HYDROXYCHLOROQUINE
What are the aims of this leaflet?
This leaflet has been written to provide information for patients about
hydroxychloroquine. It tells you what it is, how it works, how it is used to treat
skin conditions, and where you can find out more about it.
What is hydroxychloroquine and how does it work?
Hydroxychloroquine is one of several antimalarial drugs that have anti-
inflammatory effects useful in other diseases.
Hydroxychloroquine is particularly effective for systemic lupus erythematosus
(SLE) and discoid lupus erythematosus (DLE). By reducing inflammation,
hydroxychloroquine can decrease pain, swelling and stiffness of joints, and
improve or clear some rashes.
Which skin conditions are treated with hydroxychloroquine?
These include:
Various forms of lupus erythematosus
Sarcoidosis
Porphyria cutanea tarda
Skin disorders caused or aggravated by the sun (photosensitive skin
disorders)
Granuloma annulare
Lichen planus
Urticaria vasculitis
Sarcoidosis
How long will I need to take hydroxychloroquine before I see an effect?
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Hydroxychloroquine does not work immediately and it may be 12 weeks or
longer before any benefit is noted.
When should I take hydroxychloroquine?
You should take hydroxychloroquine with or immediately after food.
What dose should I take?
Your doctor will advise you about this. Usually you will be started on a full
dose (for example, 400 mg daily or 2 tablets of 200mg hydroxychloroquine)
and later your doctor may reduce the dose (for example, to 200 mg daily of
hydroxychloroquine). Some patients may only need to take
hydroxychloroquine two or three times per week or only during the summer
months when their disease is being well controlled.
What are the possible side effects of hydroxychloroquine?
Side effects are uncommon; however, a few people may develop one of the
following: rash, indigestion, diarrhoea, headache, blurred vision, cramps or
muscle weakness, darkening of the skin, or bleaching of the hair.
Hydroxychloroquine can aggravate pre-existing psoriasis.
Does hydroxychloroquine affect fertility or pregnancy?
Considering the risks and benefits of taking hydroxychloroquine during
pregnancy and breastfeeding, a systematic review and analysis of medical
publications did not show any increased risk of death or defects in the fetus,
spontaneous abortions, premature labour, or increased risk of stillbirth in
patients with autoimmune diseases.
How will I be monitored for the side effects of hydroxychloroquine
treatment?
Before starting on hydroxychloroquine your doctor may wish to carry out a
blood test to check that your liver and kidneys are working normally. It should
not be necessary to carry out regular blood tests.
Your doctor should also enquire about any visual problems you may have and
check your vision before starting you on the medication. If you are likely to
stay on hydroxychloroquine long term (5 years or more) your doctor may refer
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you to have a baseline hospital eye test within 1 year of starting the
medication. After 5 years you may be referred for annual eye screening.
Are there any other side effects if hydroxychloroquine is taken for a long
time?
Rarely, higher doses of hydroxychloroquine taken for a long period of time
may damage the retina of the eye (the layer of cells in the back of the eye that
detects light and allows you to see). This possible damage is prevented by
keeping the dose low and monitoring the eyes closely if taking
hydroxychloroquine for a long period.
May I drink alcohol while taking hydroxychloroquine?
There is no particular reason for you to avoid alcohol while taking
hydroxychloroquine, although it is advisable to adopt sensible drinking habits
in line with the NHS guidelines.
Can I take other medicines at the same time as hydroxychloroquine?
Most other drugs can be taken safely with hydroxychloroquine. There are
important interactions with Amiodarone and Digoxin (taken for heart disease)
and with drugs used for epilepsy or depression. However, if you start any new
drugs, you should remind the doctor that you are already taking
hydroxychloroquine.
Indigestion remedies, including some that are sold over the counter, can stop
hydroxychloroquine from being absorbed.
Always discuss other medications with your doctor or pharmacist before
taking them.
Where can I find out more about hydroxychloroquine?
If you want to know more about hydroxychloroquine, or if you are worried
about your treatment, you should speak to your doctor or pharmacist.
This information sheet does not list all the side effects of hydroxychloroquine.
For full details, please look at the drug information sheet enclosed in the
hydroxychloroquine leaflet:
[Link]
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References
The Royal College of Ophthalmologists guideline: Hydroxychloroquine and
Chloroquine Retinopathy: Recommendations on Monitoring
For details of source materials used please contact the BAD Clinical
Standards Unit (clinicalstandards@[Link]).
This leaflet aims to provide accurate information about the subject and
is a consensus of the views held by representatives of the British
Association of Dermatologists: individual patient circumstances may
differ, which might alter both the advice and course of therapy given to
you by your doctor.
This leaflet has been assessed for readability by the British Association of
Dermatologists’ Patient Information Lay Review Panel
BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLET
PRODUCED AUGUST 2004
UPDATED FEBRUARY 2010, JANUARY 2013,
APRIL 2016, JUNE 2019
REVIEW DATE JUNE 2022
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