Hydroxychloroquine Sulfate Chloroquine Phosphate
Hydroxychloroquine Sulfate and Chloroquine Phosphate are antimalarial drugs found to be useful in the treatment of autoimmune diseases like discoid and systemic lupus erythematosus, rheumatoid arthritis and juvenile chronic arthritis, chronic cutaneous vasculitis. These drugs are particularly effective in treating skin and joint symptoms and they have been demonstrated to reduce inflammation and improve muscle or joint pain. However, they are not effective when used alone for more severe manifestations of these diseases which involve the major organs.
Hydroxychloroquine or chloroquine tablets should be taken with or after food to reduce stomach upset. This drug does not work immediately. It may be weeks to months before you notice any benefit. Thus it is important that you take your medication regularly, otherwise, you may not receive any benefit at all.
These drugs can be taken with other medication, e.g. corticosteroids or NSAIDS, used for the treatment of lupus erythematosus or rheumatoid arthritis. In fact, they are sometimes given in combination with prednisolone to reduce the amount of steroid that is needed to improve symptoms. Do not consume these drugs together with antacids, space them apart by at least 2 hours. Please inform your doctor or pharmacist if you are taking other medications, including traditional remedies, that he is not aware of.
Side effects can occur with any drug and these drugs are no exception. When taken according to the doctor’s instruction, they are infrequent. Hydroxychloroquine and chloroquine are not equivalent in their side effects. Side effects with hydroxychloroquine are generally rare.
| Side effect | Warning signs | To reduce this side effect |
| Nausea, Anorexia Or Diarrhoea | Take medication after food | |
| A headache or Dizziness or Ringing in the ears or Muscle weakness | Improves as you get used to the medication or with dose reduction. Check with your doctor if you experience muscle weakness that progresses from your legs and upwards | |
| Blurred vision Retinal damage (uncommon if the recommended daily dose is not exceeded) | Visual disturbances, photophobia, light flashes and streaks, missing or blacked-out areas in the visual field, difficulty in focusing | Transient blurring of vision may occur but this usually resolves in 1 to 2 weeks Inform your doctor immediately. Retinal damage is usually reversible when treatment is stopped. Hydroxychloroquine has a lower risk compared to chloroquine You will have to undergo an eye examination before treatment is initiated and at least 6 monthly thereafter |
| Allergic reaction or Pigmentary changes in the skin and mucous membranes (rare) | Generalized skin rashes, itching, discoloration of the skin, fingernails and inside of the mouth | These usually resolve readily on stopping treatment |
| Blood disorder (rare) | There may be no warning signs but unusual bleeding or bruising, mouth ulcers with ‘flu-like’ symptoms may occur | Inform your doctor immediately if these symptoms occur. Monitoring of the effects of your new treatment is important, particularly during the first three months of treatment. To do this we may need to check your blood tests regularly. The monitoring is for your safety Inform your doctor if you have G6PD deficiency |
