Hydroxychloroquine
A drug Information Sheet
Why am I being prescribed hydroxychloroquine?
Although the drug hydroxychloroquine (brand name Plaquenil) is used in the treatment of malaria, it is also effective for rheumatoid arthritis and systemic lupus erythematosus (SLE). It can reduce inflammation and so reduce pain, swelling and stiffness of joints and improve the rash of SLE.
When do I take hydroxychloroquine?
You take hydroxychloroquine with or after food.
What dose do I take?
Your doctor will advise you. Usually you start on a full dose (e.g. 400 mg or two tablets of hydroxychloroquine) and later your doctor may reduce it (e.g. to 200 mg or one tablet of hydroxychloroquine). Some patients take hydroxychloroquine only 2–3 times per week when their disease is very well controlled.
How long will 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?
They are uncommon. However, a few people develop skin rashes, indigestion, diarrhoea, headaches or 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 by adjusting the dose carefully.
If you develop any new symptoms after starting this drug, you should report to 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 (see arc leaflet 'Drugs and Arthritis'). Your rheumatologist will discuss these other options with you.
Do I need any special checks while on hydroxychloroquine?
Before starting on hydroxychloroquine your doctor may wish to take a blood test to check your liver and kidneys are working normally, but you will not need any regular blood tests. Your doctor should also enquire about any visual problems 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.
May I take other medicines along with hydroxychloroquine?
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. So if you are already on a non-steroidal anti-inflammatory drug (NSAID) or painkillers you may continue to take these as well as hydroxychloroquine, unless your doctor advises otherwise.
Indigestion remedies, including some over-the-counter preparations, can stop hydroxychloroquine being absorbed. Do not take over-the-counter preparations without discussing this first with your doctor, rheumatology nurse or pharmacist.
Can I have immunisations while on hydroxychloroquine?
Yes, you can have immunisations while being treated with hydroxychloroquine.
May I drink alcohol while taking hydroxychloroquine?
There is no particular reason for you to avoid alcohol while taking hydroxychloroquine.
Does hydroxychloroquine affect pregnancy?
You should not normally take hydroxychloroquine during pregnancy as it may harm the unborn child. If you are planning a family you should seek advice from your doctor.
What about breastfeeding?
You should not breastfeed if you are taking hydroxychloroquine.
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 the content of this information sheet is correct at time of going to press, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.
