[Joandublin]

Hi everyone

Prompted by a question posed by Clare on another thread, I decided to check and see what the availability of Mepacrine (Atabrine) is in Ireland. Mepacrine (known as Quinacrine in the USA) is an anti malarial that sort of lost out in the shuffle with Plaquenil and is rarely prescribed nowadays - having been more or less forgotten.

However in recent times it is being prescribed by St. Thomas's in London for some of their patients in conjunction with Plaquenil and is proving to be extremely effective particularly with resistant skin involvement.

I checked with my pharmacy in Dublin and they advise that Mepacrine can be sourced in Ireland in 100mg tablets. It is unlicensed but can be prescribed by a doctor and the medication would be covered under the Irish Drug Payment Scheme of €90 per month.

I just wanted to post this here for information for any Irish members as a possible additional treatment option for those particularly with skin involvement that is not responding well to the Plaquenil alone.

Luv n stuff
Joan:rose:

 

[Clare.T]

Thank you Joan! That's invaluable information. This drug needs to be far better known and more widely used.

Mepacrine/ Quinacrine is a very useful alternative to Plaquenil for those who can't tolerate Plaquenil for some reason. A special advantage is that it does not affect the eyes.
Together with either Plaquenil or Aralen( chloroquine) it forms a powerful combination with each enhancing the other. Mepacrine's special attribute is energising. It can be used just like Plaquenil - although its use for lupus where skin is a major problem is better known, it is also very good for joints - any of the general symptoms of lupus and the combo could mean that more drugs with more likelihood of side effects are not necessary or in reduced doses.
A possible side effect is skin yellowing but that is very variable. I have been on it about ten years and you have to look very closely under suitable lights to detect the faintest yellow tinge on forearms and shins. On the forearms anybody with microscopic eyes would probably think it was the slightest of tans. Reactions are very individual.
As with Plaquenil there are groups for whom it is not indicated or needs to be used with caution.

I don't know how long St Thomas' has been using it although I dont think it's all that recent but its use along with Plaquenil was well known when it was available off the shelves. We have a link to a paper about it by Dr D Wallace, the eminent American lupologist, which I'll post shortly.



Cheers
Clare

 

[joirish]

Hi Joan

I was one of those people who got prescribed Mepacrine when I went to see Dr D'Cruz in London Bridge Hospital in 2005. His idea behind it was to use with Plaquenil to give it a boost. I had been on Plaquenil for 4yrs and felt it had run it course with me need something else as well as all the other usually meds.

I thought it would have fierce difficult getting it but I can get it on my medical card (free). The HSE(our health system) can give it out, all I have to do is sign a form every month.

They doc's here were slow to prescribe it but if Plaquenil needs something else then this can work......

Cheers
Jo

 

[Katharine]

That is very intersting info. Thanks for that

 

[LolaLola]

I would also recommend mepacrine for its benefits to the skin.
I did go rather yellow , having been very pale before it shows more but it is still worth it. My friends jokingly say I look like a "simpsons" character but I am not THAT yellow really.

It does taste rather bitter, but is soon got used to.
x Lola

 

[raggedyann1]

Joan,
Thank you so much for running down that information.

I will add for those in the USA that Quinacrine has to be ordered from a compounding pharmacy and not all compounding pharmacies make it. If you have trouble finding a pharmacy and your doctor is willing to prescribe please post and at least one of us will give a name of a pharmacy. The other thing is that most insurance plans do not cover medications like Quinacrine so it is cash out of pocket.

Karen

 

[mysharonna]

I can also attest to the benefits of Quinacrine, it worked wonderfully for me. As I live in the states, I had to order from a compounding pharmacy and have it delivered.

I did have to pay for it, but submitted my bill to the insurance company and was reinbursed for my out of pocket expense.
I'm not sure if all insurance companies will do the same, but certainly worth a try!