Hydroxychloroquine
Hydroxychloroquine is used to treat lupus, rheumatoid arthritis, and malaria. It is available as Plaquenil and is commonly prescribed in the immunology category.
About Hydroxychloroquine
Hydroxychloroquine is an antimalarial / conventional synthetic disease-modifying antirheumatic drug (csdmard) also known by the brand name Plaquenil. It is primarily used to hydroxychloroquine is prescribed to treat: • Lupus, rheumatoid arthritis, and malaria • Various related conditions in the immunology category • Associated symptoms and complications It is an important medication that helps manage these conditions effectively. Hydroxychloroquine is available in oral tablet (200 mg hydroxychloroquine sulfate, equivalent to 155 mg base) form. Healthcare providers commonly prescribe Hydroxychloroquine for conditions including Attention Deficit Hyperactivity Disorder (ADHD), Lupus Anticoagulant, and Vertigo.
Hydroxychloroquine at a Glance
- Brand names
- Plaquenil
- Drug class
- Antimalarial / Conventional Synthetic Disease-Modifying Antirheumatic Drug (csDMARD)
- Pregnancy category
- FDA Category Category C — Hydroxychloroquine crosses the placenta. Decades of use in pregnancy for systemic lupus erythematosus have not shown an increased risk of fetal malformations, and current rheumatology guidelines recommend continuing it during pregnancy in patients with lupus to reduce disease flares and adverse pregnancy outcomes.
- Available forms
- Oral tablet (200 mg hydroxychloroquine sulfate, equivalent to 155 mg base)
- Therapeutic categories
- Immunology, Rheumatology, Antimalarials
- Conditions treated
- 3 related conditions on this site
What Hydroxychloroquine Is Used For
Hydroxychloroquine is prescribed to treat:
• Lupus, rheumatoid arthritis, and malaria • Various related conditions in the immunology category • Associated symptoms and complications
It is an important medication that helps manage these conditions effectively.
Dosage Quick Reference
These are general dosage guidelines for Hydroxychloroquine. Your doctor will determine the appropriate dose for your specific situation.
| Condition | Starting Dose | Maintenance Dose |
|---|---|---|
| Rheumatoid arthritis | 400–600 mg/day in 1–2 divided doses with food | 200–400 mg/day; do not exceed 5 mg/kg actual body weight per day |
| Systemic lupus erythematosus | 400 mg once or twice daily | 200–400 mg/day; do not exceed 5 mg/kg actual body weight per day |
| Cutaneous lupus | 200–400 mg/day | 200–400 mg/day with annual ophthalmologic monitoring |
| Malaria prophylaxis | 400 mg once weekly, starting 1–2 weeks before travel | 400 mg once weekly during travel and for 4 weeks after return |
| Acute uncomplicated malaria | 800 mg, then 400 mg at 6, 24, and 48 hours | Total 2 g over 3 days |
Side Effects
Common side effects may include:
• Nausea or stomach upset • Headache • Dizziness or lightheadedness • Fatigue or tiredness • Mild rash or itching
Serious side effects (seek immediate medical attention):
• Severe allergic reactions (rash, hives, swelling, difficulty breathing) • Unusual bleeding or bruising • Severe stomach pain • Signs of liver problems (yellowing of skin/eyes, dark urine) • Chest pain or irregular heartbeat • Severe dizziness or fainting • Signs of serious adverse effects
See also: Drug Interactions ↓
Drug Interactions
Hydroxychloroquine has several clinically meaningful interactions, particularly involving cardiac conduction and blood glucose.
- QT-prolonging agents (e.g., azithromycin, fluoroquinolones, ondansetron, citalopram, methadone): Hydroxychloroquine prolongs the QT interval, and combinations with other QT-prolonging drugs raise the risk of torsades de pointes. Obtain a baseline ECG when combining and avoid co-use in patients with congenital long QT syndrome.
- Insulin and oral hypoglycemics (e.g., metformin, sulfonylureas): Hydroxychloroquine improves insulin sensitivity and may cause hypoglycemia. Monitor glucose closely and consider lowering antidiabetic medication doses, especially when starting therapy.
- Digoxin: Hydroxychloroquine increases serum digoxin levels. Recheck digoxin levels within 1–2 weeks of starting therapy and adjust dose to maintain a therapeutic level.
- Cyclosporine and tacrolimus: Hydroxychloroquine can raise levels of these immunosuppressants. Monitor trough levels and renal function in transplant or autoimmune patients.
- Antacids and kaolin: Reduce hydroxychloroquine absorption. Separate administration by at least 4 hours.
- Methotrexate: Combination is common in rheumatoid arthritis and is generally well tolerated. Monitor liver enzymes and complete blood count routinely.
See also: Questions to Ask Your Doctor ↓
Key Considerations
Known drug interactions
Hydroxychloroquine has documented interactions with other medications, supplements, and certain foods. Review the Drug Interactions section below and tell your healthcare provider about every medication you take, including over-the-counter products. Jump to section →
Additional Information
What is Hydroxychloroquine?
Hydroxychloroquine (generic name: Hydroxychloroquine) is a medication primarily used to treat lupus, rheumatoid arthritis, and malaria. It is marketed under the brand name(s) Plaquenil and belongs to the Immunology category of medications.
How Does Hydroxychloroquine Work?
Hydroxychloroquine works through several mechanisms to provide therapeutic benefits:
- Acts on specific receptors or pathways in the body
- Modulates biological processes related to the treated condition
- Provides symptom relief and improves quality of life
- Helps manage the underlying condition effectively
- Works best when combined with appropriate lifestyle modifications
The medication is designed to target the specific pathways involved in lupus, rheumatoid arthritis, and malaria, making it an effective treatment option.
Common Uses
Primary Indications
Hydroxychloroquine is commonly prescribed for:
- Lupus, rheumatoid arthritis, and malaria: The main indication for this medication
- Related Conditions: Associated symptoms and complications
- Prevention: May help prevent progression of certain conditions
- Symptom Management: Reduces discomfort and improves daily function
Additional Uses
In some cases, Hydroxychloroquine may also be prescribed for:
- Off-label uses as determined by your healthcare provider
- Combination therapy with other medications
- Long-term management of chronic conditions
- Short-term treatment of acute symptoms
Dosage and Administration
Hydroxychloroquine dosing varies based on the specific condition being treated and individual patient factors.
Typical Dosing:
- Starting dose is typically determined by your healthcare provider
- May be adjusted based on response and tolerability
- Can be taken with or without food (follow specific instructions)
- Usually taken once or twice daily
Administration Tips:
- Take at the same time(s) each day for best results
- Swallow tablets/capsules whole unless instructed otherwise
- Don't skip doses
- Complete full course of treatment as prescribed
- Follow your doctor's specific instructions carefully
Important Safety Information
Who Should Not Take Hydroxychloroquine?
Do not take Hydroxychloroquine if you:
- Are allergic to Hydroxychloroquine or any ingredients
- Have certain medical conditions (discuss with your doctor)
- Are taking medications that interact with Hydroxychloroquine
- Have severe liver or kidney disease (without dose adjustment)
Drug Interactions
Inform your doctor about all medications you take, including:
- Prescription medications
- Over-the-counter drugs
- Vitamins and supplements
- Herbal products
Some medications may interact with Hydroxychloroquine, affecting its efficacy or increasing side effect risk.
Pregnancy and Breastfeeding
Pregnancy:
- Discuss risks and benefits with your doctor if pregnant or planning pregnancy
- May require special monitoring or dose adjustments
- Some medications should be avoided during pregnancy
Breastfeeding:
- Consult your doctor about safety while breastfeeding
- May pass into breast milk
- Benefits and risks should be carefully considered
Monitoring and Follow-Up
While taking Hydroxychloroquine, your doctor may monitor:
- Effectiveness of treatment (symptom improvement)
- Side effects or adverse reactions
- Laboratory values if applicable
- Blood pressure, heart rate, or other vital signs as appropriate
- Overall response to therapy
Regular follow-up appointments are important to ensure the medication is working properly and to make any necessary adjustments.
Managing Side Effects
Most side effects are mild and improve with time. Here are strategies for common side effects:
Gastrointestinal Upset
- Take with food if allowed
- Stay well hydrated
- Eat smaller, more frequent meals
- Report persistent nausea or vomiting
Dizziness
- Rise slowly from sitting or lying positions
- Avoid sudden movements
- Stay hydrated
- Avoid alcohol
- Report severe or persistent dizziness
Fatigue
- Get adequate rest
- Maintain regular sleep schedule
- Exercise as tolerated
- Report excessive tiredness that interferes with daily activities
Lifestyle Considerations
To maximize the benefits of Hydroxychloroquine:
- Follow a healthy, balanced diet
- Exercise regularly as recommended by your doctor
- Maintain a healthy weight
- Avoid alcohol or limit consumption
- Don't smoke
- Manage stress through relaxation techniques
- Get adequate sleep
- Stay well hydrated
- Keep all follow-up appointments
- Take medication consistently as prescribed
When to Contact Your Doctor
Seek immediate medical attention if you experience:
- Signs of severe allergic reaction (difficulty breathing, severe rash, swelling)
- Chest pain or rapid heartbeat
- Severe dizziness or fainting
- Unusual bleeding or bruising
- Signs of liver problems (yellowing of skin/eyes, dark urine, severe fatigue)
- Severe stomach pain
- Any symptoms that concern you
Contact your doctor for non-emergency issues:
- Mild to moderate side effects that persist
- Questions about your medication
- Concerns about effectiveness
- New medications prescribed by another doctor
- Scheduled surgery or dental procedures
- Planning pregnancy
Storage
Store Hydroxychloroquine at room temperature (68-77°F or 20-25°C) away from light, heat, and moisture. Keep in original container. Keep out of reach of children and pets. Do not use past expiration date.
Important Reminders
- Take exactly as prescribed by your doctor
- Don't stop suddenly without medical advice
- Keep all follow-up appointments
- Report any unusual symptoms
- Don't share medication with others
- Store safely away from children
- Check expiration dates
- Ask your pharmacist if you have questions
Clinical Benefits
When used appropriately, Hydroxychloroquine provides several benefits:
- Effective management of lupus, rheumatoid arthritis, and malaria
- Improvement in quality of life
- Reduction in symptoms
- Prevention of complications
- Generally well-tolerated when used as directed
- Backed by clinical research and extensive use
Disclaimer: This information is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your physician or other qualified healthcare provider with any questions about a medical condition or medication.
Frequently Asked Questions
Questions to Ask Your Doctor About Hydroxychloroquine
Consider discussing these topics at your next appointment:
- When should I have my baseline and follow-up retinal eye exams?
- How will we know if hydroxychloroquine is working for my condition?
- Is my dose appropriate for my weight to minimize the risk of eye toxicity?
- Which of my other medications could interact with hydroxychloroquine, and do any need monitoring?
- What side effects should make me call you between visits?
Medical Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting, stopping, or changing any medication. Your doctor can provide personalized recommendations based on your specific health condition and medical history.