What is Hydroxychloroquine?
Hydroxychloroquine is a quinolone medication that is used to treat or help prevent malaria, which is a condition caused by parasites that get into the body via the bite of mosquitoes. The prevalence of malaria is high in places including Africa, South America, and in southern Asia.This medication isn't effective against all malaria strains.
Hydroxychloroquine does not work against the majority of malaria strains or against malaria in regions in which the disease has become resistant to another similar drug known as chloroquine.Hydroxychloroquine may also be used to treat the symptoms of arthritis, rheumatoid and discoid, as well as systemic Lupus erythematosus.
Warnings
Hydroxychloroquine could have harmful consequences for your heart, specifically if you are also taking other medications like Z-Pak, the anti-inflammatory azithromycin (Z-Pak). Take immediate medical attention when you experience rapid or pounding heartbeats as well as suddenly feeling dizzy (like the possibility of passing through).
In the long run, taking hydroxychloroquine at high doses could cause irreparable damage to your retina in the eyes, which could lead to permanent vision issues.Do not take hydroxychloroquine. Consult your physician immediately. If you experience unclear vision, difficulty focusing, blurred vision, blind spots, problems reading, changes to your color vision, or increased sensitivity to light,
Before you Take this Drug
Do not take chloroquine if you have an allergy to chloroquine or hydroxychloroquine.Long-term use or high doses of hydroxychloroquine could cause irreparable damage to the retina (the membrane inside the eye that aids in producing vision). The damage could cause permanent vision issues. The risk of damage to the retina is greater for those who have a pre-existing eye problem or kidney disease and who are also taking Tamoxifen.
To ensure that hydroxychloroquine is safe for you, inform your doctor if you've previously had:
- Vision loss as well as damage to the retina due to the use of an anti-malaria drug;
- Heart disease, the heart's rhythm (such as the long QT syndrome);
- Diabetes;
- A stomach disorder;
- An intolerance to the chemical quinine;
- Kidney disease or liver failure;
- Psoriasis;
- Alcoholism;
- Porphyria (a genetic disorder of the enzyme that can cause symptoms in the nervous system, skin,
- A genetic enzyme deficiency known as glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Inform your physician if you are expecting or planning to be pregnant. The risk of malaria being able to trigger serious illnesses or even death in pregnant women is higher. Having malaria during pregnancy could also increase the chance of stillbirth, miscarriage, preterm delivery, and an infant with a low birth weight.If you're pregnant and you are a registered mother, your name could be included on the pregnancy registry to monitor how hydroxychloroquine affects you as an infant.
It isn't known if hydroxychloroquine can harm an unborn child. If you're expecting, consult your physician about the dangers of going to areas where malaria is prevalent (such as Africa, South America, and Southern Asia).It is not recommended to breastfeed while taking this medication. Talk to your doctor about any potential risks.Hydroxychloroquine isn't approved to treat lupus or rheumatoid arthritis in people younger than 18 years old.
How to Take Hydroxychloroquine?
Follow the exact dosage as recommended by your physician. Follow the instructions on the prescription label and review all medication guides or instruction sheets.Consume hydroxychloroquine with meals or a glass of milk, unless your doctor advises you otherwise.
Don't crush or break the tablet of hydroxychloroquine.To treat arthritis or lupus, hydroxychloroquine medication is typically taken every day.
To stop malaria, hydroxychloroquine is typically taken once each week on the exact same day. Start taking the medicine two weeks prior to entering an area in which malaria is prevalent. Continue taking the medicine throughout your stay and for a minimum of 4 weeks after leaving the zone.To treat malaria, hydroxychloroquine is usually given in one dose and then in smaller doses for the next two days.
Take this medication for the entire prescribed duration, even if symptoms do not improve immediately.Contact your physician as soon as you can if you've had exposure to malaria or if you've had fever or other signs of illness following the time you were in a place in which malaria is prevalent.Wear protection clothes, insect repellents, and mosquito nets around your bed to protect yourself from mosquito bites that can cause malaria.
The medication you choose to use is not 100% efficient in preventing or treating all forms of malaria. Discuss with your doctor if you are experiencing symptoms of fever, diarrhea, vomiting, or diarrhea in the course of treatment.When you are taking hydroxychloroquine, it might require frequent eye tests and medical exams.Maintain at room temperature, free of heat, moisture, and light.
Details on Dosage
Usual Adult Dose for Malaria Prophylaxis:
400 mg of salt (310 mg of base) every week, orally.
Dosing on the basis of weight: 6.5 mg/kg salt (5 mg/kg base) every week, orally.
Maximum dose: 400 mg salt (310 mg base)/dose
Comments:
The medication should be administered on the same days every week.
Therapy for suppression should commence 2 weeks before exposure and be continued for 4 weeks following the time you leave the affected area.
Use: To treat malaria prevention in regions where resistance to chloroquine is not known.
US CDC Recommendations: 310 mg base (400 mg salt) daily, once or twice a week.
Comments:
An alternative to chloroquine for prophylaxis just in areas with chloroquine-sensitive malaria
The treatment should begin at least 2 weeks prior to departure to areas of malaise and should be continued weekly (same day every week) when in areas of malarious conditions and for a period of 4 weeks following having left the area.
If you notice that malaria occurs while taking the drug to treat chemoprophylaxis, it shouldn't be used in the treatment plan.
The current guidelines should be read for further details.
Usual Adult Dose for Malaria:
800 mg sodium (620 mg basis) in a single oral dose, and then 400 mg of salt (310 mg base) at 6, 24, and 48 hours following the initial dose.
Total dose: 2000 mg salt (1550 mg base)
Weight-based dosing:
The first dose is 13 mg/kg salt (10 mg/kg base) orally.
Second dose (6 hours after the first dosage): 6.5 mg/kg salt (5 mg/kg base) orally
Third dose (24 hours after the first dosage): 6.5 mg/kg salt (5 mg/kg base) orally
Fourth dose (48 hours after the first dosage): 6.5 mg/kg salt (5 mg/kg base) orally
Maximum Dose:
First dose: 800 mg salt (620 mg base)/dose
Second, third, and fourth doses fourth dose: 400 mg sodium (310 mg base)/dose
Comments:
A concurrent treatment with an 8-aminoquinoline compound is essential to treat the underlying cause of Plasmodium vivax or P. ovale-related infections.
Use: To treat malaria that is not complicated due to P. falciparum, P. malariae, P. ovale, and P. vivax.
US CDC Recommendations: 620 mg of base (800 mg salt) all at once orally, and then 310 mg of base (400 mg salt) orally at 6 hours, 24 hours, and 48 hours.
Total dose: 1550 mg base (2000 mg salt)
Comments:
Recommend for malaria that is not complicated (P. falciparum or species not yet identified) in regions that have chloroquine susceptibility.
recommended for uncomplicated malaria (P malariae, P knowlesi, P vivax [unless chloroquine-resistant P vivax is suspected], or P ovale) in all regions; if treating P vivax or P ovale infections,The treatment of primaquine in conjunction with it (after qualitative testing to rule out the glucose-6-phosphate dehydrogenase insufficiency) is suggested.
Recommended for simple malaria treatment for women who are pregnant in areas where chloroquine is a sensitivities
The current guidelines should be reviewed for more details.
Usual Adult Dose for Systemic Lupus Erythematosus:
200-400 mg of salt (155 to 300 mg base) per day, divided orally into either 2 or 1 dose
Comments:
Doses of more than 400 mg per day are not advised.
Retinopathy is more common in cases where this maintenance dose is exceeded.
Uses: In the treatment of chronic discoid lupus and systemic lupus
Usual Adult Dose for Rheumatoid Arthritis:
Initial dosage: 400–600 mg of salt (310 or 465 mg base) per day, divided orally into one or two doses.
Maintenance dosage: 200–400 mg sodium (155–300 mg base)/day orally divided into either 2 or 1 dose
Maximum dosage: 600 mg of salt (465 mg base)/day or 6.5 mg/kg of salt (5 mg/kg base)/day, whichever is lower.
Comments:
The effect of this medication is cumulative and could take several weeks to attain the highest therapeutic effects.
If a positive response is observed when a good response is obtained, the initial dose can be decreased by 50% and then maintained at a lower dose.
Retinopathy is more likely to be diagnosed in the event that this dose for maintenance is exceeded. 600 mg of salt (465 mg of base) or 6.5 mg/kg sodium (5 mg/kg basis), whichever is less, is not recommended daily.
The salicylates and corticosteroids can be utilized with this drug, and, in general, they can be decreased slowly in dosage or removed once a minimum dosage of the drug is achieved.
Use: In the treatment of chronic and acute rheumatoid arthritis
Usual Pediatric Dose for Malaria Prophylaxis:
6.5 mg/kg sodium (5 mg/kg base) daily, orally.
Maximum dose: 400 mg salt (310 mg base)/dose
Comments:
The drug must be given on the same day every week.
The treatment for immunosuppression should start two weeks before exposure and be continued for a period of four weeks following the departure from the area of endemicity.
Use: To prevent the spread of malaria in geographical regions where resistance to chloroquine is not known.
US CDC Recommendations: 5 mg/kg of base (6.5 mg/kg salt) every week, orally.
Maximum dose: 310 mg base (400 mg salt)/dose
Comments:
An alternative to chloroquine for prophylaxis just in areas with chloroquine-sensitive malaria
The treatment should begin about 2 to 3 weeks prior to traveling to areas that are prone to violence. It should be maintained every week (same day every week) when in areas of malady and for a period of 4 weeks following leaving these areas.
If you notice that malaria occurs while taking the drug to treat chemoprophylaxis, it shouldn't be taken as part of the treatment plan.
The current guidelines should be reviewed for more details.
Usual Pediatric Dose for Malaria:
Initial dose 1: 13 mg/kg salt (10 mg/kg base) orally
2nd dose (6 hours after the first dosage): 6.5 mg/kg salt (5 mg/kg base) orally
3rd dose (24 hours after the first dosage): 6.5 mg/kg salt (5 mg/kg base) orally
4. (48 hours after the first dosage): 6.5 mg/kg salt (5 mg/kg base) orally
Maximum Dose:
First dose: 800 mg salt (620 mg base)/dose
Second, third, and fourth doses fourth dose: 400 mg sodium (310 mg base)/dose
Comments:
A concurrent treatment with an 8-aminoquinoline-based compound is required for the complete cure of P. viridans and P. ovale infections.
Use: To treat malaria that is not complicated due to P. falciparum, P. malariae, P. ovale, and P. vivax.
US CDC Recommendations: 10 mg/kg base orally at once, followed by 5 mg/kg of base orally at 6 hours, 24, and 48 hours.
Total dose: 25 mg/kg base
Comments:
Pediatric doses should not exceed adult doses.
Recommended for mild malaria (P. falciparum or species that are not recognized) in regions that have chloroquine susceptibility.
recommended for uncomplicated malaria (P malariae, P knowlesi, P vivax [unless chloroquine-resistant P vivax is suspected], or P ovale) in all regions; if treating P vivax or P ovale infections, The use of primaquine as a complement to treatment (after tests to test for quantitatively to confirm G6PD deficiencies) is highly recommended..
The current guidelines should be read for more details.
What Happens if I Miss a Dose?
Contact your doctor for advice when you have missed the dose.
What Happens If I Overdose?
If you are experiencing a medical emergency, seek immediate medical treatment or contact to the Poison Help Line at 1-800-222-1222. An overdose of hydroxychloroquine could be fatal and should be treated immediately.
Overdose symptoms can include drowsiness, changes in vision, seizures, a slow heart rate, and a weak pulse. a beating heart beats that pound, sudden dizziness and weakening of the breath, shortness of breath, or a breath that is slow (breathing could cease).
Keep hydroxychloroquine out of the reach of children. A hydroxychloroquine dose could be fatal for children who accidentally swallow the drug.
What Should be Avoided?
The medicine can cause blurred vision and affect your reaction time. Avoid driving and other hazardous activities until you are aware of the effects this medication will have on your vision.
Beware of taking an antacid and kaopectate (kaolin-pectin) for at least 4 hours prior to or after you have taken hydroxychloroquine.
Side effects of Hydroxychloroquine
Get immediate medical attention. If you are experiencing symptoms that indicate that you are experiencing an allergic reaction due to hydroxychloroquine (hives, breathing difficulties, or swelling of your throat or face) or an extremely severe skin reaction (fever, sore throat, eye burning, irritation, and red or purple skin itching, blistering, and peeling),
Get medical attention immediately when you notice signs of a serious heart issue, such as heartbeats that are fast or pounding, a fluttering chest, breathlessness, or a sudden feeling of dizziness (like you may be stricken with a stroke).
Hydroxychloroquine can cause serious adverse side effects. Contact your physician immediately. If you suffer from:
- A seizure;
- Eyes that are yellow;
- Your ears are ringing and you are having difficulty hearing.
- Unexpected mood swings;
- Severe muscle weakness, loss of coordination, subactive reflexes;
- Changes in mood or behaviour, or thoughts of suicide
- Low blood cell counts: fatigue, chills, fever, and sore throats; mouth sores; easy bruising; abnormal bleeding; pale skin and feet; feeling lightheaded and short-tempered.
- Low blood sugar levels—headaches and thirst, sweating, irritability, and dizziness. rapid heart rate and feeling nervous or shaky;
- A serious reaction to a drug that may affect multiple organs and tissues—the skin or fever, swollen glands, muscle pains, extreme weakness, unusual bruising, or the appearance of yellowing in the eyes or skin.
If you take hydroxychloroquine for a long time or in excessive doses, it could cause irreparable damage to your retina in the eyes. Take hydroxychloroquine off your prescription. Consult your physician if you are:
- Blurred vision, difficulty finding, and reading problems;
- Vision distortion, blind spots;
- Color vision changes;
- Blurry or cloudy vision
- Seeing light streaks or flashes and seeing halos around lights seeing light flashes or halos around lights
- Greater sensitivity to increased sensitivity to
Common side effects of hydroxychloroquine include:
- Headache;
- Dizziness;
- Nausea or vomiting;
- Stomach pain;
- Loss of appetite
- Weight loss;
- Experiencing anxiety or feeling anxious;
- Itching, a skin rash,
- Hair loss.
This isn't a complete list of all the side effects. Others could happen. Contact your physician for advice regarding medical effects. You may report any adverse reactions to the FDA at 1-800-FDA-1088.
Interaction with Other Drugs
Hydroxychloroquine may cause serious heart conditions. Your risk of developing heart problems is greater if you are also taking various other drugs for asthma, infections, or heart issues, as well as for high blood pressure, mental illness, depression, malaria, cancer, or HIV.
Inform your doctor about any other medications you take, including:
- Cimetidine;
- Cyclosporine;
- Methotrexate;
- Rifampicin;
- Praziquantel;
- Ampicillin;
- Digoxin;
- Tamoxifen
- Heart rhythm medicine;
This list isn't exhaustive. Other medications can interact with hydroxychloroquine. These include medications that are prescribed and available over the counter, vitamins, and herbal products. Some interactions with drugs are not listed here. are outlined here.
