Specifically, is the risk of impaired wound healing or increased chance of infection worth avoiding the possible side effects associated with temporary cessation during the perioperative period. The appropriate use of immunosuppressants (IS) during elective surgery has been debated extensively with conflicting results, through the current body of literature. Substitutes for plaquenil Hydroxychloroquine class Plaquenil mechanism of action Nov 12, 2009 Plaquenil is a 6-weeker as far as the benefits are concerned, but it would be more dangerous to stop if you spend a lot of time outside and if this were the summer. If you're gonna experiment, I went off it cold turkey as it didn't hurt to do it that way, but you better get back on before the summer or you could experience a flare-up. Biologic agents should be held with surgery scheduled at the end of dosing cycle and restarted when the wound is healed, sutures/staples are removed, and there are no signs of infection ~14 days. Tofacitinib should be held for all conditions except SLE for 1 week. After the surgery, the blind area was more noticeable because my sight in that eye was so much clearer,” she says. “The surgeon sent me to a retina specialist, who recommended that I cut down my dose of Plaquenil. Finally, my rheumatologist recommended that I stop taking the drug altogether.” This discussion includes an overview of the pharmacology and use of eight of the common IS medications: azathioprine, cyclosporine, hydroxychloroquine, infliximab, leflunomide, methotrexate, methylprednisolone, and mercaptopurine. Herein, we aim to provide a comprehensive, yet streamlined, overview of the common IS medications that surgeons are likely to encounter in practice in a wide variety of patients. Stopping plaquenil before surgery Perioperative Management of Medications Used in the Treatment., Summary of guidelines for DMARDs for elective surgery. Plaquenil vs rituximab rituxan It is my impression that most rheumatologists discontinue MTX during the perioperative period -- generally the week of surgery and for 1-2 weeks post surgery. Rheumatoid Arthritis Should Methotrexate Be Discontinued.. Protecting your eyesight when taking Plaquenil Lupus.. Stopping Plaquenil - General Discussion - Life With Lupus. Nov 29, 2010 my rheumy's assistant left me a message to tell me to stop 2 weeks before my procedure, but didn't explain why. one more question for those of you who had surgery aside from going off or staying on plaquenil, did the surgery cause any noticeable flare up of your symptoms? i will certainly update you once i am back home and online again. Three hundred and eighty-eight patients undergoing elective orthopedic surgeries were randomized to either continue or to stop MTX therapy for 2 weeks before surgery and resume 2 weeks postoperatively. The patients were followed for up to 1 year. Patients who continued their MTX had an infection rate of 2%. It may take up to six months before the full benefits of Plaquenil are realized. Dosage The usual starting dose of Plaquenil is 200 mg twice a day or 400 mg once a day, administered orally, in people weighing 80 kg or more.