Hydroxychloroquine

What is Hydroxychloroquine used for?

Hydroxychloroquine is commonly used to treat:

1. Malaria: It is used for both the treatment and prevention of malaria caused by Plasmodium species.
2. Rheumatoid Arthritis: It helps reduce inflammation and pain associated with rheumatoid arthritis.
3. Systemic Lupus Erythematosus (SLE): It is used to manage the symptoms of lupus, such as inflammation, joint pain, and skin rashes.
4. Discoid Lupus: A type of lupus that primarily affects the skin.
5. Other Autoimmune Disorders: Sometimes used off-label for conditions like Sjögren's syndrome and other inflammatory diseases.

How does Hydroxychloroquine work?

Hydroxychloroquine works by interfering with the normal functioning of cells in the body, particularly the immune cells. It is thought to:

Inhibit immune system activity: It affects the immune system by suppressing the overactive immune response in diseases like lupus and rheumatoid arthritis. It reduces the production of inflammatory chemicals and prevents the immune system from attacking the body's own tissues.

Modulate pH levels: Hydroxychloroquine alters the pH within cells, particularly in lysosomes (cell compartments), which helps to prevent the replication of certain pathogens, such as the malaria parasite.

Anti-inflammatory effects: It helps reduce inflammation in conditions like rheumatoid arthritis by interfering with the signaling pathways that cause the release of inflammatory chemicals.

Is Hydroxychloroquine effective?

Hydroxychloroquine is proven effective for treating malaria, rheumatoid arthritis, and lupus. It works by inhibiting the growth of malaria parasites and reducing inflammation in autoimmune conditions. Although it showed limited benefit for COVID-19, its effectiveness in malaria and autoimmune diseases is well-established.

How does one know if Hydroxychloroquine is working?

The benefit of Hydroxychloroquine is evaluated through regular monitoring of clinical symptoms, such as the reduction of malaria symptoms (fever, chills) or improvement in conditions like rheumatoid arthritis and lupus. For malaria, blood tests may confirm parasite clearance, while for autoimmune diseases, laboratory tests (e.g., inflammatory markers) and clinical assessments of joint or skin symptoms are used. Regular eye exams are also recommended due to the potential for retinal toxicity.

How do I take Hydroxychloroquine?

Hydroxychloroquine should be taken with food or milk to reduce stomach upset. There are no specific food restrictions, but it's important to follow the prescribed dosage and avoid exceeding the recommended dose. Swallow the tablet whole and do not crush, chew, or break it. It’s also advised to drink plenty of water while taking it to stay hydrated.

For how long do I take Hydroxychloroquine?

The duration of hydroxychloroquine depends on the condition:

• Malaria: Short-term (3-day regimen for treatment, longer for prevention).
• Autoimmune conditions (e.g., lupus, rheumatoid arthritis): Long-term, often for years.

Follow your doctor's guidance for your specific situation.

How long does it take for Hydroxychloroquine to start working?

Hydroxychloroquine may take several weeks to show its full effect, especially for conditions like rheumatoid arthritis or lupus. For malaria prevention, it may start working within a few days, but the full effect can take a week or more. The exact time depends on the condition being treated and individual response to the medication.

How should I store Hydroxychloroquine?

Store the Hydroxychloroquine in a cool, dry place at normal room temperature, between 68°F to 77°F (20°C to 25°C). It can be briefly stored between 59°F and 86°F (15°C and 30°C).

Who should avoid taking Hydroxychloroquine?

Hydroxychloroquine should be used with caution in individuals with pre-existing heart conditions (especially arrhythmias), liver or kidney disease, and vision problems, as it can cause retinal damage or worsen pre-existing conditions. It is contraindicated in people with hypersensitivity to the drug, G6PD deficiency (due to the risk of hemolytic anemia), and porphyria. It is also not recommended during pregnancy unless necessary and should be avoided in breastfeeding mothers unless the benefit outweighs the risk. Regular eye exams are advised for long-term users.

Can I take Hydroxychloroquine with other prescription drugs?

Hydroxychloroquine can interact with several prescription medications. Key interactions include:

1. Antacids: These can reduce hydroxychloroquine absorption, making it less effective. It's recommended to separate the dosing of these drugs by a few hours.
2. Corticosteroids: Combining hydroxychloroquine with corticosteroids can increase the risk of side effects like eye damage.
3. Digoxin: Hydroxychloroquine may increase digoxin levels in the blood, raising the risk of toxicity.
4. Rifampin: Rifampin may decrease hydroxychloroquine's effectiveness by speeding up its elimination.
5. QT-prolonging drugs: Hydroxychloroquine may increase the risk of heart arrhythmias when taken with other drugs that prolong the QT interval (e.g., amiodarone).

Can I take Hydroxychloroquine with vitamins or supplements?

Hydroxychloroquine can interact with certain vitamins and supplements, particularly those containing calcium, magnesium, or iron, as they may reduce the absorption of the medication, making it less effective. Vitamin D supplements can affect calcium metabolism, which may be significant for people with certain underlying conditions. It is important to consult with a healthcare provider before taking any new supplements to ensure they do not interfere with hydroxychloroquine's effectiveness.

Can Hydroxychloroquine be taken safely while pregnant?

Hydroxychloroquine is classified as a Category C drug during pregnancy, meaning that its safety has not been fully established. Animal studies have shown potential risks, but there are no well-controlled human studies. However, the drug is generally considered to be safe for use during pregnancy when the benefits outweigh the risks, especially for conditions like lupus or malaria where the mother’s health could be severely affected. It should only be used if prescribed by a healthcare provider after careful consideration of the potential risks to the fetus.

Can Hydroxychloroquine be taken safely while breastfeeding?

Hydroxychloroquine is excreted in breast milk in small amounts, but it is generally considered safe for use during breastfeeding. Studies suggest that the levels of the drug in breast milk are low and unlikely to cause harm to the infant. However, as with any medication, it should be used during breastfeeding only when necessary and under the guidance of a healthcare provider. Monitoring the infant for any side effects is recommended.

Is Hydroxychloroquine safe for the elderly?

Yes, but elderly individuals may be more sensitive to side effects, such as heart issues, so careful monitoring is important.

Is it safe to exercise while taking Hydroxychloroquine?

Yes, exercise is safe, but if you experience dizziness or fatigue, adjust accordingly

Is it safe to drink alcohol while taking Hydroxychloroquine?

Moderate alcohol consumption is usually safe, but it can increase the risk of side effects like liver damage.