Plaquenil (Hydroxychloroquine): Uses, Dosage, Side Effects, and Essential Information

NOT FOR COVID-19 TREATMENT

Hydroxychloroquine, the active component in Plaquenil, is not advised for treating COVID-19 caused by the SARS-CoV-2 virus. Only take Plaquenil if prescribed by your healthcare provider.
For reliable information on COVID-19 prevention and care, visit our dedicated coronavirus resource center.

Understanding Plaquenil

Plaquenil is a prescription medication commonly prescribed for malaria, lupus, and rheumatoid arthritis (RA). It is designed to treat or prevent specific types of malaria in adults and children, manage chronic discoid lupus erythematosus (DLE), systemic lupus erythematosus (SLE), and alleviate symptoms of RA in adults.

Key Features of Plaquenil

Available as oral tablets, Plaquenil belongs to the antimalarial drug class and contains hydroxychloroquine as its active ingredient. A generic version, hydroxychloroquine, is also accessible.

This guide covers Plaquenil’s side effects, dosing instructions, therapeutic uses, and more.

Potential Side Effects of Plaquenil

Like all medications, Plaquenil can cause side effects ranging from mild to severe. Below is an overview of common side effects reported post-approval. Side effect occurrence can vary based on age, existing health conditions, and concurrent medications.

Consult your healthcare provider or pharmacist for a full list of side effects and management strategies.

Note: Approved by the FDA in 1955, Plaquenil’s initial studies were less comprehensive than modern standards, so some side effect data emerged after widespread use.

Mild Side Effects

Some mild side effects include:

• Digestive issues such as nausea, diarrhea, vomiting, or abdominal discomfort
• Fatigue or low energy
• Headache and dizziness
• Irritability or nervousness
• Ringing in the ears (tinnitus)
• Weight loss
• Skin rash
• Hair thinning or loss*

*Refer to the “Side Effect Spotlight” section for more details on hair loss.

Mild side effects often resolve within days to weeks. If symptoms persist or worsen, seek medical advice.

Serious Side Effects

Though uncommon, serious side effects require immediate medical attention. These include:

• Muscle weakness or pain
• Nerve damage
• Mood alterations, depression, or suicidal ideation
• Hypoglycemia (low blood sugar)
• Hearing loss or persistent tinnitus
• Liver dysfunction or failure
• Sleep disturbances such as nightmares
• Toxicity affecting the retina, heart, skin, or blood
• Severe allergic reactions

If experiencing any severe symptoms, contact your doctor promptly or emergency services if necessary.

SUICIDE PREVENTION

If you or someone you know is at risk of self-harm:

• Call emergency services immediately.
• Stay with the individual until help arrives.
• Remove potential means of harm.
• Offer support without judgment.

For crisis support, contact the National Suicide Prevention Lifeline at 800-273-8255.

Side Effect Spotlight

Toxicity Risks

Rare cases of toxicity have been documented, affecting various organs:

• Retinal Toxicity: Damage to the retina can impair vision. Regular eye exams are vital.
• Cardiac Toxicity: May cause irregular heartbeats or weakened heart muscle, especially in patients with pre-existing heart conditions or electrolyte imbalances.
• Skin Toxicity: Severe skin reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis may occur; seek emergency care if rash develops.
• Blood Toxicity: Can cause low blood cell counts leading to fatigue, bleeding, or infections.

Eye-Related Effects

Plaquenil may cause vision changes or damage, particularly with long-term use or high doses. Risk factors include pre-existing eye or kidney conditions and concurrent medications. Early detection through periodic eye exams is important.

Hair Loss

Hair thinning may be linked to Plaquenil or the underlying autoimmune disease. Discuss with your healthcare provider for appropriate management.

Allergic Reactions

Mild allergic responses include rash, itching, and skin redness. Severe reactions may involve swelling of the face, tongue, or throat, causing breathing difficulties. Seek urgent medical care if severe symptoms arise.

Common Questions About Plaquenil

Is Plaquenil an immunosuppressant, steroid, DMARD, or blood thinner?

Plaquenil is classified as a disease-modifying antirheumatic drug (DMARD) and an antimalarial. It is not an immunosuppressant, steroid, or blood thinner.

Does Plaquenil cause weight gain?

Weight gain is not commonly reported. Conversely, weight loss and appetite reduction have been noted. Consult your doctor if you experience significant changes.

Will stopping Plaquenil cause side effects?

Discontinuing Plaquenil usually does not cause withdrawal effects, but symptoms of the treated condition may worsen. Always discuss cessation plans with your healthcare provider.

Is Plaquenil effective for Sjögren’s syndrome, fibromyalgia, or psoriatic arthritis?

Though not FDA-approved for these conditions, Plaquenil may be used off-label. Consult your doctor about treatment options tailored to your condition.

How does Plaquenil work and how long does it stay in the body?

Plaquenil’s exact mechanism is not fully understood. It has a long half-life of approximately 40 to 50 days, meaning it can remain in the body for up to 200 to 250 days.

Is sun exposure safe while taking Plaquenil?

Plaquenil can increase skin sensitivity to sunlight. Use sunscreen and protective clothing to minimize sunburn risk.

Dosage Guidelines for Plaquenil

Your healthcare provider will determine the appropriate dosage based on your condition, age, and other health factors. Plaquenil is available in 200 mg tablets.

Typical dosing includes weekly doses for malaria prevention, multiple doses over 48 hours for malaria treatment, and daily dosing for lupus and RA. Pediatric dosages are weight-based and prescribed by a doctor.

Missed Dose and Duration

• If you miss a dose, contact your healthcare provider for guidance.
• Duration of treatment varies by condition; long-term use is common for autoimmune diseases.
• Onset of action differs: immediate for malaria, several weeks for autoimmune conditions.

Therapeutic Uses of Plaquenil

Plaquenil is prescribed for:

• Prevention and treatment of specific malaria types in adults and children over 31 kg (68 lbs).
• Management of chronic discoid lupus erythematosus (DLE) in adults.
• Treatment of systemic lupus erythematosus (SLE) in adults.
• Alleviation of rheumatoid arthritis symptoms in adults.

Off-label uses may include other autoimmune or inflammatory conditions; discuss with your healthcare provider for personalized advice.

Proper Administration of Plaquenil

Take Plaquenil tablets orally with food or milk to reduce stomach upset. Consistency in timing helps maintain effective drug levels.

If you struggle with medication labels or bottle openings, consult your pharmacist for accessible packaging or assistive tools.

Drug Interactions

Inform your doctor about all medications, supplements, and vitamins you are taking, as Plaquenil can interact with various drugs, including antiarrhythmics, diabetes medications, antacids, certain antibiotics, and more.

Precautions Before Using Plaquenil

Discuss your full medical history with your doctor, especially if you have eye, heart, kidney, or liver conditions, blood disorders, electrolyte imbalances, mental health issues, or allergies to Plaquenil or its ingredients.

Pregnant or breastfeeding individuals should consult their healthcare provider to assess safety.

Alcohol and Plaquenil

While no direct contraindications exist, both alcohol and Plaquenil can impact liver health. Limit alcohol intake and consult your doctor.

Cost and Alternatives

Plaquenil is available as a generic (hydroxychloroquine), often at a lower cost. Discuss with your healthcare provider and pharmacist about affordability and alternative treatments such as chloroquine or Humira.

Overdose Information

Taking more than prescribed can cause serious side effects including heart irregularities, seizures, and vision loss. In case of overdose, seek emergency medical help immediately.

Consult Your Healthcare Provider

Always communicate openly with your doctor or pharmacist regarding Plaquenil treatment, side effects, and any concerns. They can provide tailored guidance and support for your health journey.

Pharmacist Insight

Will Plaquenil affect my liver?

While rare, Plaquenil has been associated with sudden liver failure in isolated cases. Patients with porphyria should exercise caution. Discuss liver health concerns with your healthcare provider.

Disclaimer: This content is informational and not a substitute for professional medical advice. Always consult your healthcare provider before starting or stopping any medication.

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