Hydroxychloroquine

Hydroxychloroquine (brand name Plaquenil) is a type of drug known as a disease-modifying anti-rheumatic drug, or DMARD. These drugs have the effect of dampening down the underlying disease process, rather than simply treating symptoms.

Why is hydroxychloroquine prescribed?

Hydroxychloroquine is used to treat rheumatoid arthritis and systemic lupus erythematosus (SLE). It can reduce inflammation and so reduce pain, swelling and stiffness of joints and improve the SLE rash.

Hydroxychloroquine is also used in the treatment of malaria.

When and how do I take hydroxychloroquine?

Hydroxychloroquine is taken in tablet form, with or after food.

Your doctor will advise you about the correct dose. Usually you will start on a full dose of 400 mg (two tablets) daily, and later your doctor may reduce this. Some patients take hydroxychloroquine only 2–3 times per week when their disease is very well controlled.

How long does hydroxychloroquine take to work?

Hydroxychloroquine does not work immediately. It may be 12 weeks or longer before you notice any benefit.

What are the possible risks or side-effects?

Risks and side-effects are uncommon. However, a few people develop the following:

• skin rashes
• indigestion
• diarrhoea
• headaches
• blurred vision.

Very rarely hydroxychloroquine may damage the retina (part of the eye), but there is evidence that the risk may be almost completely eliminated if the doctor adjusts the dose carefully.

If you develop any new symptoms or there is anything else that concerns you after starting hydroxychloroquine, you should tell your doctor or rheumatology nurse specialist as soon as possible.

What other treatments could be used instead of hydroxychloroquine?

A number of other drugs are used in the treatment of rheumatoid arthritis and related conditions. Your doctor will discuss these other options with you.

Will I need any special checks while on hydroxychloroquine?

Before starting on hydroxychloroquine your doctor may take a blood test to check that your liver and kidneys are working normally, but you will not need any regular blood tests. Your doctor will also enquire about any problems with your eyesight and may check your vision before you start the medication, and then at least once a year afterwards. This check of your vision may be carried out by an optician.

Can I take other medicines along with hydroxychloroquine?

Hydroxychloroquine may be prescribed along with other drugs in treating your condition. Some drugs interact with hydroxychloroquine – for example, indigestion remedies, including some over-the-counter preparations, can stop hydroxychloroquine being absorbed. So you should discuss any new medications with your doctor before starting them, and you should always tell any other doctor treating you that you are taking hydroxychloroquine.

Hydroxychloroquine is not a painkiller. If you are already on a non-steroidal anti-inflammatory drug (NSAID) or painkillers you can carry on taking these as well as hydroxychloroquine, unless your doctor advises otherwise.

Do not take over-the-counter preparations or herbal remedies without discussing this first with your doctor, rheumatology nurse or pharmacist.

What about immunisations?

You can have immunisations while on hydroxychloroquine.

Can I drink alcohol while on hydroxychloroquine?

There is no particular reason to avoid alcohol while on hydroxychloroquine.

Does hydroxychloroquine affect fertility or pregnancy?

The risks to the unborn child of taking hydroxychloroquine seem to be very small. Sometimes it is recommended that hydroxychloroquine is continued through pregnancy to prevent a flare of disease. If you are planning a family you should seek advice from your doctor. If you become pregnant while taking hydroxychloroquine, you should discuss this with your doctor as soon as possible.

What about breastfeeding?

You should not breastfeed if you are on hydroxychloroquine. The drug may pass into the breast milk and could be harmful to your baby.

Where can I obtain further information?

If you would like any further information about hydroxychloroquine, or if you have any concerns about your treatment, you should discuss this with your doctor, rheumatology nurse or pharmacist.

 

Remember to keep all medicines out of reach of children.

PLEASE NOTE: We have made every effort to ensure that this content is correct at time of publication, but remember that information about drugs may change. This page is for general education only and does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet that comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects that may be relevant in your particular case.

Our drug information is revised annually and published at the start of the year.