Hydroxychloroquine is generally safe at normal doses, but higher amounts can damage the retina, the light-sensitive tissue at the back of the eye, and could result in partial or complete blindness.
“If you feel like your central vision is getting blurred, if you lose the ability to see a digital clock, if you lose color vision—if reds look kind of washed out—or if you have trouble seeing at night: Those are early signs that you might be developing Plaquenil retinopathy,” says Katz.
[6] HCQ retinopathy is not reversible and cellular damage may progress for a number of years even after the drug is stopped. Therefore, it is essential to continue following the patient appropriately.
Effects on the eye
The most important side effect of hydroxychloroquine is on the eye. Blurred vision may occur in the first few weeks after starting hydroxychloroquine. This usually returns to normal even when you continue taking the tablets.
In the initial stages of hydroxycloroquine toxicity, patients are often asymptomatic. If they do have symptoms they complain of visual color deficits, specifically red objects, missing central vision, difficulty reading, reduced or blurred vision, glare, flashing lights, and metamorphopsia.
Long-term use and high doses of hydroxychloroquine are risk factors for the development of cardiomyopathy. Cardiac failure, conduction disorders (including QT prolongation and Torsades de Pointes) and sudden cardiac death are consequences of the cardiomyopathy.
How long you take hydroxychloroquine for depends on why you're taking it. For some conditions, if hydroxychloroquine works for you then you may need to take it for several years, or even for the rest of your life, to control your symptoms.
Cautions with other medicines
If you take antacids, leave a gap of at least 4 hours between taking them and hydroxychloroquine. Tell your doctor or pharmacist if you're taking any other medicines, including: azithromycin, erythromycin or clarithromycin, antibiotics. amiodarone or digoxin, medicines for heart problems.
Keep taking hydroxychloroquine until your doctor tells you to stop. Do not stop taking it just because you feel better. If you stop, your symptoms may get worse again.
Adults—At first, 400 to 600 milligrams (mg) taken as a single dose or in two divided doses per day. Then, 200 mg once a day or 400 mg taken as a single dose or in two divided doses per day. Your doctor may adjust your dose if needed. Children—Use and dose must be determined by your doctor.
Is weight gain a side effect of Plaquenil? No, weight gain hasn't been reported as a side effect of Plaquenil. But weight loss has been reported as a side effect. Two conditions Plaquenil is prescribed to treat, rheumatoid arthritis (RA) and lupus, can cause symptoms that contribute to weight gain.
Weight gain or weight loss
For some people, Plaquenil may cause weight loss. This is because the drug can decrease your appetite, which may lead to the weight loss.
Using Plaquenil for a long period of time may harm the retina, causing serious vision loss. People with retinal damage from Plaquenil are not aware at first that they are losing vision. Unfortunately, once they lose a severe amount of vision loss, it is permanent.
Patients starting treatment with Plaquenil should have a baseline eye examination within the first year of taking this medication and then regular screenings thereafter; every six months or yearly as advised by your eye doctor.
Hydroxychloroquine acts by suppressing Toll-like receptors to trigger important immunomodulatory effects. Hydroxychloroquine is a well-established and effective therapy for systemic and cutaneous lupus and other autoimmune diseases.
This medicine may cause muscle and nerve problems. Check with your doctor right away if you have muscle weakness, pain, or tenderness while using this medicine. Hydroxychloroquine may cause some people to be agitated, irritable, or display other abnormal behaviors.
Hydroxychloroquine may potentially result in adverse effects on the central nervous system, mainly irritability, nervousness, emotional changes, nightmares, and even true psychoses [3, 4].
This medication may irritate the stomach, and should be taken with food. It is best to avoid coffee, spicy food or alcohol.
There's no known interaction between alcohol and hydroxychloroquine. However, if you're also taking methotrexate you should keep well within the recommended limits (no more than 14 units of alcohol per week for adults) as methotrexate can interact with alcohol and affect your liver.
Replenish Depleted Nutrients
Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K.
Plaquenil and other anti-malarials are the key to controlling lupus long term, and some lupus patients may be on Plaquenil for the rest of their lives.
In 1956, the U.S. Food and Drug Administration approved HCQ for symptoms of lupus and rheumatoid arthritis, particularly skin inflammation, hair loss, mouth sores, fatigue, and joint pain.
Hydroxychloroquine (HCQ), a relatively safe derivative of chloroquine, is effectively used for the treatment of systemic lupus erythematosus and other inflammatory rheumatic diseases. It acts by accumulating in lysosomes, where its basic pH modifies the normally acidic milieu.