Hydroxychloroquine is a one of a number of drugs which have been used for many years in the treatment of malaria. Fortuitously, it was discovered that these drugs often are helpful in the treatment of various rheumatic diseases, particularly systemic lupus erythematosus (SLE or "Lupus") and rheumatoid arthritis. Although chloroquine is sometimes used, the preferred antimalarial drug is hydroxychloroquine due to its greater safety. These drugs are not painkillers.
It is not possible at the present time to explain precisely why hydroxychloroquine is effective in various rheumatic diseases. When effective, it can decrease damage to the tissues of the joints, skin and other organs in the body.
HOW IS HYDROXYCHLOROQUINE GIVEN ?
Hydroxychloroquine is a tablet that is best taken with food as it has a slightly bitter taste. Generally it is taken once a day, but occasionally it will be prescribed to be taken on alternate days. Treatment generally starts with two tablets per day and subsequently may be reduced to one a day (or every other day).
WILL MY ARTHRITIS GET BETTER ?
The majority of patients will find hydroxychloroquine to be effective, but like other anti-rheumatic drugs, it may take between 8 to 12 weeks for the disease to respond. Often you will be given other medications when you start hydroxychloroquine so that you will improve more quickly.
ARE THERE ANY SIDE EFFECTS ?
Hydroxychloroquine is one of the better tolerated anti-rheumatic drugs. However, as with all medications, there is a potential for side effects to occur. Mostly, these are not serious and often we may not need to stop the treatment if side effects occur. However, if any serious problems occur, we will stop the treatment. If you develop any of the problems that I will mention, you should inform your GP and rheumatology clinic.
Skin rashes occasionally develop and hydroxychloroquine may make you more sensitive to the sun, so it is advisable to use the usual precautions of sunscreens and a hat if you are in the sun. Also, your hair may become a little bleached with the drug and rarely a degree of thinning of the hair can develop.
Anti-malarial drugs can sometimes cause problems with the eyes. The side-effects range from temporary blurring of the vision and a slightly increased appreciation of glare (so wear sunglasses in the sun) which are not uncommon to more serious but rare changes in the back of the eye. Eye problems were much more common in the past when chloroquine was the most commonly used anti-malarial drug and dosages of these drugs were considerably higher. Because of these problems, before you start hydroxychloroquine you should schedule an appointment with an Ophthalmologist to assess the eyes and to make sure that there are no eye problems present that could make side effects more likely. Your Opthalmologist should schedule regular eye exams every 6 months to test for possible eye problems associated with hydroxychloroquine.
Finally, hydroxychloroquine should be avoided in pregnancy, so please discuss this with your rheumatologist if you wish to become pregnant.
Generally there are no drugs that make a side effect more likely with hydroxychloroquine. Indigestion remedies should not be taken at the same time as hydroxychloroquine. Try to allow 4 hours to pass between taking one and the other.
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