Hydroxychloroquine

In Aotearoa New Zealand hydroxychloroquine is available as tablets (200 mg).

• Rheumatoid arthritis or lupus: Your doctor may start you on a higher dose (2 to 4 tablets daily) and reduce it after a few weeks. The usual dose of hydroxychloroquine is 1 or 2 tablets daily, although your dose may differ from this. 
• Malaria: The dose of hydroxychloroquine for malaria is different. Your prescriber will advise you on how much to take.
• Always take your hydroxychloroquine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

• Timing: Take hydroxychloroquine at the same times each day, with a full glass of water or a glass of milk (to help reduce nausea or feeling sick). It's best to take hydroxychloroquine with or after food, but don't take it with antacids (medicines for heartburn).
• Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.
• Keep taking hydroxychloroquine every day: It may take up to a few months before you experience the full benefits of hydroxychloroquine.

Here are some things to know when you're taking hydroxychloroquine. Other things may be important as well, so ask your healthcare provider what you should know about.

• Tests and monitoring: You will need to have regular blood tests to monitor for side effects and to check whether the treatment is effective.
• Risk of infections: Hydroxychloroquine weakens your body’s defence (immune) system, so you're more likely to pick up infections. It's important to avoid anyone who has chickenpox or shingles.
• Pregnant or planning a pregnancy: You should avoid becoming pregnant while you're taking hydroxychloroquine. Talk to your healthcare provider about which types of contraception are suitable for you and your partner.
• Vaccines: Some vaccines shouldn't be taken if you're on hydroxychloroquine. Always check with your doctor or pharmacist first. It is safe for you to have the annual flu vaccine.
• Other medicines: Hydroxychloroquine interacts with some other medicines and herbal supplements, so check with your doctor or pharmacist before starting hydroxychloroquine or before starting any new medicines, including those you can buy over the counter. Don't take antacids for at least 4 hours before or after hydroxychloroquine.
• Increased sensitivity to the sun: Hydroxychloroquine makes your skin more sensitive to the sun. Protect your skin when you're in the sun, especially between 10am and 3pm. Wear protective clothing and use a high factor sunscreen (SPF 30+) and sunglasses.

Like all medicines hydroxychloroquine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine. Read more about what to expect when starting hydroxychloroquine(external link).

Problems with your eyesight

Hydroxychloroquine can affect your eyesight. Blurred vision may occur in the first few weeks after starting it. This usually returns to normal even when you continue taking the tablets. Talk to your doctor if you are worried.

• Taking hydroxychloroquine over a long time (more than 5 years) or taking it at higher doses can cause damage to your eyes.
• You will need an eye test in your first year of treatment, and another one after 5 years (unless your doctor decides you need one sooner).
• After 5 years of treatment, you will need to have an eye test every year. 
• After 10 years of taking hydroxychloroquine, you will need to have specialised eye testing to measure the electrical activity of your eyes. You may need to go to a hospital for this.  
• If you notice any changes in your eyesight, such as sensitivity to light, blurred vision, seeing light flashes, streaks or black spots, tell your doctor as soon as possible.
• It's important to wear sunglasses when you're in bright sunlight to protect your eyes.

Other side effects

Read more about medicines and side effects and reporting a reaction you think might be a side effect.