Drug Profile

Pregnancy Warning

Hydroxychlorquine rapidly crossed the placenta in an animal study and accumulated in fetal eyes; it remained there for five months after it had been removed from the rest of the body. Irreversible retinal damage has occurred in some patients taking this drug. Because of the potential for serious adverse effects to the fetus, this drug should not be used by pregnant women except for the treatment of malaria.

Breast-feeding Warning

There is no information on excretion of hydroxychloroquine in milk. However, because of the potential for serious adverse effects in nursing infants, you should not take this drug while nursing.

Tell your doctor if you have or have had:

• allergies to drugs
• alcohol dependence
• liver or kidney problems
• severe blood disorders
• gastrointestinal disease
• glucose-6-phosphate dehydrogenase deficiency
• disorders of the nervous system or seizures
• psoriasis
• eye disease
• porphyria
• pregnancy or are breast-feeding

Tell your doctor about any other drugs you take, including aspirin, herbs, vitamins, and other nonprescription products.

• Do not drink alcohol.
• Be alert to changes in vision and stop drug immediately. Hydroxychloroquine can cause irreversible damage to the eyes.
• Have regular eye exams during and after long-term use.
• Check with your doctor if there is no improvement in your arthritis after a few weeks or months. If there is no improvement in rheumatoid arthritis joint swelling or mobility after six months, the drug should be discontinued.
• Until you know how you react to this drug, do not drive or perform other activities requiring alertness. Hydroxychloroquine causes lightheadedness and drowsiness.

• If you miss a dose, use the following guidelines: If you take the drug once a week, take the missed dose as soon as you remember and resume your regular schedule. If you take the drug once a day, take the missed dose as soon as you remember, but skip it if you don’t remember until the next day. If you take the drug more than once a day, take the missed dose if you remember less than an hour after you were supposed to take it. If more than an hour has passed since you were supposed to take it, skip it. Continue to follow your regular schedule. Do not take double doses.
• Take with food or milk to reduce stomach upset.
• Store at room temperature with lid on tightly. Do not store in the bathroom. Do not expose to heat, moisture, or strong light. Keep out of reach of children.

The following drugs, biologics (e.g., vaccines, therapeutic antibodies), or foods are listed in Evaluations of Drug Interactions 2003 as causing “highly clinically significant” or “clinically significant” interactions when used together with any of the drugs in this section. In some sections with multiple drugs, the interaction may have been reported for one but not all drugs in this section, but we include the interaction because the drugs in this section are similar to one another. We have also included potentially serious interactions listed in the drug’s FDA-approved professional package insert or in published medical journal articles. There may be other drugs, especially those in the families of drugs listed below, that also will react with this drug to cause severe adverse effects. Make sure to tell your doctor and pharmacist the drugs you are taking and tell them if you are taking any of these interacting drugs:

digoxin, FLAGYL, LANOXICAPS, LANOXIN, metronidazole.

Call your doctor immediately if you experience:

• changes of vision
• seizures
• mood or mental changes
• hearing loss; ringing or buzzing in ears
• unusual bleeding or bruising
• unusual muscle weakness
• sore throat and fever
• fatigue, weakness

Call your doctor if these symptoms continue:

• vision changes
• diarrhea
• loss of appetite
• nausea, stomach cramps or pain
• headache
• itching
• bleaching of hair or increased hair loss
• blue-black discoloration of skin, fingernails, or inside mouth
• dizziness or lightheadedness
• nervousness or restlessness
• skin rash

Call your doctor if this symptom continues after you stop taking this drug:

• blurred vision or any change in vision

Signs of overdose:

• difficulty breathing
• drowsiness
• fainting
• seizure
• coma
• headache
• very excitable

If you suspect an overdose, call this number to contact your poison control center: (800) 222-1222.

Ask your doctor which of these tests should be done periodically while you are taking this drug:

• eye exams (before use, and at least every six months during long-term use)
• complete blood count
• neuromusclar exams