Hydroxychloroquine oral tablet side effects: A detailed guide

Specifically, the Food and Drug Administration (FDA) has approved hydroxychloroquine oral tablet to:

• help prevent and treat malaria in certain situations in adults and some children
• treat rheumatoid arthritis (RA) in adults
• treat systemic lupus erythematosus in adults
• treat chronic (long-term) discoid lupus in adults

This article describes possible side effects of hydroxychloroquine oral tablet. You can explore this overview article to learn more about hydroxychloroquine, including the drug’s uses, dosages, and more.

Hydroxychloroquine oral tablet is a generic version of the brand-name drug Plaquenil. To learn more about brand-name Plaquenil, talk with your doctor.

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More common side effects of hydroxychloroquine

Hydroxychloroquine oral tablet may cause mild or serious side effects. Below are some of the more common side effects of this medication.

Commonly reported side effects of hydroxychloroquine oral tablet include:

• nausea and vomiting
• diarrhea
• abdominal pain

Mild side effects of hydroxychloroquine

Hydroxychloroquine may cause certain mild side effects. Most often, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.

Mild side effects reported with hydroxychloroquine oral tablet include:

• nausea and vomiting
• diarrhea
• abdominal pain
• appetite loss
• dizziness
• fatigue
• hair loss
• headache
• ataxia (problems with muscle coordination and control)
• tinnitus (ringing in the ear)

Hydroxychloroquine oral tablet may cause more mild side effects than those listed above. For details, see the drug’s prescribing information.

Serious side effects of hydroxychloroquine

Hydroxychloroquine may cause certain serious side effects. If you have any serious side effects from hydroxychloroquine oral tablet, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number, or go to the nearest emergency room.

After the FDA approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with hydroxychloroquine.

Serious side effects reported with hydroxychloroquine oral tablet include:

• low blood sugar
• problems with muscle and nerve function
• protein in the urine and kidney damage
• serious skin reactions, including Stevens-Johnson syndrome
• new or worsened mental health symptoms, such as depression or mania
• suicidal thoughts or actions
• eye-related side effects*
• heart-related side effects*
• blood cell problems*

* To learn more about this side effect, see the “Side effects of hydroxychloroquine in detail” section below.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Text Line at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

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Allergic reaction

For some people, hydroxychloroquine oral tablet can cause an allergic reaction.

Allergic reactions have been reported in people taking hydroxychloroquine since the drug was approved for use.

In general, symptoms of an allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to hydroxychloroquine oral tablet, your doctor may recommend taking a different medication instead.

Common questions about side effects of hydroxychloroquine

Here are answers to some common questions about side effects of hydroxychloroquine oral tablet. If you have other questions, talk with your doctor or pharmacist.

Does the hydroxychloroquine 200-milligram (mg) dose have a lower risk of side effects than other doses?

Possibly. The hydroxychloroquine 200 mg dose is typically prescribed for lupus or RA. Higher doses are prescribed for certain types of malaria. The risk of side effects and their severity may increase with higher doses of hydroxychloroquine. This is because there is a high amount of the drug in your system. So, depending on what dose of hydroxychloroquine your doctor prescribes, your risk of side effects may be different.

Talk with your doctor or pharmacist if you have concerns about hydroxychloroquine side effects and your dosage.

Can hydroxychloroquine cause long-term side effects?

Yes, long-term side effects are possible with hydroxychloroquine oral tablet. These are side effects that can occur after taking hydroxychloroquine for a long time. Or they may cause long lasting effects even if you stop taking hydroxychloroquine.

Long-term side effects reported with hydroxychloroquine include:

• new or worsened mental health symptoms, such as depression or mania
• protein in the urine and kidney damage
• problems with muscle and nerve function
• eye-related side effects*
• heart-related side effects*
• blood cell problems*

Talk with your doctor or pharmacist if you have additional questions about possible long-term side effects and hydroxychloroquine.

* To learn more about this side effect, see the “Side effecs of hydroxychloroquine in detail” section below.

Does hydroxychloroquine cause different side effects when taken for RA?

No, it’s not expected to. Hydroxychloroquine’s side effects are expected to be the same regardless of the condition it’s prescribed to treat, according to reports of the drug.

Hydroxychloroquine is prescribed to treat RA (a type of autoimmune disease) in adults. Studies show people with RA are more likely to develop certain other conditions. Examples include certain heart problems, certain kidney problems, and depression.

Hydroxychloroquine can also cause heart problems, kidney problems, and depression as side effects. So, you may have a higher risk of these side effects if you have RA and take hydroxychloroquine. But the benefits of treating your condition may outweigh these risks.

Talk with your doctor if you’d like to learn more about the risks and benefits of taking hydroxychloroquine for RA.

Side effects of hydroxychloroquine in detail

Below you’ll find details on some of the side effects of hydroxychloroquine oral tablet.

Eye-related side effects

Eye-related side effects have rarely been reported in people taking hydroxychloroquine oral tablet. However, these side effects may be serious.

Eye-related side effects reported with hydroxychloroquine include decreased ability to see in the dark,
swelling of the cornea, and retinopathy (damage to the retina, a thin tissue layer at the back of the eye). It also includes macular degeneration (a condition that leads to the breakdown of a part of the retina called the macula).

Symptoms of eye-related side effects may include:

• blurry or cloudy vision
• seeing halos around lights
• vision loss

Damage to the retina caused by hydroxychloroquine can be permanent.

Certain factors can increase the risk of eye-related side effects with hydroxychloroquine oral tablet. These include:

• taking a higher hydroxychloroquine dosage
• taking hydroxychloroquine for a long time
• having a kidney condition, such as chronic kidney disease
• having existing macular disease, including existing macular degeneration
• taking other medications that can cause these effects, such as tamoxifen

Ways to manage

If you experience symptoms of eye-related side effects, immediately tell your doctor. They’ll likely recommend stopping treatment with hydroxychloroquine. It’s important to let your doctor know about your symptoms as soon as possible. This is because eye-related side effects may continue to worsen even after you stop taking the drug.

If you take hydroxychloroquine long-term, your doctor will likely monitor your eye health. They can provide more information on the types of tests and how often you should have them.

Heart-related side effects

Heart-related side effects have rarely been reported in people taking hydroxychloroquine oral tablet, but they may be serious.

Heart-related side effects reported with hydroxychloroquine treatment include cardiomyopathy, heart block, long QT syndrome, sick sinus syndrome, and ventricular arrhythmia. These side effects can be life threatening. And they’re possible whether hydroxychloroquine is taken short or long term.

Symptoms of heart-related side effects may include:

• nausea and heart palpitations
• flutter feeling in the chest
• unusual or fluttering heartbeat
• weakness and feeling short of breath
• fainting
• lightheadedness
• being unable to tolerate exercise

Certain factors can increase the risk of heart-related side effects with hydroxychloroquine oral tablet. These include:

• existing long QT syndrome
• heart disease, including heart failure or past heart attack
• existing arrhythmia
• low blood potassium or magnesium levels that aren’t treated
• taking other medications that can cause long QT syndrome

Ways to manage

If you experience symptoms of heart-related side effects that are mild, tell your doctor. They’ll likely recommend you stop taking hydroxychloroquine.

If your symptoms feel severe or life threatening, call 911 or go to the closest emergency room

Blood cell problems

Blood cell problems have rarely been reported in people taking hydroxychloroquine oral tablet. However, these side effects may be serious.

Blood cell problems reported with hydroxychloroquine include aplastic anemia (a condition causing damaged stem cells) and agranulocytosis (inability of the bone marrow to make enough white blood cells). Low white blood cell counts and low platelet counts were also reported.

Symptoms of blood cell problems may include:

• dizziness
• bruising easily
• purpura (bursting of small blood vessels) or petechiae (small colored spots on the skin)
• nosebleeds

Your risk of infection may also increase if you develop a blood cell problem.

Having an existing blood cell condition can increase the risk of this side effect with hydroxychloroquine oral tablet.

Ways to manage

If you take hydroxychloroquine long term, your doctor will regularly monitor your blood cell counts. They can give more information on the types of tests they’ll order and how often you’ll need them. If they notice any low counts on your test results, they’ll likely suggest stopping hydroxychloroquine treatment.

Warnings for hydroxychloroquine

Below are some factors you may want to discuss with your doctor before taking hydroxychloroquine oral tablet.

Warnings

It may not be safe for you to take hydroxychloroquine oral tablet if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether hydroxychloroquine oral tablet is a safe treatment option for you.

Before taking hydroxychloroquine oral tablet, tell your doctor about your health and the medications you take. Things to consider include:

• blood cell problems, such as anemia
• glucose-6-phosphate dehydrogenase deficiency
• heart disease or other heart conditions, such as arrhythmia or past heart attack
• low blood potassium or magnesium levels
• kidney conditions, such as chronic kidney disease
• mental health conditions, including depression or mania
• current or past suicidal thoughts or behaviors
• porphyria
• psoriasis
• pulmonary hypertension
• type 1 or type 2 diabetes
• taking certain medications, including tamoxifen or thioridazine
• past allergic reaction to hydroxychloroquine

Hydroxychloroquine and pregnancy

It’s not known whether hydroxychloroquine oral tablet should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Hydroxychloroquine and breastfeeding

It’s not known whether hydroxychloroquine oral tablet should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

Hydroxychloroquine and alcohol

Hydroxychloroquine oral tablet is not known to interact with alcohol.

However, alcohol and hydroxychloroquine can cause some similar side effects. Examples include nausea, vomiting, and diarrhea. So, drinking alcohol while taking hydroxchloroquine could worsen these side effects if you experience them.

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment with hydroxychloroquine oral tablet.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.