interact with
mepacrine. For example, mepacrine may increase the blood level of primaquine (a
medication used in the treatment of malaria), resulting in a higher risk of
toxicity, and it has been recommended that these two drugs should not be used
together
You should always let any doctors who are
treating you know that you are taking mepacrine.
TAJ
PHARMA INDIA, Taj Pharma Group (India), P.O. Box No. 12002, Azad Nagar Post
office,
Andheri
(w), Mumbai - 400 053. India. (+91) -22-2637 4592 (IST) (+91) -22-2637 4593
Fax: (+91) - (0)22-2634-1274
If
you want to know more about mepacrine, or if you are worried about your
treatment, you should speak to your doctor or pharmacist. This information
sheet does not list all of the side effects of mepacrine. For fuller details,
look at the medicine information sheet which comes as an insert with your
prescription for mepacrine.
Web links to detailed
leaflets:
Taj Pharma India's business can be
contacted by common group
e-mail: tajgroup@tajpharma.com, and query --will be forwarded to the relevant departments; additionally, telephone lines +91 - (0)22 - 26374592 / 93 can be utilised if -you have an enquiry about the company, our healthcare business, or one of our medicines at India Standard Time (IST)
e-mail: tajgroup@tajpharma.com, and query --will be forwarded to the relevant departments; additionally, telephone lines +91 - (0)22 - 26374592 / 93 can be utilised if -you have an enquiry about the company, our healthcare business, or one of our medicines at India Standard Time (IST)
TAJ PHARMA INDIA
Taj
Pharma India Correspondence
Taj Pharma Group (India)
P.O. Box No. 12002,
Azad Nagar Post office,
Andheri (w), Mumbai - 400 053.
India.
Taj Pharma Group (India)
P.O. Box No. 12002,
Azad Nagar Post office,
Andheri (w), Mumbai - 400 053.
India.
(+91)
-22-2637 4592 (IST)
(+91) -22-2637 4593
Fax: (+91) - (0)22-2634-1274
(+91) -22-2637 4593
Fax: (+91) - (0)22-2634-1274
TAJ
PHARMA INDIA, Taj Pharma Group (India), P.O. Box No. 12002, Azad Nagar Post
office,
Andheri
(w), Mumbai - 400 053. India. (+91) -22-2637 4592 (IST) (+91) -22-2637 4593
Fax: (+91) - (0)22-2634-127
