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Hydroxychloroquine Sulphate: Brands, Price & Uses in Bangladesh
Hydroxychloroquine Sulphate is a 4-aminoquinoline antimalarial and disease-modifying antirheumatic drug (DMARD) with the following indications: Established / FDA-approved uses Malaria: Treatment of…
About Hydroxychloroquine Sulphate
Indications of Hydroxychloroquine Sulphate
Hydroxychloroquine Sulphate is a 4-aminoquinoline antimalarial and disease-modifying antirheumatic drug (DMARD) with the following indications:
Established / FDA-approved uses
- Malaria: Treatment of uncomplicated malaria due to susceptible strains of Plasmodium falciparum, P. malariae, P. ovale, and P. vivax, and chemoprophylaxis of malaria in geographic areas where chloroquine resistance is not reported.
- Chronic discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE): Treatment of skin, joint and systemic manifestations.
- Rheumatoid arthritis (RA): Treatment of active RA, usually as part of combination DMARD therapy rather than as monotherapy in moderate-to-severe disease.
Guideline-supported / adjunct uses
- As a background or adjunct DMARD alongside methotrexate or other agents in combination regimens for rheumatoid arthritis, per rheumatology treatment guidelines.
- Maintenance therapy to reduce lupus flare frequency and long-term organ damage in SLE, as recommended in lupus management guidelines.
Off-label uses (not FDA-approved; use only under physician supervision)
- Other connective tissue and autoimmune conditions such as Sjogren's syndrome and certain forms of juvenile idiopathic arthritis, based on limited evidence and specialist judgment.
Note: Hydroxychloroquine Sulphate does not have proven efficacy for the treatment or prevention of COVID-19; use for this purpose is not supported by current evidence and is not recommended.
Dosage & Administration of Hydroxychloroquine Sulphate
Dosage of Hydroxychloroquine Sulphate is individualized by indication, body weight and clinical response. The following is a general guide; the treating physician's prescription should always be followed.
| Indication | Adult dose | Notes |
|---|---|---|
| Malaria treatment (adult) | 800 mg salt initially, then 400 mg at 6 hours, 400 mg at 24 hours, and 400 mg at 48 hours (total 2000 mg salt over 3 days) | Confirm local resistance patterns; combination therapy may be required in some regions |
| Malaria prophylaxis (adult) | 400 mg salt once weekly, starting 1-2 weeks before travel, continued weekly during exposure and for 4 weeks after leaving the endemic area | Only for areas without chloroquine resistance |
| Rheumatoid arthritis | Initially 400-600 mg/day in divided doses; maintenance 200-400 mg/day once optimal response achieved | Usually combined with other DMARDs; reassess after 3-6 months if no benefit |
| Lupus erythematosus (SLE/DLE) | 200-400 mg/day (up to 400-600 mg/day initially in some regimens), given once daily or in divided doses | Long-term maintenance often continued at the lowest effective dose |
Pediatric dosing (malaria only)
For malaria in children, dosing is calculated on a mg/kg body-weight basis under direct physician supervision; hydroxychloroquine sulfate is not recommended for long-term therapy in children (see Use in Special Populations).
Renal/hepatic impairment
No well-established formal dose-adjustment schedule exists; however, Hydroxychloroquine Sulphate should be used with caution and at the lowest effective dose in patients with significant renal or hepatic impairment, with closer clinical monitoring.
Take Hydroxychloroquine Sulphate exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice.
Side Effects of Hydroxychloroquine Sulphate
Common and serious side effects of Hydroxychloroquine Sulphate include:
Common
- Nausea, vomiting, diarrhea, abdominal pain, loss of appetite
- Headache, dizziness
- Skin rash, itching, and reversible skin/mucosal pigmentation changes; hair lightening or hair loss
Serious (less common but clinically important)
- Retinopathy: dose- and duration-dependent risk of irreversible retinal damage with long-term use (see Precautions & Warnings).
- Cardiac effects: QT interval prolongation, and rare cases of cardiomyopathy with long-term high-dose use.
- Hematologic: hemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency; rarely, blood dyscrasias (aplastic anemia, agranulocytosis, thrombocytopenia).
- Hypoglycemia
- Neuromuscular/muscular weakness (myopathy) with prolonged use
- Central nervous system effects: irritability, nightmares, rarely psychosis
Seek prompt medical attention for visual changes, palpitations, unusual bruising/bleeding, or profound muscle weakness while taking Hydroxychloroquine Sulphate.
Contraindications of Hydroxychloroquine Sulphate
Hydroxychloroquine Sulphate is contraindicated in:
- Patients with known hypersensitivity to hydroxychloroquine, chloroquine, or other 4-aminoquinoline compounds.
- Patients with pre-existing retinal or visual field changes attributable to 4-aminoquinoline compounds (see Precautions & Warnings for retinopathy monitoring).
Long-term use of Hydroxychloroquine Sulphate in children is not recommended (short-term use for malaria treatment/prophylaxis under medical supervision is not included in this restriction).
Frequently Asked Questions about Hydroxychloroquine Sulphate
What is Hydroxychloroquine Sulphate used for?
Hydroxychloroquine Sulphate is used to treat and prevent malaria, and to treat chronic discoid and systemic lupus erythematosus and rheumatoid arthritis.
How long does it take for Hydroxychloroquine Sulphate to work in lupus or arthritis?
Unlike its rapid antimalarial action, the anti-inflammatory benefit of Hydroxychloroquine Sulphate in lupus or rheumatoid arthritis usually takes several weeks to a few months of regular use to become apparent; it should not be stopped early without medical advice.
Why do I need regular eye exams while taking Hydroxychloroquine Sulphate?
Long-term use of Hydroxychloroquine Sulphate carries a well-established risk of retinal (eye) toxicity that increases with cumulative dose and duration of therapy. A baseline eye examination and periodic ophthalmologic monitoring, generally annually after five years of use, are recommended to detect early changes before vision is permanently affected.
Can Hydroxychloroquine Sulphate be taken during pregnancy?
Hydroxychloroquine Sulphate is often continued in pregnant women with lupus when the physician judges that the benefit of preventing a disease flare outweighs potential risk to the fetus; however, it should be used in pregnancy only if clearly needed and under close physician guidance.
Can Hydroxychloroquine Sulphate lower my blood sugar?
Yes, Hydroxychloroquine Sulphate can enhance the effect of insulin or oral antidiabetic medicines and cause hypoglycemia; monitor blood glucose closely, especially if you have diabetes, and inform your doctor if you notice symptoms such as sweating, shakiness, or confusion.
What should I do if I take too much Hydroxychloroquine Sulphate?
An overdose of Hydroxychloroquine Sulphate can be serious and even fatal, especially in children, and symptoms can develop quickly. Seek immediate emergency medical attention or contact a poison control center right away; do not wait for symptoms to appear.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.