Hydroxychloroquine Explained

Hydroxychloroquine (Plaquenil) is indicated for the treatment of malaria, discoid and systemic lupus erythematosus and rheumatoid arthritis. Hydroxychloroquine, at this time, is NOT indicated for the treatment of COVID019.

At the time of this publication, there is no evidence that using hydroxychloroquine is beneficial to COVID-19 patients. As of 4/24/20, the Centers for Disease Control and Prevention, the Food and Drug Administration, and a National Institutes of Health panel of experts have pulled back on any guidance regarding the use of hydroxychloroquine or hydroxychloroquine and azithromycin to treat COVID-19.

Approved Uses of Hydroxycholoroquine

Hydroxychloroquine is available as a brand-name drug (Plaquenil) and as a generic drug. It is used to treat malaria, lupus erythematosus, and rheumatoid arthritis. It can decrease the pain and swelling of arthritis. It may prevent joint damage and reduce the risk of long-term disability. 

Hydroxychloroquine is in a class of medications that was first used to prevent and treat malaria. Today it is commonly used to treat rheumatoid arthritis, some symptoms of lupus, childhood arthritis (or juvenile idiopathic arthritis) and other autoimmune diseases.

IMPORTANT WARNING: Accidentally swallowing just a few tablets has been fatal in some children. Keep this drug in a child-resistant bottle and out of the reach of children.

How it works: Hydroxychloroquine treats malaria by killing the parasites that cause the disease. It is not fully understood how the drug works to treat lupus erythematosus or rheumatoid arthritis. It is believed that the drug affects the immune system and prevents it from releasing auto-antibodies that attack healthy cells.

Side Effects of Plaquenil

Side effects: The most common side effects are headache, dizziness, diarrhea, stomach cramps, and vomiting.

Serious side effects: Serious side effects are rare, but they include the following:

  • blurred vision or other vision changes, which may be permanent 
  • heart disease, including heart failure and issues with heart rhythm
  • ringing in the ears or hearing loss
  • angioedema (rapid skin swelling)
  • hives
  • mild or severe bronchospasm
  • sore throat
  • severe hypoglycemia
  • unusual bleeding or bruising
  • changes in skin color
  • muscle weakness
  • hair loss or changes in hair color
  • abnormal mood changes

Plaquenil Toxicity

Plaquenil toxicity refers to an uncommon loss of vision due retinal damage caused by hydroxychloroquine.  

Long-term autoimmune patients who take hydroxychloroquine are routinely examined by their eye doctors or retina specialists looking for signs of Plaquenil toxicity.

Plaquenil toxicity can cause permanent loss of vision.  The vision rarely improves despite cessation of the medications.  In fact, vision loss may continue even after the medication is stopped.  

Patients taking hydroxychloroquine (Plaquenil) should consult with their prescribing doctor about routine eye exams.