What Is Plaquenil Used For?

Plaquenil contains hydroxychloroquine sulfate and is prescribed to treat several different conditions affecting the joints, immune system, and to prevent or treat malaria.

Primary Uses

Plaquenil is used to treat rheumatoid arthritis (joint inflammation with stiffness, swelling and pain), systemic lupus erythematosus (SLE – an autoimmune disease affecting multiple organs), discoid lupus erythematosus (DLE – a skin condition with scaling red rashes), and for malaria treatment and prevention.

How It Works

For rheumatoid arthritis, Plaquenil may slow down joint damage and relieve disease symptoms. For malaria, it destroys the harmful parasites in red blood cells that cause the illness. For lupus conditions, it helps control the overactive immune response.

How to Take Plaquenil

Take Plaquenil tablets whole with a little water or other liquid at mealtimes. Your dosage will depend on the condition being treated.

Dosage Instructions

For rheumatoid arthritis: Adults typically start with 2-3 tablets daily, which may be reduced to 1-2 tablets daily. For SLE and DLE: Adults typically take 2-4 tablets daily, which may be reduced to 1-2 tablets daily. For malaria prevention: Adults take 2 tablets once weekly on the same day each week. For malaria treatment: Adults start with 4 tablets, then 2 tablets six to eight hours later, followed by 2 tablets daily for the next 2 days. Children’s doses are calculated based on body weight.

What If You Miss a Dose?

For rheumatoid arthritis, SLE, or DLE: Don’t double dose – just continue with your regular dose the next day. For malaria prevention or treatment: Take the missed dose as soon as you remember, then return to your normal schedule. If it’s almost time for your next dose, skip the missed dose.

Available Tablet Strengths

Side Effects

Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.

Common Side Effects

These side effects occur relatively frequently and usually don’t require emergency care:

• Nausea
• Vomiting
• Diarrhea
• Abdominal cramps
• Loss of appetite
• Muscle weakness
• Dizziness
• Ringing in ears
• Headache
• Nervousness
• Skin rash and itching
• Hair loss
• Darkening of urine
• Decreased hemoglobin on blood tests

Important Warnings

There are several important conditions and situations where Plaquenil should not be used or requires special caution.

Who Should Not Take Plaquenil

Do not use Plaquenil if you are allergic to hydroxychloroquine, chloroquine, or any ingredients; have previously experienced vision changes when taking arthritis or malaria medicines; have a heart rhythm disorder; or are a child under 6 years old. Children over 6 should not use it for long periods.

Medical Conditions to Discuss

Tell your doctor if you have: allergies to quinine; eye disorders; history of low blood sugar; inactive chronic infections (hepatitis B, chickenpox/shingles, tuberculosis); chloroquine-resistant malaria; liver or kidney problems; diabetes; stomach, brain or blood disorders; heart muscle disease; skin diseases (especially psoriasis); G-6-PD deficiency; porphyria; myasthenia gravis (muscle weakness disease).

Pregnancy and Breastfeeding

Plaquenil should be avoided in pregnancy unless benefits outweigh risks. Long-term use increases risk to unborn children, potentially causing brain, hearing, balance, and vision problems. The drug passes into breast milk and infants are extremely sensitive to toxic effects. Breastfeeding mothers should only use if benefits outweigh risks.

Drug Interactions

Many medications can interact with Plaquenil and affect how it works. Always tell your doctor about all medicines you’re taking.

• Depression medicines (fluoxetine, paroxetine, St John’s wort)
• Heart medicines (digoxin, flecainide, propafenone, quinidine)
• Diabetes medicines
• Immune system suppressants (ciclosporin)
• Heart rhythm medicines (amiodarone, moxifloxacin)
• Other antimalarial drugs
• Epilepsy medicines (carbamazepine, phenobarbital)
• Tamoxifen (breast cancer medicine)
• Certain antibiotics (moxifloxacin, azithromycin, clarithromycin, erythromycin, roxithromycin)
• Blood-affecting medicines
• Eye-affecting medicines
• Antacids (magnesium, kaolin, cimetidine)
• Antifungal medicines (itraconazole)
• Rifampicin (antibiotic)
• Blood thinners (dabigatran, clopidogrel)
• Cholesterol medicines (gemfibrozil, statins)
• HIV medicines (ritonavir)

Alcohol & Driving

Plaquenil can affect your ability to drive safely and may interact with alcohol. Take precautions until you know how the medication affects you.

Alcohol

Tell your doctor if you drink alcohol, as this may affect your treatment.

Driving and Operating Machinery

Be careful before driving or using machines until you know how Plaquenil affects you. The medication may cause dizziness and vision problems including blurred vision. Make sure you know how you react before driving or operating dangerous equipment.

Storage

Keep tablets in the original bottle until ready to take them – they won’t keep well if removed early. Store in a cool, dry place below 25°C. Avoid heat, dampness, moisture, and direct sunlight. Don’t store in bathrooms, cars, or on windowsills. Keep away from children, who are particularly sensitive to Plaquenil’s effects.

Overdose Information

If you think you’ve taken too much Plaquenil, seek urgent medical attention immediately. Call the Poisons Information Centre (13 11 26 in Australia or 0800 764 766 in New Zealand), contact your doctor, or go to the nearest hospital emergency department. Do this even without symptoms. Overdose symptoms may include headaches, drowsiness, visual disturbances, or seizures, which can occur within 30 minutes.

Frequently Asked Questions