What are the other indications for Hydroxychlorquine (Plaquenil) besides Rheumatoid Arthritis?

From the Guidelines

Hydroxychloroquine (Plaquenil) is used for several diseases besides rheumatoid arthritis, including systemic lupus erythematosus (SLE), Sjögren's syndrome, dermatomyositis, and juvenile idiopathic arthritis, as well as for malaria prevention and treatment, and certain dermatological conditions like cutaneous lupus, lichen planus, and porphyria cutanea tarda. The medication works by reducing inflammation, modulating the immune system, and interfering with lysosomal activity in cells.

Indications for Hydroxychloroquine

• Systemic lupus erythematosus (SLE) to manage symptoms and prevent flares 1
• Sjögren's syndrome
• Dermatomyositis
• Juvenile idiopathic arthritis
• Malaria prevention and treatment
• Certain dermatological conditions:
  • Cutaneous lupus
  • Lichen planus
  • Porphyria cutanea tarda

Dosage and Administration

Typical dosing ranges from 200-400 mg daily, though this varies by condition and patient factors like weight and kidney function. The recommended starting dose of hydroxychloroquine is around 5 mg/kg/d, with a maximum daily dose not exceeding 5 mg/kg real body weight 1.

Monitoring for Retinal Toxicity

Patients taking Plaquenil should have regular eye exams as the medication can rarely cause retinal toxicity with long-term use, particularly at higher doses or in patients with kidney disease. Baseline testing is advised to rule out confounding disease when a patient is started on HCQ, and annual screening with sensitive tests should begin no more than 5 years after treatment initiation 1.

From the FDA Drug Label

1 INDICATIONS AND USAGE

1. 1 Malaria Hydroxychloroquine sulfate tablets are indicated in adult and pediatric patients for the: Treatment of uncomplicated malaria due to Plasmodium falciparum, Plasmodium malariae, Plasmodium vivax, and Plasmodium ovale. Prophylaxis of malaria in geographic areas where chloroquine resistance is not reported 1.2 Rheumatoid Arthritis Hydroxychloroquine sulfate tablets are indicated for the treatment of acute and chronic rheumatoid arthritis in adults.
2. 3 Systemic Lupus Erythematosus Hydroxychloroquine sulfate tablets are indicated for the treatment of systemic lupus erythematosus in adults. 1.4 Chronic Discoid Lupus Erythematosus Hydroxychloroquine sulfate tablets are indicated for the treatment of chronic discoid lupus erythematosus in adults.

The other indications for Hydroxychloroquine (Plaquenil) besides Rheumatoid Arthritis are:

• Malaria: treatment and prophylaxis of uncomplicated malaria
• Systemic Lupus Erythematosus: treatment in adults
• Chronic Discoid Lupus Erythematosus: treatment in adults 2

From the Research

Indications for Hydroxychloroquine (Plaquenil)

• Besides Rheumatoid Arthritis, Hydroxychloroquine (Plaquenil) is also used to treat:
  • Systemic Lupus Erythematosus (SLE) 3, 4, 5, 6
  • Sjögren's syndrome 5, 6
  • Osteoarthritis (OA) 5
  • Phospholipid antibody (aPL) syndrome 5
  • As an antimalarial drug 3, 6, 7
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 7

Other Potential Uses

• Hydroxychloroquine may also have benefits in:
  • Reducing atherosclerosis and risks of cardiovascular disease in rheumatic patients 5
  • Improving glycaemia and reducing the risks of type II diabetes mellitus 5
  • Treating other rheumatic diseases 3, 5