Hydroxychloroquine

• Hydroxychloroquine is typically very well tolerated, and serious side effects are rare. However, you should be aware of some of the side effects which can possibly occur:
• Nausea
• Stomach upset
• Skin rash
• Skin pigmentation
• Headache
• Dizziness
• Nervousness
• Muscle weakness (rare)
• Anemia (rare)
• Hair changes (bleaching or thinning of hair)
• Transient blurring of vision – this usually resolves in one to two weeks
• Damage to the retina (cell layer at the back of the eye) may occur. Affected patients may notice blurring around lights or have to look to one side of an object in order to see it clearly. Such vision problems are more likely to occur in individuals taking high doses for many years, in persons 60 years or older, or in those with significant kidney disease. The dose used today is lower than the one originally used to treat arthritis or malaria, hence, development of visual problems while taking this medication is extremely unusual. In addition, this risk is greatly reduced by regular eye examination and following the doctor’s instructions on daily dosage

• It is given orally, after food, usually once a day.
• Taking hydroxychloroquine with food or milk will reduce common side effects e.g. nausea and diarrhea.
• A typical dose will range from 200mg to 400mg daily. In some cases, higher doses can be used.
• The dose will vary for each person depending on the weight of the person, how disease activity and response to treatment.

• If you forget to take a dose, take it as soon as you remember.
• If it is almost time for next dose, skip the missed dose and continue with your regular dosing schedule.
• Do not double the dose to make up for the missed dose.

Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#Store at room temperature;#

What is the TIME to EFFECT?

• Improvement is usually seen in 3-4 weeks. The full benefits of this drug may not be seen until after 12 weeks of treatment.
• You need to take it continuously to keep your symptoms controlled.

What should I do when I am taking the medicine?

• Inform your doctor or pharmacist if you have G6PD (glucose-6-phosphate dehydrogenase) deficiency.
• Your doctor may also suggest regular eye check-up while taking this medication. Visual changes experienced early on or seen early during regular eye check-ups usually improve after stopping the medication.
• Because side-effects can occur at any time during the course of treatment and you may not experience any symptoms in the early stages of the side-effects, it is very important that you have your regular blood tests.

When do I seek medical attention IMMEDIATELY?

• Come back to the hospital if you have:
• Any changes in your vision e.g. reading or seeing difficulties (words, letters, or parts of objects missing); sensitivity to light; blurred distance vision or seeing light flashes or streaks.
• Muscle weakness.
• Bleeding or bruising of the skin.
• Difficulty hearing or ringing in the ears.
• Stop immediately if you developed skin rash or swelling of eyes/lips and seek medical advice from General Practitioners or Polyclinics

Do I skip a dose if I am SICK?

• Seek prompt advice from your doctor when you develop high fever (more than 38°C).
• Your doctor will decide whether to stop hydroxychloroquine on a case-by-case basis.

Can I take other MEDICINES or SUPPLEMENTS?

• Although there are few drug interactions with hydroxychloroquine, to be safe be sure to tell your doctor about all of the medications you are taking, including over-the-counter drugs and supplements.
• This drug does not have a strong effect on the immune system, so vaccines recommended by other physicians are generally acceptable.

Can I get PREGNANT or BREASTFEED?

• If you are pregnant or are considering having a child, discuss this with your doctor. Although hydroxychloroquine use is safe during pregnancy, any medication taken during pregnancy should be discussed with your doctor.
• For mothers receiving hydroxychloroquine, breastfeeding is safe.

SUMMARY… what you need to know about droxychloroquine?

• Take hydroxychloroquine once daily. Always come for your BLOOD TESTS and EYE EXAMINATIONS on the scheduled date.
• Be vigilant of the SIDE EFFECTS and when to seek immediate medical attention.
• Do not take OVER-THE-COUNTER medicines, supplements or herbal treatments without checking with your doctor / pharmacist / nurse
• For female patients intending to start a family, please inform your doctor.
• If you have any questions about your hydroxychloroquine treatment, please discuss with your doctor or Advanced Practice Nurse at 65762418 or pharmacist at 63265077.