Hydroxychloroquine

Hydroxychloroquine is an anti-malarial drug found to be useful in the treatment of autoimmune diseases like Discoid & Systemic Lupus Erythematosus (DLE & SLE), rheumatoid arthritis (including juvenile arthritis), Sjogren’s syndrome and cutaneous vasculitis.

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What is this medication used for

  • Hydroxychloroquine is an anti-malarial drug found to be useful in the treatment of autoimmune diseases like Discoid & Systemic Lupus Erythematosus (DLE & SLE), rheumatoid arthritis (including juvenile arthritis), Sjogren’s syndrome and cutaneous vasculitis.

  • This drug, which is believed to interfere with the communication of various cells in the immune system, is particularly effective in treating skin and joint symptoms.

  • Hydroxychloroquine is also commonly used with other drugs to reduce inflammation and improve muscle or joint pain.

Dosage and How to Use

  • Hydroxychloroquine tablets should be taken with or after food to reduce stomach upset.

  • A typical daily dose ranges from 200mg to 400mg. Dosage may vary depending on patient’s weight and disease response.

  • This drug does not work immediately. It may take up to 12 weeks or longer before you can notice any benefit. Thus, it is important that you take your medication regularly, otherwise you may not benefit at all.

  • If you miss a dose, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dose. Do not double the dosage to make up for the missed dose.

Side Effects, Precautions, Contraindication

Can hydroxychloroquine be taken with other medications?

  • These drugs can be taken with other medications, e.g. corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs), which are used for the treatment of SLE or rheumatoid arthritis.

  • Please inform your doctor, pharmacist or rheumatology nurse clinician if you are taking other medications including over-the-counter medicines, supplements and traditional/herbal remedies as they may interact with Hydroxychloroquine.

What are the important side effects of hydroxychloroquine?

  • Hydroxychloroquine is generally well-tolerated and serious side effects are rare. However, you should be aware of some possible side effects. Always discuss with your doctor if you experience any side effects.

Side Effect

Management

Nausea, diarrhoea or loss of appetite

Take medication after food to minimise the side effects. Sucking hard, sugar-free candy may reduce nausea and vomiting. Inform your doctor if symptoms are severe or if you experience loss of appetite.

Headache, dizziness, ringing in the ears or muscle weakness (rare side effect)

Improves as you get used to the medication or with dose reduction. Check with your doctor if you experience muscle weakness that progresses from your legs and upwards.

Blurred vision

Retinal problem (uncommon at usual recommended daily dose)

(Warning signs: Visual disturbances, photophobia, light flashes and streaks, missing or blacked-out areas in the visual field, difficulty in focusing)

Transient blurring of vision may occur but this usually resolves in 1 to 2 weeks.Consult your doctor immediately.

Retinal problem is usually reversible when the treatment is stopped. You will be referred to see an eye specialist for regular eye screening/monitoring.

Generalized skin rash, itching, discolouration of the skin, fingernails and insides of the mouth

Consult your doctor as these symptoms usually improves or lightens on stopping the treatment.

Blood disorder (rare side effect)

(Warning signs: Unusual bleeding or bruising, lip or mouth ulcers with more frequent “flu-like” symptoms. In some cases, there may be no warning signs)

Consult your doctor immediately.

Monitoring of the effects of your new treatment is important, particularly during the first 3 months of treatment. For your safety, you need regular blood tests for monitoring.

Inform your doctor if you have G6PD deficiency.

If you develop rashes, facial swelling or shortness of breath after taking the medication, you could be allergic to the medication. Please seek medical attention immediately.

Are there any special precautions that I need to take?

  • It is important to inform your doctor if you intend to conceive or breastfeed while taking this medication.

  • Hydroxychloroquine is generally safe to be taken during pregnancy. It is often advisable to continue with the medication to prevent a flare-up of your disease.

  • It is safe to breastfeed while on Hydroxychloroquine.

Handling and Storage

  • Store your medication in a cool, dry place away from heat, moisture and direct sunlight.

If you have any problem with your treatment, please contact your doctor, pharmacist or rheumatology nurse clinician.

Please keep all medications out of reach of children.


© Tan Tock Seng Hospital, Singapore 2017. All rights reserved. All information correct as of August 2017. No part of this document may be reproduced, copied, reverse compiled, adapted, distributed, commercially exploited, displayed or stored in a database, retrieval system or transmitted in any form without prior permission of Tan Tock Seng Hospital. All information and material found in this document are for purposes of information only and are not meant to substitute any advice provided by your own physician or other medical professionals.

PECC-PHA-ED-2017-023-v1

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