Mepacrine

50-100 mg three times per week, often with hydroxychloroquine on the alternate days

• Base line assessment only - FBC, U&E and LFT inc Albumin
• Further blood monitoring is not required
• Enquiries about visual impairment will be done in the rheumatology clinic optician assessment within 1^st year, and annual assessments after 5 years
• Referral to ophthalmologist is appropriate if:
  • Visual impairment/eye disease detected at baseline
  • Change in acuity or blurred vision whilst on treatment (stop treatment until assessed)
  • Children

Avoid in psoriasis

Common effects are in bold type.

Mucocutaneous

• pruritis erythematous rash seen after treatment commenced.
• blue-black pigmentation of skin

Haematological

• thrombocytopenia
• agranulocytosis (very rare)

Gastrointestinal

• nausea
• diarrhoea
• abdominal cramps

Ocular

• cycloplegia
• keratopathy (reversible)
• irreversible retinopathy/maculopathy
• photophobia – advise sunglasses in bright light

Other

• headache
• bleaching of skin/hair
• proximal myopathy
• peripheral neuropathy

Secretaries 01387 241776

• Iseabail Graham
• Caron Cowen

Helpline 01387 241095 (answering machine)

Nurse Specialists:

• Petra Cannon
• Ingrid Crane
• Andrew Wilson 

Department of Rheumatology doctors via Switchboard 01387 246246

• Dr A Russell - Consultant
• Dr R Akintayo - Locum Consultant
• Dr A Drever - Associate Specialist
• Dr L Moran - Associate Specialist