Class: Aminoquinoline
Dosage Forms. Tablet: 200 mg
Common FDA Label Indication, Dosing, and Titration.
1. Lupus erythematosus: maintenance: 200-400 mg po daily
2. Malaria: suppression: Adults: 400 mg po q week on the same day; Children: 5 mg base/kg (200 mg hydroxychloroquine sulfate = 155 mg hydroxychloroquine base) begin 2 wk prior to entering an endemic area and continue for 8 wk after leaving the endemic area
3. Rheumatoid arthritis: maintenance: 200-400 mg po daily
Off-Label Uses. None
MOA. The mechanism of action of hydroxychloroquine is unknown. It is effective in treating Plasmodium vivax, Plasmodium malariae, and susceptible strains of Plasmodium falciparum.
Drug Characteristics: Hydroxychloroquine
Medication Safety Issues: Hydroxychloroquine
Drug Interactions: Hydroxychloroquine
Adverse Reactions: Hydroxychloroquine
Efficacy Monitoring Parameters. Rheumatoid arthritis: decreased pain and improved range of motion. Lupus: decreased joint pain, decrease in butterfly rash, improved energy. Malaria: avoidance of malaria.
Toxicity Monitoring Parameters. Seek medical attention if signs/symptoms heart palpitations, severe rash, unusual bruising or bleeding, or difficulty seeing or changes in visual fields. Baseline and periodic eye exams.
Key Patient Counseling Points. If taking weekly, take on same day each week. Take with food or milk.
Clinical Pearls. One tablet of 200 mg of hydroxychloroquine sulfate is equivalent to 155 mg base. If serious toxic symptoms occur, ammonium chloride (8 g daily in divided doses for adults) administered 3-4 d a week for several months may increase the renal excretion of hydroxychloroquine.