Hydroxychloroquine is a medication that has been in medical use for decades. Originally developed to treat and prevent malaria, it has since gained recognition as an important drug in managing autoimmune diseases such as lupus and rheumatoid arthritis. In recent years, it gained media attention due to its controversial use during the COVID-19 pandemic. However, its primary role remains in chronic disease management. In this article, we’ll explore what hydroxychloroquine is, how it works, its medical uses, safety profile, and what patients should know before taking it.
What Is Hydroxychloroquine?
Hcqs 200 is an oral prescription medication sold under brand names such as Plaquenil. It belongs to a class of drugs known as antimalarials, though its immune-modulating effects make it beneficial for autoimmune conditions. It is closely related to chloroquine, another antimalarial drug, but is generally considered to have fewer side effects and better tolerability.
Originally approved by the FDA in 1955, hydroxychloroquine is included in the World Health Organization’s List of Essential Medicines due to its safety and effectiveness in treating specific conditions. You can also buy hydroxychloroquine online from dosepharmacy.
How Does Hydroxychloroquine Work?
Hydroxychloroquine works through multiple mechanisms depending on the disease it is used to treat:
1. In Malaria
Hydroxychloroquine interferes with the growth of parasites in red blood cells. It raises the pH inside the parasite’s food vacuoles, which disrupts its digestive functions, ultimately killing it. This mechanism makes it useful both for prevention and treatment of certain types of malaria.
2. In Autoimmune Diseases
In conditions like lupus and rheumatoid arthritis, the immune system mistakenly attacks healthy tissues. Hydroxychloroquine is believed to suppress parts of the immune response that cause inflammation and damage. It interferes with antigen processing and presentation, reducing the activation of T cells, and limits the release of inflammatory cytokines.
This immune-modulating property helps reduce pain, swelling, rash, and fatigue in autoimmune disorders.
Medical Uses of Hydroxychloroquine
1. Systemic Lupus Erythematosus (SLE)
Hydroxychloroquine is a cornerstone therapy in lupus treatment. It helps prevent flares, improves skin symptoms, and can reduce the need for steroids. Long-term use is associated with improved survival in lupus patients.
2. Rheumatoid Arthritis (RA)
In RA, hydroxychloroquine is often used in combination with other disease-modifying antirheumatic drugs (DMARDs) to reduce joint inflammation and prevent long-term joint damage.
3. Malaria
Though no longer the first-line treatment due to widespread resistance, hydroxychloroquine is still used in some areas for treating uncomplicated malaria, particularly strains of Plasmodium vivax, P. malariae, P. ovale, and susceptible P. falciparum.
4. Other Off-Label Uses
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Sjögren’s syndrome
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Chronic Q fever
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Porphyria cutanea tarda
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Occasionally studied for COVID-19, though not recommended due to lack of proven benefit
Dosage and Administration
The typical dose varies by condition:
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Lupus or RA: 200 to 400 mg per day
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Malaria prevention: 400 mg once weekly
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Malaria treatment: A loading dose of 800 mg, followed by smaller doses
It is usually taken with food or milk to reduce stomach upset. Since hydroxychloroquine accumulates in body tissues, it can take weeks to months before noticeable improvements are seen in autoimmune diseases.
Side Effects of Hydroxychloroquine
While hydroxychloroquine is generally well-tolerated, it may cause side effects. Most are mild and go away over time, but some can be serious.
Common Side Effects:
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Nausea or vomiting
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Diarrhea
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Headache
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Dizziness
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Skin rash
Rare but Serious Side Effects:
1. Retinal Toxicity
The most concerning long-term risk is retinal damage, which can lead to permanent vision loss. The risk increases with:
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High doses
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Long-term use (over 5 years)
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Kidney dysfunction
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Pre-existing eye disease
To prevent this, patients should undergo a baseline eye exam and annual screening after 5 years of use.
2. Heart Problems
Hydroxychloroquine can affect heart rhythm (QT prolongation), especially when taken with other medications that impact the heart. This can lead to arrhythmias in rare cases.
3. Muscle Weakness and Neuropathy
Long-term use may rarely cause muscle or nerve damage, leading to weakness or tingling.
4. Blood Disorders
Very rarely, it can affect blood cells and lead to anemia or low white blood cell count.
Monitoring and Safety Measures
To ensure safe use, healthcare providers typically recommend:
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Regular Eye Exams: Every 12 months, especially after 5 years of continuous use.
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Kidney and Liver Function Tests: Periodically check organ health.
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EKG Monitoring: For those at risk of heart rhythm problems.
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Blood Tests: To detect any rare hematologic effects.
Always inform your doctor about any other medications or supplements you’re taking, as interactions may occur.
Who Should Avoid Hydroxychloroquine?
Hydroxychloroquine may not be suitable for everyone. It is not recommended for individuals with:
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Retinal or visual field problems
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Severe kidney or liver impairment
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History of heart rhythm disorders
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Allergies to 4-aminoquinoline compounds
Pregnant and breastfeeding women should only use it under medical guidance. While it has been used safely in pregnancy for lupus, the risks and benefits must be carefully weighed.
Hydroxychloroquine and COVID-19: A Note
During the early stages of the COVID-19 pandemic, hydroxychloroquine was studied as a potential treatment. However, multiple large-scale studies found no significant benefit in reducing severity or mortality. As a result, the FDA revoked its emergency use authorization in 2020, and it is no longer recommended for COVID-19 prevention or treatment.
Hydroxychloroquine is a valuable medication with a long history of safe use when properly monitored. It plays a crucial role in managing autoimmune diseases such as lupus and rheumatoid arthritis, offering symptom relief and long-term disease control. Although side effects are possible, regular checkups and proper dosing greatly reduce the risks.
It is important to use hydroxychloroquine only under a doctor’s supervision, especially if you have other health conditions or take multiple medications. With responsible use and ongoing monitoring, hydroxychloroquine can be a safe and effective part of your treatment plan.
