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Hydroxychloroquine

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Hydroxychloroquine

What is Hydroxychloroquine?

Hydroxychloroquine is an anti-malarial drug that is used to treat a wide variety of skin conditions. The way in which it works is unknown but it is understood to have anti-inflammatory effects.

What is Hydroxychloroquine used for?

Hydroxychloroquine is mainly used to treat malaria, but has a wide variety of uses in dermatology.

It may be used in the treatment of the following skin conditions:

  • Cutaneous and systemic lupus
  • Rheumatoid arthritis
  • Dermatomyositis
  • Polymorphic light eruption
  • Sarcoidosis
  • Granuloma annulare
  • Lichen planus
  • Morphoea, scleroderma
  • Graft versus host disease
  • Panniculitis
  • Solar urticaria
  • Pemphigus foliaceus
  • Sjogrens syndrome
  • Reticular erythematous mucinosis.

What precautions should you take with Hydroxychloroquine?

  • Hydroxychloroquine in general should not be taken during pregnancy but may be used in specific situations.
  • Do not give your medication to anyone else.
  • Avoid taking Hydroxychloroquine if you have known eye disease (e.g. Maculopathy).
  • Do not breastfeed while taking Hydroxychloroquine.
  • Avoid using Hydroxychloroquine if you are taking digoxin or MAO-inhibitors.
  • Avoid taking Hydroxychloroquine if you have a medical condition known as G6PD (glucose-6-phosphate dehydrogenase) deficiency.
  • Hydroxychloroquine may have effects on diabetic medications including insulin.
  • Hydroxychloroquine may worsen certain diseases such as Psoriasis.
  • Hydroxychloroquine is best avoided in children younger than 6 years old.

What monitoring is required when taking Hydroxychloroquine?

A blood test may be required before and during treatment with Hydroxychloroquine.
An eye examination by an Ophthalmologist should be considered before treatment commences, and repeated every 6-12 months during treatment.

What to expect when taking Hydroxychloroquine and possible side effects

  • The most significant but very rare side effect of Hydroxychloroquine involves irreversible damage to the lining at the back of the eye which enables vision (the retina). Hydroxychloroquine can cause irreversible retinopathy. Damage to the eyes is more likely to occur when recommended doses are exceeded or when Hydroxychloroquine is taken long-term. Initial damage may not be noticed at first, which highlights the importance of having regular examinations of the eyes. Changes in vision that may occur include blurring, darkness, halos around lights (bull’s eye) and changes in visual acuity. Corneal deposits may cause blurring or altered vision however this condition could be reversible.

    If you notice any changes in your vision it is important you stop taking the medication and let your dermatologist know immediately. 

  • Nausea, vomiting and/or diarrhoea can be common.
  • Other possible side effects include:
    • Headache, tinnitus (ringing in the ears), vertigo (dizziness)
    • Muscle weakness
    • Mood changes and/ or mental disease changes
    • Increased pigmentation (darkening) of the skin. Blue-grey to black discolouration may appear on sun exposed areas of the skin such as the face and shins as well as nails and roof of the mouth
    • Skin rashes
    • Bleaching (lightening) of the hair roots or hair loss but this is usually reversible
    • Anaemia (low blood count), low platelets and low white cell blood counts. Severe cases have been reported on rare occasions which highlights the importance of regular blood test monitoring
    • Liver abnormalities may occur.

Tell your dermatologist if you experience any of the above mentioned side effects of Hydroxychloroquine. In most cases side effects improve when treatment is stopped.

Other potential side effects have been reported. Please refer to the product information that is provided with the medication for a complete list of possible side effects. Ensure you have read and understood the leaflet before taking this medication.

This information has been written by Dr Eleni Yiasemides

 

 

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