From the FDA Drug Label
Hydroxychloroquine sulfate can cause severe and potentially life-threatening hypoglycemia, in the presence or absence of antidiabetic agents [see Drug Interactions (7)]. Measure blood glucose in patients presenting with clinical symptoms suggestive of hypoglycemia and as adjust the antidiabetic treatment as necessary Warn hydroxychloroquine sulfate-treated patients about the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia; diabetic patients should monitor their blood sugar levels. Advise patients to seek medical attention if they develop any signs and symptoms of hypoglycemia.
Yes, Plaquenil (hydroxychloroquine) can cause hypoglycemia. Patients should be warned about the risk of hypoglycemia and educated on its signs and symptoms. Diabetic patients should monitor their blood sugar levels, and all patients should seek medical attention if they develop any signs and symptoms of hypoglycemia 1, 1, 1.
From the Research
Yes, Plaquenil (hydroxychloroquine) can cause hypoglycemia as a side effect, particularly in patients with diabetes, as evidenced by a recent case report in 2024 2. This medication, commonly used to treat autoimmune conditions like rheumatoid arthritis and lupus, has been shown to lower blood glucose levels. The hypoglycemic effect occurs because hydroxychloroquine increases insulin sensitivity in peripheral tissues and may enhance pancreatic insulin secretion. Some key points to consider:
- Patients taking insulin or other diabetes medications alongside Plaquenil may be at higher risk for hypoglycemic episodes and might require adjustment of their diabetes medications.
- The hypoglycemic effect can occur at standard therapeutic doses (typically 200-400 mg daily for adults) and may develop even after long-term use, as seen in a study from 2021 3.
- Patients should monitor their blood glucose levels regularly, especially when starting Plaquenil or changing dosages, and should be aware of hypoglycemia symptoms such as shakiness, sweating, confusion, and heart palpitations.
- If experiencing these symptoms, patients should check their blood sugar and treat low levels promptly with fast-acting carbohydrates. It's also worth noting that hydroxychloroquine has been associated with hypoglycemia in patients without diabetes, as reported in a case study from 2024 2, highlighting the need for careful monitoring of blood glucose levels in all patients taking this medication.