Hydroxychloroquine

 

What is Hydroxychloroquine?

Hydroxychloroquine is a DMARD- a disease modifying anti-rheumatic drug. This means it affects the disease itself to reduce the effects of the immune system.

The immune system causes inflammation that protects the body from infections and injury. In certain diseases however, the immune system is over active and this can target healthy tissues such as joints. This results in pain, swelling and tenderness and eventually permanent damage.

Hydroxychloroquine works to suppress the over activity of the immune system and prevent the inflammation from occurring, reducing the long-term risk of permanent joint or organ damage.

 

What is Hydroxychloroquine used for?

Hydroxychloroquine is used for a number of different conditions, most commonly in types of arthritis such as rheumatoid arthritis and systemic lupus erythematosus (SLE).

 

How is it taken?

Hydroxychloroquine is a tablet that is taken daily. It is prescribed based on your weight and is usually prescribed at doses of 200-400mg each day. It can be taken with or without food.

 

It can take up to 12 weeks for the medication to have its full effect. It is a long-term treatment as it prevents any long-term damage.

 

It is often taken along side another DMARD such as methotrexate.

 

Before starting to take it, your blood tests will be checked in clinic for your blood counts, liver and kidney tests. You will not require any blood monitoring whilst you are on this medication.

 

Before you start taking hydroxychloroquine you will need your vision checked, this is to get a baseline of your sight, as hydroxychloroquine can rarely cause vision changes. Annual eye checks should be carried out whilst you are on hydroxychloroquine.

 

An 8-week supply of tablets will be provided by the hospital at your rheumatology appointment, you will then receive a phone call from the rheumatology nurse specialists at 6-8 weeks to see how you are getting along. If you experience any side effects, these can be discussed with the nurses or your GP.

 

Side effects

Side effects with hydroxychloroquine are not common. Below are some side effects that have been noted:

 

• Feeling sick, indigestion or diarrhoea
• Headaches
• Skin rashes, these can be made worse by sunlight
• Mild hair loss and colour bleaching
• Ringing in the ears
• Visual changes
  • In a very small number of people, the back of the eye called the retina can be damaged. It is important to get annual eye checks whilst you are taking hydroxychloroquine and report any changes in your vision to your optician.

 

Cautions of use

Interactions with other medications

• Heart burn or indigestion remedies can interact with hydroxychloroquine, therefore these should be taken at a different time, with at least a 4 hour gap.

Contraindications with other conditions

• If you have poor vision due to problems with your eyesight, we would not usually recommend hydroxychloroquine.

Operations

• There is no need to stop taking hydroxychloroquine before or after surgery.

During pregnancy and breastfeeding

• Hydroxychloroquine is safe in pregnancy and breastfeeding.

Alcohol

• There is no known interaction of hydroxychloroquine and alcohol, but we would recommend keeping within the recommended 14 units of alcohol weekly.

Vaccinations

• There are no contraindications for any vaccines whilst on hydroxychloroquine.

 

Useful Links 

Versus Arthritis: http://www.versusarthritis.org