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Can a Gp prescribe Plaquenil?

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  • Can a Gp prescribe Plaquenil?

    Just wondering if a Gp can prescribe plaq? Im ana negative but have lots of symptoms such as joint and muscle pain, fatigue sun sensitivity dry eyes and a butterfly rash which was biopsied but nothing was picked up. Ive been to see a rheumatolgist but he wont diagnose or treat without the ana. My Gp believes thats theres something autoimmune going on but can he treat me or does it have to be a consultant to first prescribe it?

    Thanks

  • #2
    I'm not sure, my GP does, but I have been diagnosed. Where do you live? I'm only familiar with the Irish system.

    :welcome: to the site by the way!

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    • #3
      Hi Chasing butterlfies
      not totally sure.all can say in my case i was also ana negative my rheumy got me see a collegaue of his who added plaquenil.and my Gp then did repeats once got consultants medication change precription for her.

      no harm asking 2nd opinion to see different rheumy...take care...hope you get chance give it go.
      countrylass

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      • #4
        Hi Butterflies and welcome to the lupus site.

        Not knowing where you are from makes answering hard. When first diagnosed by my old GP he did prescribe plaq.
        Take care,
        Lyn

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        • #5
          Hiya.. I would be concerned by a Rheumy that doesn't know that 2% don't have positive bloodwork..so maybe if you could get a second opinion from a Rheumy who knows his onions then you would start getting the treatment generally that you need to feel better.....just my thoughts.
          I wish you well x

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          • #6
            My GP does, but I had it originally prescribed by a rheumatologist and my GP just writes out the script if I run out before I have another appointment. I don't have a solid diagnosis. The biggest thing is the build up in your eyes, so your GP would have to be confident that he/she could monitor that and you'd have to trust them.

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            • #7
              I'm Irish also. I was prescribed plaquenil by my Rheumy after extensive blood tests for nearly a year in the hospital 2010. I'm positive for nuclear antigens SSA, RO52, SSB and a very elevated IGG which they were extremely concerned about cos it's very high! Over 28! (normal level are 6.4 14.3) I think my IGG prompted them to give me every blood test possible, albeit they suspected I had MGUS, but a final blood test that had to be sent away came back negative. MGUS is early stage Myleoma but I don't want everyone to worry that they have MGUS as it is very rare, So let there be no panic! I had all my tests done through the public health system here which I found very good but unfortunatley in Ireland our health system is regressing! I consider myself lucky because I'm in the system now!?!? Anyways if your tests are negative and you have a good health system? try not to worry yourself too much and I know it is easier said than done! but blood tests are very significant and negative results are very positive in a good way! however I appreciate that there are the small % that are missed. Hope this is helpful to you. Susan:luck:

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              • #8
                Im Irish, 29 and have had symptoms for a few years. I have a provisional diagnosis from a leading consultant dermatologist who does clinics with rheumatologists and haematologists, of 'incomplete lupus with sjogrens overlap' in which she thinks will eventually evolve into full SLE. She said that she often sees it where a person is symptomatic and the antibodies are slow to show up in the blood but that they will eventually turn positive. But this was just an opinion really as my GP met with her at a conference and showed her photos of my rashes. I thought he might be able to prescribe me the plaq as she suggested it, but now he wants to send me to another dermatologist to confirm the diagnosis because even though hes sure its lupus he cannot prescribe plaq. Hes a Gp but specialises in skin conditions. He performed my biopsy. Hes a really nice man and is doing all he can to help me.

                I was diagnosed with sjogrens and raynauds by the first private rheumatolgoist i seen but no treatment was offered then second rheum agreed my symptoms were lupus like but because of negative ana lupus was out of question and sent me on my way! All ive had done are ANA test and FB counts the labs here refuse to do any more antibody testing once the ANA is negative even under instruction from a private rheum! So I have not been tested for the Ro or La antibody. I had a positive schrimer test which suggested the sjogrens overlap.

                I also sent an email to the london lupus centre with my photos as attachments and professor graham hughes wrote back to me and said that my symptoms and clincial picture strongly suggest an autoimmune problem. Ive also just found out that my grandmother has had RA since her early 30s which she has been on medication for since. I know that RA and lupus are of the same spectrum. I feel im definately getting closer to a firm diagnosis but its been one heck of a fight!
                Last edited by chasingbutterflies; 03-12-2012, 05:35 PM. Reason: Forgot to add something

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                • #9
                  Hi Chasingbutterflies,

                  Susan here again. I have Sjogrens with Lupus markers and raised RA, Raynauds and Neutropenia. Did you have a CRP and ESR blood test (a blood test which indicates inflammation)? these are important blood tests for imflammatory markers. I'm just taking the Plaquenil at the moment with prescribed pain relief. I was with my Rheumy 2 weeks ago as I have some new problems particularly with pain in my left leg which is severe, its nerve pain called sciatica, but my left leg feels very heavy and rheumatoid also. He suggested Lyrica, my doctor had also suggested this medication, but I'm unhappy to take it at the moment but I may have to as the mobility in my leg is very compromised now and the pain is constant, even wakes me up in the night. I'm older than you, 48! I feel young though because I'm a mature student in a class full of very young people but they are all very good to me and we all get on great! I'm only on the Plaquenil now for 5 months and the most noticeable improvement I noticed was with my Lungs as I had some Sjogren's Pleurisy which has now completely cleared up and that's a great relief for me. I'm hoping the same will happen for my leg issue! It's better to be optimistic than pessimistic but that's easier said than done also. Hope all goes well for you with your diagnosis. Susan :luck:

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                  • #10
                    How frustrating! It certainly seems as if it has been a struggle to even get answers this far. I'd imagine your GP won't prescribe plaquenil without the express consent of a specialist. Can your GP not send your to the dermy he showed pictures of your rashes to?

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                    • #11
                      Thanks Susan

                      Nellie, that dermatologist was over from Oxford England and is retiring soon (typical) so hes sending me to another dermatologist he met with here in ireland who specialises in connective tissue diseases. so im hoping he will prescribe me the plaq. I just want to see if theres improvement. The last rheumatologist i went to offered me steroids but didnt think there was anything wrong with me! so i refused them because i want to treat the problem not mask it. I asked him to put me on plaq instead but his nose was out of joint because i told him of this ladys diagnosis and he said that whoevers diagnosing u will have to treat u! cant win

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                      • #12
                        Steroids to help though - sometimes a really good response to steroids can indicate an autoimmune condition. Plaq takes a lot of time to kick in, so doctors often prescribe a boost of steroids while it kicks in.

                        Good luck with referral!

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