Hydroxychloroquine is a drug that treats symptoms in people with rheumatoid arthritis (RA) who have not seen improvements with other treatments. It is available in tablet form under the brand name Plaquenil.

Hydroxychloroquine is a disease-modifying antirheumatic drug (DMARD). The Food and Drug Administration (FDA) has approved the drug to treat malaria and autoimmune diseases, including RA and lupus.

This article explains how hydroxychloroquine helps reduce RA symptoms. It also outlines the medication’s risks and other treatments for RA.

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Hydroxychloroquine is a prescription drug that can help improve symptoms in people with RA by blocking the immune system’s effects on the body.

The drug can help ease pain, stiffness, and inflammation. Healthcare professionals may prescribe it alone or with another DMARD, such as methotrexate.

According to the American College of Rheumatology, medical professionals generally prescribe hydroxychloroquine at a dose of 200–400 milligrams daily for adults with RA symptoms.

A person may take a dose once or twice per day. A doctor or pharmacist will usually recommend taking the drug with food to minimize potential gastrointestinal side effects.

Hydroxychloroquine can cause some side effects, but these usually go away with time.

Possible side effects include:

  • stomach pain
  • nausea
  • headaches
  • skin itching
  • skin rashes

Serious side effects that may require medical attention include:

  • frequent bruising
  • blurred vision
  • low blood sugar levels and symptoms such as sweating and dizziness
  • anxiety
  • confusion
  • visual disturbances
  • retinal damage
  • heart palpitations

The Arthritis Foundation also recommends people consult an eye doctor annually to check whether the drug is causing vision problems.

Before starting an RA treatment, people should let their doctors know of any medications they are taking. This is to minimize any interactions with hydroxychloroquine.

Drugs that may interact with hydroxychloroquine include:

It is also important for people to tell their doctor about any herbal supplements they are taking.

According to the FDA, supplements may contain ingredients beyond those on the product label. These ingredients may interact with prescription medications.

People who take hydroxychloroquine may experience noticeable benefits within 1 to 2 months.

If symptoms do not improve, people can speak with their doctor. However, they should not stop their treatment without the approval of a doctor.

Some medical conditions can increase the risk of side effects when taking DMARDs, such as:

  • infections
  • liver disease
  • heart problems

A 2020 systematic review suggests that hydroxychloroquine could also worsen symptoms for people with psoriasis.

Additionally, some DMARDs may be harmful to take during pregnancy. However, while hydroxychloroquine can pass through the placenta, there are limited reports of adverse effects during pregnancy.

A 2020 study suggests that congenital anomalies from hydroxychloroquine exposure are more likely to occur during the first trimester.

Other drugs can help ease pain and inflammation due to RA. These include:

Lifestyle changes may also help manage RA symptoms. These include:

  • quitting smoking, if applicable
  • reducing the consumption of sugary beverages
  • engaging in aerobic and resistance-training exercise
  • getting enough sleep
  • eating a nutritious diet

Hydroxychloroquine can treat other medical conditions besides RA. They include the below.

Lupus

Doctors commonly prescribe hydroxychloroquine to treat lupus since it has fewer side effects than other drugs.

According to the Lupus Foundation of America, the drug can reduce flare-ups, prevent future damage, and increase survival rates.

Malaria prevention

Hydroxychloroquine is also an antimalarial drug. People commonly take it while traveling to malaria-prone areas. The Centers for Disease Control and Prevention (CDC) recommend buying the medication from a pharmacy before traveling outside the United States.

COVID-19 symptoms

According to the FDA, ongoing clinical trials are looking to determine whether hydroxychloroquine effectively treats COVID-19 symptoms. Some doctors have used it to alleviate symptoms in people hospitalized with COVID-19.

However, it is important to note that the drug comes with a high risk of causing heart rhythm problems when treating those with COVID-19 symptoms.

Current treatment guidelines recommend against using this drug to treat COVID-19.

Learn more about hydroxychloroquine and COVID-19.

Hydroxychloroquine is an FDA-approved drug that treats RA and lupus. People also use it to help prevent malaria.

It may be an effective drug for people whose RA has not responded to other treatments.

Hydroxychloroquine can cause side effects, including nausea, headaches, and skin rash. Additionally, current treatment guidelines recommend against using it to treat COVID-19.

It may also interact with other drugs, such as antibiotics. Additionally, it may not be safe for people with an infection, liver disease, or heart problems.

A person should seek urgent medical help if they develop heart palpitations, chest pain, or shortness of breath when taking hydroxychloroquine.