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Hydroxychloroquine Drug information

Hydroxychloroquine can be used to treat rheumatoid or . Page 1 Fold

Hydroxychloroquine should Before starting on hydroxychloroquine effectively treat your condition, your doctor may take a blood and stop it causing damage to your test to check that your and joints. It has been tested and has kidneys are working normally, but helped many people. However, you won’t need any regular blood as with all drugs some people will tests during the treatment. have side-effects. This leaflet sets Your doctor will ask you about any out what you need to know. problems with your eyesight and may suggest you get your vision checked What is hydroxychloroquine before you start the medication. and how is it used? Your doctor will explain that your Hydroxychloroquine is a disease- vision needs to be monitored modifying anti-rheumatic drug regularly during treatment (often (DMARD). These drugs regulate the with a yearly review) and will ask you activity of the body’s immune system, to report any visual symptoms. which may be overactive in some If you have any existing eye problems conditions. Hydroxychloroquine before starting hydroxychloroquine can modify the underlying you may need more frequent checks. disease process, rather than Hydroxychloroquine won’t usually simply treating the symptoms. be prescribed if you have existing Hydroxychloroquine is used to treat: maculopathy of the eye (problems with the central part of the retina). • • discoid and systemic (SLE). Over the long term hydroxychloroquine can reduce inflammation and so reduce pain, swelling and joint stiffness. If you have Hydroxychloroquine lupus it may also improve the rash. doesn’t work It’s often taken in combination with immediately – other drugs (such as ). it may be 12 weeks Hydroxychloroquine is a long-term before you notice treatment and it may be 12 weeks the benefit. before you notice the benefit. Page 2 Fold

When and how do I take hydroxychloroquine? Hydroxychloroquine is taken in form, with or after food. If you have lupus, Your doctor will advise you about hydroxychloroquine the correct dose. Usually you will may help with the start on a full dose of 200–400 mg rash as well as joint daily, and later your doctor may pain and stiffness. reduce this. When your condition is very well controlled you may be advised to take hydroxychloroquine only 2–3 times per week. Unless you have severe side- effects it’s important to keep taking hydroxychloroquine: eye) and this risk increases with long-term use and higher dose. • even if it doesn’t seem to be working at first Your doctor will advise you on a • even when your symptoms safe dose to take according to your start to improve – to help keep weight, and you will need to have the disease under control. regular monitoring of your eyes. This monitoring of your eyes may be Possible risks and side-effects arranged at a hospital clinic when you Side-effects aren’t common. start the drug and then again once a However, in some people year in hospital when you have been hydroxychloroquine can cause: taking the drug for more than five years. Otherwise, you should have a check with • skin rashes, especially those an optician once a year and tell them made worse by sunlight that you’re taking hydroxychloroquine. • feeling sick () or indigestion You should report any new eye • diarrhoea symptoms to your doctor straight away. • • bleaching of the hair or mild If you develop any new symptoms or • ringing in the ears () there’s anything else that concerns you • blurred vision. after starting hydroxychloroquine, you should tell your doctor or rheumatology There is a small risk that nurse specialist as soon as possible. hydroxychloroquine may damage the retina (part of the Page 3

Taking other medicines Hydroxychloroquine is commonly given alongside other disease- modifying anti-rheumatic Hydroxychloroquine drugs (DMARDs) including is also used to treat methotrexate, especially in – but that rheumatoid arthritis, rather than doesn’t mean it will being prescribed on its own. protect against malaria However, some drugs can interact if you’re travelling. with hydroxychloroquine. For example, indigestion remedies (including some over-the- counter preparations) can stop hydroxychloroquine being absorbed. It’s recommended that you wait at least 4 hours after taking Vaccinations hydroxychloroquine before you take You can have vaccinations, an indigestion remedy (). including live vaccines such as You should discuss any new yellow fever and shingles, while medications with your doctor before on hydroxychloroquine. starting them, and you should always Even though hydroxychloroquine is tell anyone else treating you that also used in the treatment of malaria, you’re taking hydroxychloroquine. you shouldn’t assume that it will • You can carry on taking protect you if you’re travelling to an painkillers or non-steroidal area where there’s a risk of malaria. anti-inflammatory drugs (NSAIDs) as Always check with a healthcare well as hydroxychloroquine, unless professional what precautions you your doctor advises otherwise. need to take against malaria. If hydroxychloroquine works for you, you may be able to reduce your Alcohol NSAIDs or painkillers after a time • Don’t take over-the-counter There’s no known interaction preparations or herbal remedies between alcohol and without discussing this first hydroxychloroquine. However, if with your healthcare team. you’re also taking methotrexate you should keep well within the recommended limits (2–3 units of alcohol per day for women or Page 4 Fold

3–4 units per day for men). This is pharmacist. They will also be able because methotrexate can interact to advise on possible alternatives if with alcohol and affect your hydroxychloroquine doesn’t suit you. liver. In some circumstances your Arthritis Research UK publishes doctor may advise lower limits. a wide range of information on arthritis including conditions, Fertility, treatments, surgery and living with and breastfeeding arthritis. You may be particularly We suggest you discuss your interested in our booklets on: medication with your doctor if • rheumatoid arthritis you’re planning to have a baby, • lupus (SLE) become pregnant or you’re You can order these free of thinking of breastfeeding. charge by visiting our website, Current guidelines state that calling the number on the back hydroxychloroquine can be taken in of this leaflet or writing to us. pregnancy. It’s often best to continue taking it to prevent a flare of disease as the benefits of the medication usually outweigh the possible risks. The guidelines also advise that If you use indigestion you can breastfeed if you’re on hydroxychloroquine. Hardly any remedies, try to detectable amounts of the drug get avoid taking these into the and there’s no within 4 hours of your evidence that it has any effect on hydroxychloroquine. the baby. The benefits of continuing to take hydroxychloroquine to control your disease are likely to outweigh any risk.

Further information If you would like any further information about hydroxychloroquine or have any concerns about your treatment, you should discuss this with your doctor, rheumatology nurse specialist or Arthritis Research UK Thank you for supporting Arthritis works to improve the Research UK. With your generosity we can keep doing our vital work. quality of life for people To donate visit with arthritis so that www.arthritisresearchuk.org/donate they can say they are in control, independent and recognised.

We’re dedicated to funding research into We would like to thank the team of people the cause, treatment and cure of arthritis who contributed to the development of this so that people can live pain-free lives. booklet. It was written by Prof Ariane Herrick and updated by Dr Taryn Youngstein, For more expert information visit our Dr Benjamin Ellis, Sue Brown and Dr Ian Giles. website or if you would like to tell us An Arthritis Research UK medical advisor, what you think about our booklets email Dr Ben Thompson, is responsible for the [email protected] content overall. or write to the address below. Please note: we have made every effort to Arthritis Research UK ensure that this content is correct at time of publication, but remember that information Copeman House about drugs may change. This information St Mary’s Gate sheet is for general education only and does Chesterfield not list all the uses and side-effects associated S41 7TD with this drug. 0300 790 0400 www.arthritisresearchuk.org

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Date published: 2018. Registered charity in England and Wales no. 207711, Scotland no. SC041156. ©Arthritis Research UK 2018 A Company registered in England and Wales. Limited by Guarantee no. 490500. 2242/D-HYDROX/18-1