Indications 

Plaquenil or Hydroxychloroquine, a medication belonging to the class of disease-modifying antirheumatic drugs (DMARDs), is commonly prescribed to prevent or treat malaria resulting from mosquito bites. The United States Center for Disease Control provides current guidelines and travel recommendations for the prevention and treatment of malaria in various regions across the globe. 

Before traveling to malaria-prone areas, this drug recommends that patients confer with their physician regarding the most up-to-date information. In addition, Hydroxychloroquine is utilized to manage autoimmune diseases such as lupus and rheumatoid arthritis, which can mitigate skin problems in lupus patients and decrease swelling and pain in arthritis sufferers. 

Hydroxychloroquine for treating COVID-19, or coronavirus infection, is only advised if one is enrolled in a clinical study. Discuss the potential risks and benefits with your healthcare provider. 

Uses and Dosage 

Hydroxychloroquine is an oral tablet medication that is prescribed to treat rheumatic diseases. The recommended adult dosage ranges from 200 mg to 400 mg per day, usually 5 mg/kg, with a maximum of 400 mg daily.  

Higher doses may be used in some cases. The medication can be taken once daily or split into two doses if taking multiple tablets. Taking hydroxychloroquine with food is recommended, as the medication can cause gastrointestinal side effects that may be alleviated by consuming fats such as butter. It may take up to six months to experience the full benefits of the medication, but symptoms may improve after one to two months. 

Side Effects 

Hydroxychloroquine is usually well-tolerated with rare severe side effects. 

Common Side Effects 

• Nausea 
• Diarrhea 

Less Common Side Effects 

• Rash 
• Hair changes 
• Muscle weakness 

Rarely, Hydroxychloroquine can lead to anemia in individuals with G6PD deficiency or porphyria. Visual changes or loss of vision can occur in individuals taking high doses for many years, those over 60, those with significant kidney or liver disease, and those with underlying retinal disease. 

An eye exam is recommended within the first year of use and repeated every one to five years based on current guidelines. Monitoring for this risk is not typical in the office setting but has been indicated in hospitalized and critically ill patients to evaluate interactions with other medications. 

Caution 

Before taking hydroxychloroquine, inform your doctor or pharmacist if you have any allergies, especially to this medication, chloroquine, or other substances in the product. Certain inactive ingredients in this medication may lead to allergic reactions or other complications, hence, essential to speak with your pharmacist for additional information. 

Before using this medication, discuss your medical history with your doctor or pharmacist, especially if you have a specific enzyme issue (glucose-6-phosphate dehydrogenase deficiency – G6PD), vision/eye or hearing problems, kidney or liver disease, alcohol abuse, skin disorders (like psoriasis), a specific blood disorder (porphyria), or seizures. 

If you have diabetes, this product may impact your blood sugar levels. Monitor your blood sugar levels frequently, as advised, and share the results with your doctor. If you experience symptoms of low blood sugar, inform your doctor promptly (refer to the Side Effects section). Your doctor may need to modify your diabetes medication, exercise regimen, or diet. 

This medication may cause dizziness. The consumption of alcohol or marijuana (cannabis) may intensify dizziness. Do not operate machinery, drive, or perform any activity that requires vigilance until you can do so safely. Avoid alcoholic drinks. Speak with your doctor if you are using marijuana (cannabis). Alcohol can raise the risk of liver problems while taking this medication. 

This medication may increase your sensitivity to sunlight. Limit sun exposure, avoid tanning beds and sunlamps, and wear protective clothing and sunscreen outdoors. Notify your doctor immediately if you get sunburned or have skin blisters/redness.