Dizziness as a Side Effect of Plaquenil (Hydroxychloroquine)
Yes, Plaquenil (hydroxychloroquine) can cause dizziness as a minor side effect. According to guidelines from the Centers for Disease Control and Prevention, dizziness is one of the known minor side effects of hydroxychloroquine, along with gastrointestinal disturbance, headache, blurred vision, and pruritus 1.
Frequency and Severity
- Dizziness is considered a minor side effect of hydroxychloroquine that generally does not require discontinuation of the medication 1, 2
- These minor side effects tend to be transient and self-limited in most patients 1
- Dizziness occurs at a lower frequency compared to more serious adverse effects like retinopathy 2
Risk Factors and Monitoring
- Elderly patients may be at higher risk for experiencing dizziness due to age-related changes in baroreceptor sensitivity 1
- Patients with cardiovascular comorbidities may have an increased risk of experiencing dizziness when taking hydroxychloroquine 2
- Blood pressure monitoring during initiation of therapy is recommended, particularly in patients with cardiovascular risk factors 2
Management Considerations
- Most cases of hydroxychloroquine-associated dizziness do not require discontinuation of the medication 1
- If dizziness becomes persistent or severe, dosage adjustment or medication change may be considered 2
- Patients should be advised about the possibility of dizziness, particularly when operating machinery or driving 2
Other Important Side Effects to Monitor
- More serious concerns with hydroxychloroquine include retinal toxicity, which requires baseline and periodic ophthalmologic examinations 2, 3, 4
- Cardiac effects including QT interval prolongation may occur, particularly when used with other QT-prolonging medications 2
- Rare but serious neuropsychiatric effects such as hallucinations have been reported 5
Clinical Pearls and Pitfalls
- Dizziness from hydroxychloroquine is different from the more serious vestibular toxicity seen with some other medications 6
- Do not confuse minor dizziness with more serious neurological adverse effects that would require immediate discontinuation 2
- When prescribing hydroxychloroquine, consider potential drug interactions that may exacerbate dizziness 2
- Patients taking hydroxychloroquine should be informed about common side effects including dizziness to improve adherence and reduce anxiety 1