hydroxychloroquine (Plaquenil)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Get a Grip on Rheumatoid Arthritis

What is hydroxychloroquine, and how does it work (mechanism of action)?

Hydroxychloroquine is classified as an anti-malarial drug. It is similar to chloroquine (Aralen) and is useful in treating several forms of malaria as well as lupus erythematosus and rheumatoid arthritis. Its mechanism of action is unknown. Malarial parasites invade human red blood cells. Hydroxychloroquine may prevent malarial parasites from breaking down (metabolizing) hemoglobin in human red blood cells. Hydroxychloroquine is effective against the malarial parasites Plasmodium vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum. Hydroxychloroquine prevents inflammation caused by lupus erythematosus and rheumatoid arthritis. The FDA approved hydroxychloroquine in April, 1955.

What brand names are available for hydroxychloroquine?

Plaquenil

Is hydroxychloroquine available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for hydroxychloroquine?

Yes

What are the side effects of hydroxychloroquine?

Side effects include irritability, headache, weakness, hair lightening or loss, stomach upset, nausea, dizziness, muscle pain, rash and itching. Rarely, hydroxychloroquine can affect the bone marrow leading to reduced white blood cells (leukopenia) or platelets (thrombocytopenia) and abnormal red blood cells (anemia). Rare but potentially serious eye toxicity can occur. This toxicity affects a part of the eye called the retina and can lead to color blindness and even loss of vision. An ophthalmologist (eye specialist) often can detect changes in the retina that suggest toxicity before serious damage occurs. Therefore, regular eye examinations, even when there are no symptoms, are mandatory. Patients who are genetically deficient in a certain enzyme, called G6PD, can develop a severe anemia resulting from the rupture of red blood cells. This enzyme deficiency is more common in persons of African descent and can be evaluated by blood testing. Hydroxychloroquine may worsen psoriasis.

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment

What is the dosage for hydroxychloroquine?

The usual adult dose for treating malaria is 800 mg initially, followed by 400 mg 6-8 hours later and then 400 mg at 24 hours and 48 hours. The dose for malaria prevention is 400 mg every week starting 1 or 2 weeks before exposure and for 4 weeks after leaving the high risk area.

The recommended adult dose for rheumatoid arthritis is 400-600 mg daily for 4-12 weeks followed by 200-400 mg daily.

Systemic lupus erythematosus is treated with 400 mg once or twice daily for several weeks then 200-400 mg daily. Hydroxychloroquine should be taken with food or milk in order to reduce stomach upset.

Which drugs or supplements interact with hydroxychloroquine?

Administration of hydroxychloroquine with penicillamine (Cuprimine, Depen) may increase penicillamine levels, increasing the risk of penicillamine side effects. The mechanism is unknown. Combining telbivudine (Tyzeka) and hydroxychloroquine may increase the risk of unexplained muscle pain, tenderness, or weakness because both drugs cause such side effects.

Hydroxychloroquine suppresses the immune system and should not be combined with drugs that also suppress the immune system or live vaccines.

Is hydroxychloroquine safe to take if I'm pregnant or breastfeeding?

Hydroxychloroquine should only be used in pregnant women for malaria prophylaxis or treatment.

Hydroxychloroquine may be secreted in breast milk and may cause side effects in the infant.

What else should I know about hydroxychloroquine?

What preparations of hydroxychloroquine are available?

Tablet: 200 mg.

How should I keep hydroxychloroquine stored?

Hydroxychloroquine should be stored at room temperature up to 30 C (86 F) in a sealed, light resistant container.

Reference: FDA Prescribing Information

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment

Summary

Hydroxychloroquine (Plaquenil) is a drug that is classified as an anti-malarial drug. Plaquenil is prescribed for the treatment or prevention of malaria. It is also prescribed for the treatment of rheumatoid arthritis, lupus, and the side effects of lupus such as hair loss, joint pain, and more. Side effects, drug interactions, pregnancy safety information, and dosage information should be reviewed prior to taking this medication.

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

Subscribe to MedicineNet's Arthritis Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Reviewed on 10/28/2014
References
Reference: FDA Prescribing Information

Health Solutions From Our Sponsors