plaquenil, retinopathy, antacids and methotrexate.?

[just_z]

my grandmother has been prescribed all of the above to treat her rheumatoid arthritis(of course the antacids are for something else but just as necessary, and the retinopathy is a possible side effect of the medications)
i'm attempting to research the effects of plaquenil and methotrexate together but i also need to know about the interaction of the plaquenil and the antacids as well as the possibility of the retinopathy.

every doctor she has seen seems to be less than sub par and don't quite have time to answer her questions.. this seems to be what happens when medicare is involved.. if you could help me out i'd greatly appreciate it.
thankyou

[ladypam]

With plaquenil and methotrexate, there are no known adverse interactions between the two, therefore safe to take together, although not simultaneously. However, with plaquenil and antacids, there is a moderate interaction wherein each may depress each individual action since they affect both their absorption in the body. It is suggested, especially if the benefits of taking them outweigh the moderate interaction that is caused, that the two medications be taken at least 2-4 hours apart to avoid them interacting with each other.

what medication is she taking for her retinopathy? or did it develop due to the medications taken?

It is quite unfortunate that a lot of doctors assigned to Medicare patients are not competent. I would suggest, if you are able, to check with another doctor, if you do not seem to be satisfied with your present one. You may want to pay a bit more for the health of your grandmother.

Hope this helps.

[just_z]

Hi, you mentioned that Planequil and methotrexate are safe to be taken together but not simultaneously. Then when is the right time I should give the other one? Thanks for the advice.

[tinmuning]

Another view here:

A small, single dose pharmacokinetic study has indicated that coadministration of methotrexate and chloroquine (a drug class where plaquenil belongs) may lead to a reduced bioavailability of methotrexate. Although it is agreed that more research should be done to prove this, it is advised that patients taking both drugs be monitored for signs of reduced efficacy of methotrexate & adjust its dose as needed.

As for plaquenil & antacids, it would be better if you specified what particular antacid is being taken. For example, Aluminum hydroxide (like Alu-Cap, Aludrox or Pepsamar) & magnesium compounds (such as milk of magnesia) can reduce the bioavailability of plaquenil, thus the latter is less absorbed by the body by 30 - 50%. The efficacy of plaquenil may be decreased, which could potentially result in therapeutic failure.
As ladypam had mentioned above, it is recommended that the administration of these antacids and plaquenil be separated by at least 4 hours.

[ladypam]

Since she is taking 3 different medications, you have to schedule them, based on their dosage. If she needs to take them only once a day, then you can space them at least 4 hours apart or better, 2 medications in the morning, like the antacid and methotrexate, then the plaquenil in the evening. at least you have more than 4 hours between medications.

Hope this helps.

[just_z]

Thank you Tinmuning for your informative view and thanks ladypam for your advice. I will take them 4 hours apart.