Formulary
Hydroxychloroquine sulfate: Indications, Dosing, Side Effects and Interactions
Hydroxychloroquine sulfate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Hydroxychloroquine sulfate: Indications, Dosing, Side Effects and Interactions
Hydroxychloroquine sulfate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Active rheumatoid arthritis (administered on expert advice),Systemic and discoid lupus erythematosus (administered on expert advice),Dermatological conditions caused or aggravated by sunlight (administered on expert advice)**
- **Adult** (By Mouth): Active rheumatoid arthritis (administered on expert advice), Systemic and discoid lupus erythematosus (administered on expert advice), Dermatological conditions caused or aggravated by sunlight (administered on expert advice) 200-400 mg daily, daily maximum dose to be based on ideal body-weight; maximum 6.5 mg/kg per day.
**Active rheumatoid arthritis (including juvenile idiopathic arthritis) (administered on expert advice), Systemic and discoid lupus erythematosus (administered on expert advice), Dermatological conditions caused or aggravated by sunlight (administered on expert advice) for hydroxychloroquine sulfate**
- **Child** (By mouth): 5-6.5 mg/kg once daily (max. per dose 400 mg), dose given based on ideal body-weight.
Cautions
Acute porphyrias ; diabetes (may lower blood glucose); G6PD deficiency; maculopathy; may aggravate myasthenia gravis; may exacerbate psoriasis; neurological disorders (especially in those with a history of epilepsy-may lower seizure threshold); severe gastro-intestinal disorders
Side effects
Common or very common Abdominal pain; appetite decreased; diarrhoea; headache; mood altered; nausea; skin reactions; vision disorders; vomiting Uncommon Alopecia; anxiety; corneal oedema; dizziness; eye disorders; hair colour changes; neuromuscular dysfunction; retinopathy; seizure; tinnitus; vertigo Frequency not known Acute hepatic failure; agranulocytosis; anaemia; angioedema; bone marrow disorders; bronchospasm; cardiac conduction disorders; cardiomyopathy; confusion; delusions; depression; hallucination; hearing loss; hypoglycaemia; leucopenia; movement disorders; muscle weakness; myopathy; photosensitivity reaction; psychiatric disorder; psychosis; QT interval prolongation; reflexes absent; severe cutaneous adverse reactions (SCARs); sleep disorder; suicidal behaviour; thrombocytopenia; tremor; ventricular hypertrophy Overdose Hydroxychloroquine is very toxic in overdosage; overdosage is extremely hazardous and difficult to treat. Urgent advice from the National Poisons Information Service is essential. Life-threatening features include arrhythmias (which can have a very rapid onset) and convulsions (which can be intractable).
Interactions
**Other interactions (18):**
- Digoxin Hydroxychloroquine sulfate has been reported to increase plasma digoxin levels: serum digoxin levels should be closely monitored in patients receiving combined therapy.
- Chloroquine Hydroxychloroquine sulfate may also be subject to several of the known interactions of chloroquine even though specific reports have not appeared.
- These include: potentiation of its direct blocking action at the neuromuscular junction by aminoglycoside antibiotics; inhibition of its metabolism by cimetidine which may increase plasma...
- Antacids As with chloroquine, antacids may reduce absorption of hydroxychloroquine so it is advised that a 4 hour interval be observed between Hydroxychloroquine sulfate and antacid dosaging.
- Anti-diabetics As hydroxychloroquine may enhance the effects of a hypoglycaemic treatment, a decrease in doses of insulin or antidiabetic drugs may be required.
- Halofantrine Halofantrine prolongs the QT interval and should not be administered with other drugs that have the potential to induce cardiac arrhythmias, including hydroxychloroquine.
Pregnancy
Hydroxychloroquine is the antimalarial drug of choice in females with rheumatic disease planning a pregnancy, and may be continued during pregnancy. A
Breast feeding
May be used during breast-feeding. A Present in milk in very small amounts-very long plasma half-life increases risk of accumulation in the infant, however no adverse effects reported with longer term use. Although adverse effects are unlikely, monitor infant for irritability, insomnia, skin reactions, vomiting, diarrhoea, poor feeding, and adequate weight gain. Avoid in infants with G6PD deficiency, hyperbilirubinaemia, or jaundice (risk of haemolytic anaemia and kernicterus). E
Hepatic impairment
Manufacturer advises caution. Dose adjustments Manufacturer advises consider dose adjustment in severe impairment.
Renal impairment
Caution-monitor plasma-hydroxychloroquine concentration in severe impairment. M Dose adjustments Consider dose adjustment in severe impairment. M
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Hydroxychloroquine sulfate in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

