Hydroxychloroquine is a Disease Modifying Anti-Rheumatic Drug (DMARD) that is widely used to reduce inflammation (pain and swelling) in the treatment of many types of arthritis and lupus.
Hydroxychloroquine is also known as a treatment for malaria, a blood-borne parasite spread by mosquitoes in many tropical and sub-tropical environments.
Hydroxychloroquine is available in 200 mg oral tablets. The usual dose is between one and two tablets per day (200 to 400 mg per day).
When Hydroxychloroquine works, most patients start to feel improvement after 8-12 weeks. The maximum effect can take 6-12 months.
When patients start Hydroxychloroquine, doctors usually have them try it for 3 months before they assess the patient to determine if it is working. If it isn’t working at all after this time then it is usually stopped.
Important Tests and Risks
Hydroxychloroquine is considered to be pretty safe, but it can rarely damage the eyes. Patients that take Hydroxychloroquine should have their eyes checked by an eye doctor at least once a year to make sure the medication isn’t affecting the retina at the back of each eye.
It is not well understood how Hydroxychloroquine helps treat autoimmune diseases like lupus and many types of arthritis.
It is thought that Hydroxychloroquine interferes with how cells in the immune system communicate with each other.
MORE COMMON side-effects include:
- Nausea & diarrhea – Hydroxychloroquine agrees with most people. Rarely it can cause an upset stomach or diarrhea.
- Skin rash – Hydroxychloroquine can rarely cause a rash. Patients who experience this rare side effect should stop taking this medicine and contact their doctor.
- Headaches – Hydroxychloroquine can rarely cause a headache.
- Sun Sensitivity – Hydroxychloroquine can sometimes make the skin more sensitive to the sun. Patients should wear sunscreen.
- Ringing in the Ears (Tinnitus)
RARE BUT SERIOUS side-effects include:
- Changes to the Eyes – Hydroxychloroquine can rarely cause changes to the retina in the back of the eye. Patients should get their eyes checked by an eye doctor every year to make sure the medicine isn’t affecting the back of the eye. The most common symptoms of this side effect are difficulty reading or seeing (words, letters, or parts of objects may be missing) or blurred vision. The changes are reversible if this is detected early.
How to minimize the side-effects of Hydroxychloroquine:
- Patients should get their eyes checked by an eye doctor every year.
People taking Hydroxychloroquine should tell their doctor if they are concerned about any side effects.
Hydroxychloroquine is felt to be safe in pregnancy. However, anyone who becomes pregnant while taking Hydroxychloroquine should let their doctor know.
People who should NOT be taking Hydroxychloroquine include:
- Anyone who has had a previous reaction to Hydroxychloroquine
- Those who have had eye problems as a result of Hydroxychloroquine
People taking Hydroxychloroquine should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons to call a doctor while taking Hydroxychloroquine include:
- Development of a rash
- Feeling sick
- Ringing in the ears
Watch Canadian rheumatologist Dr. Andy Thompson introduce Hydroxychloroquine in this short video: