From the Guidelines
Hydroxychloroquine sulfate is indicated for the treatment of systemic lupus erythematosus (SLE), rheumatoid arthritis, and malaria, with a recommended dose not exceeding 5 mg/kg real body weight, as supported by the most recent and highest quality study 1.
Indications and Dosage
The indications for hydroxychloroquine sulfate include:
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis
- Malaria (treatment and prevention) The recommended dose is:
- For SLE and rheumatoid arthritis: 200-400 mg daily as a single or divided dose
- For malaria treatment: 800 mg initially, followed by 400 mg at 6, 24, and 48 hours
- For malaria prophylaxis: 400 mg once weekly, starting 1-2 weeks before travel and continuing for 4 weeks after leaving endemic areas ### Important Considerations
- Long-term use requires regular ophthalmologic examinations (every 6-12 months) due to the risk of retinopathy, as highlighted in 2 and 3
- The medication works by interfering with lysosomal activity and autophagy, reducing inflammation in autoimmune conditions, and disrupting parasite metabolism in malaria
- It should be taken with food to minimize gastrointestinal side effects, and patients should report any visual changes immediately
- Hydroxychloroquine requires baseline and periodic monitoring of complete blood counts, liver function, and renal function ### Side Effects and Monitoring Common side effects include:
- Nausea
- Headache
- Dizziness
- Visual disturbances Regular monitoring is necessary to minimize the risk of retinopathy and other adverse effects, as emphasized in 1 and 4
From the FDA Drug Label
Hydroxychloroquine sulfate tablets are indicated for the treatment of systemic lupus erythematosus in adults. Hydroxychloroquine sulfate tablets are indicated for the treatment of chronic discoid lupus erythematosus in adults. Hydroxychloroquine sulfate tablets are an antimalarial and antirheumatic indicated for the: Treatment of uncomplicated malaria due to Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax in adult and pediatric patients. Prophylaxis of malaria in geographic areas where chloroquine resistance is not reported in adult and pediatric patients. Treatment of rheumatoid arthritis in adults. Treatment of systemic lupus erythematosus in adults. Treatment of chronic discoid lupus erythematosus in adults.
The indications for Hydroxychloroquine (HCQ) sulfate are:
- Treatment of uncomplicated malaria due to Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax in adult and pediatric patients.
- Prophylaxis of malaria in geographic areas where chloroquine resistance is not reported in adult and pediatric patients.
- Treatment of rheumatoid arthritis in adults.
- Treatment of systemic lupus erythematosus in adults.
- Treatment of chronic discoid lupus erythematosus in adults. 5, 6, 7
From the Research
Indications for Hydroxychloroquine (HCQ) Sulfate
The indications for Hydroxychloroquine (HCQ) sulfate include:
- Treatment of acute attacks of malaria due to Plasmodium vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum 8
- Treatment of rheumatoid arthritis 8, 9, 10, 11, 12
- Treatment of discoid and systemic lupus erythematosus 8, 10, 12
- Proposed treatment for COVID-19 therapy 8
Patient Populations
HCQ sulfate is used to treat various patient populations, including:
Formulations
HCQ sulfate is available in various formulations, including: