Hydroxychloroquine - Brand name: Quinoric

What hydroxychloroquine is for

Hydroxychloroquine is a type of medicine called a DMARD (disease-modifying anti-rheumatic drug).

DMARDs work by calming your immune system or changing the way it responds. They're used to treat autoimmune conditions, where your body's natural defence system mistakenly attacks healthy parts of your body.

Hydroxychloroquine is mainly used to treat autoimmune conditions that cause inflammation, swelling and pain, such as:

• rheumatoid arthritis
• juvenile idiopathic arthritis
• lupus (systemic lupus erythematosus)

It's also used to treat skin conditions like:

• sarcoidosis
• lichen planus
• conditions that are caused or made worse by sunlight, such as porphyria cutanea tarda

How to take hydroxychloroquine

Hydroxychloroquine usually comes as tablets that you swallow.

How much you need to take and for how long depends on why you're taking it, but some people may need to take it once or twice a day for at least 6 months.

If you're taking it to treat a skin condition caused by sunlight, you will need to take it when you know you'll spend a lot of time in the sun or be in intense sunlight, even for a short time. For example, during the summer months.

When taking hydroxychloroquine:

• swallow the tablets whole with a meal or glass of milk
• try to take it at the same time each day – if you take it twice a day, this could be once in the morning and once in the evening

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

If you miss a dose of hydroxychloroquine

If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next dose.

If it is nearly time for your next dose, skip the dose you missed and take your next dose at the usual time.

Do not take 2 doses to make up for a forgotten dose.

If you take too much hydroxychloroquine

Taking too much hydroxychloroquine can be dangerous.

Side effects of hydroxychloroquine

Like all medicines, hydroxychloroquine can cause side effects, although not everyone gets them.

Common side effects

Common side effects of hydroxychloroquine include:

• stomach ache
• feeling sick (nausea) and being sick (vomiting)
• loss of appetite
• diarrhoea
• headache
• an itchy rash
• mood changes

Hydroxychloroquine can sometimes cause blurred vision when you first start taking it. If this happens, do not drive, ride a bike or use machinery until your vision has gone back to normal.

Serious side effects

Hydroxychloroquine can sometimes cause serious side effects, although most of them are rare.

Possible serious side effects of hydroxychloroquine include:

• an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing
• severe skin reactions – causing symptoms such as spots, sores, blisters or peeling skin, as well as a high temperature and flu-like symptoms
• vision problems (hydroxychloroquine retinopathy) – causing symptoms like constant blurred vision, changes to how you see colours or being sensitive to light
• liver problems – causing symptoms such as itchy skin, darker pee than normal, pale poo and yellowing of the skin or eyes (this may be harder to see on black or brown skin)

If you've been taking hydroxychloroquine for a long time or are at higher risk of eye problems, you will have regular eye check-ups to look for any signs of retinopathy.

Who can and cannot take hydroxychloroquine

Most adults can take hydroxychloroquine. Children can take hydroxychloroquine, but they may not be prescribed it if they do not weigh enough.

Hydroxychloroquine is not suitable for some people. For example, it may not be suitable if you have:

• liver, kidney, blood or heart problems
• maculopathy or other eye problems
• diabetes
• psoriasis
• had an allergic reaction to hydroxychloroquine or related medicines, like quinine

Before taking hydroxychloroquine, tell your doctor if you have any medical conditions.

Breastfeeding and hydroxychloroquine

Tell your doctor if you're breastfeeding.

Hydroxychloroquine can often be used while breastfeeding, but it's best to check because the medicine can pass into your breast milk in very small amounts.

If you're taking hydroxychloroquine while breastfeeding, speak to a healthcare professional or call NHS 111 if you have any concerns about your baby.

Pregnancy and hydroxychloroquine

Hydroxychloroquine can be used during pregnancy if needed. Tell your doctor if you're pregnant or planning a pregnancy.

If you need to take hydroxychloroquine while you're pregnant, your doctor will prescribe the lowest possible effective dose.

Find out more about taking hydroxychloroquine during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking hydroxychloroquine with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with hydroxychloroquine.

This includes some types of:

• medicines to treat heart problems, such as digoxin
• epilepsy medicines
• antacids and other kinds of indigestion medicine – they may stop hydroxychloroquine from being absorbed properly
• antibiotics, such as azithromycin, clarithromycin and erythromycin
• antidepressants

Speak to a pharmacist or your doctor before taking any other medicines if you've been prescribed hydroxychloroquine.

Before starting hydroxychloroquine, tell your doctor about any other medicines, or any herbal remedies, vitamins or supplements you take.

Food, drink and alcohol with hydroxychloroquine

You can eat and drink normally while taking hydroxychloroquine.