Hydroxyquine

Recommended doses of the medication vary according to the condition being treated.

Rheumatoid arthritis: The usual adult starting dose is 400 mg to 600 mg daily. It may take several weeks before the beneficial effects of hydroxychloroquine for the treatment of rheumatoid arthritis are seen, and several months before maximum effects are achieved. After 5 to 10 days, the dose may be gradually increased. After a good response to treatment is seen (usually within 4 to 12 weeks), the dose is decreased to 200 mg to 400 mg daily.

Lupus: The usual starting dose for adults is 400 mg once or twice daily. This dose may be continued for several weeks or months depending on the benefits that occur. For long-term use, the dose of hydroxychloroquine is usually reduced to 200 mg to 400 mg daily.

Malaria: The recommended preventative adult dose is 400 mg on exactly the same day of each week, beginning 2 weeks before exposure and continued for 8 weeks after leaving the high-risk area. Children's doses are based on body weight and are calculated as 5 mg of hydroxychloroquine base per kilogram of body weight to a maximum dose of 400 mg.

For treatment of acute attacks of malaria, the recommended starting dose for adults is 800 mg followed by 400 mg after 6 to 8 hours. This is followed by 400 mg on each of the next 2 days for a total of 2,000 mg of hydroxychloroquine. Some doctors may decide to prescribe a single dose of 800 mg only, as this method has also been found effective in the treatment of malaria. Children's doses are based on body weight as prescribed by the doctor.

To help reduce stomach upset, hydroxychloroquine should be taken with a meal or a glass of milk.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is within 12 hours of your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store at room temperature and keep out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Each white, capsule-shaped, biconvex, film-coated tablet engraved "HCQ 200" on one side contains 200 mg of hydroxychloroquine sulfate. Nonmedicinal ingredients: croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, microcrystalline cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyethylene glycol, and titanium dioxide.

Do not take hydroxychloroquine if you:

• are allergic to hydroxychloroquine or any ingredients of the medication
• are allergic to any of the 4-aminoquinoline compounds, such as chloroquine
• have been previously diagnosed with retinopathy of the eye

Do not give to children under 6 years of age.

There may be an interaction between hydroxychloroquine and any of the following:

• acetylsalicylic acid (Asa)
• agalsidase
• aminoglycoside antibiotics (e.g., Amikacin, gentamicin, tobramycin)
• Amiodarone
• androgens (e.g., testosterone)
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• Cyclosporine
• Dapsone
• diabetes medications (e.g., Glyburide, chlorpropamide, insulin, Rosiglitazone)
• Digoxin
• Disopyramide
• dofetilide
• Dronedarone
• Lanreotide
• Mefloquine
• Methadone
• mifepristone
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Rasagiline, Selegiline, Tranylcypromine
• Octreotide
• Pasireotide
• Pimozide
• procainamide
• pyridostigmine
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• Rabies vaccine
• seizure medications (e.g., Carbamazepine, Levetiracetam, Phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
• Tamoxifen

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with . Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use .

HEALTH CANADA ADVISORY

April 25, 2020

Health Canada has issued information concerning the use of chloroquine and hydroxychloroquine. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Blood counts: can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

If you take for a long period of time, your doctor will likely want you to have blood tests to monitor your levels of red and white blood cells.

Blood sugar levels: Hydroxychloroquine may cause hypoglycemia (low blood sugar levels). People with Diabetes may find it necessary to monitor their blood sugar more frequently while using . People without diabetes have also been known to experience low blood sugars while taking hydroxychloroquine. If you experience signs of low blood sugar (cold sweat, cool pale skin, headache, or weakness), contact your doctor immediately.

Blurred vision: While taking , use caution when driving or operating machinery, since hydroxychloroquine can cause blurring of vision. If your vision blurs, call your doctor.

Eye damage: Irreversible damage to the Retin A of the eye has occurred for some people who take long-term or high-dosage treatment with hydroxychloroquine. Eye damage is more likely to occur if recommended doses are exceeded. Your doctor will want you to have regular eye exams if you take for a period of time. If you notice any new problems with sight or symptoms such as light flashes and streaks, stop the medication at once and call your doctor.

Heart disease: Rarely, weakening of the heart muscle has been reported with the use of hydroxychloroquine. If you have heart disease, discuss with your doctor how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Heart rhythm: Hydroxychloroquine can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels), discuss with your doctor how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Kidney Disease: If you have kidney disease, you may need a lower dose of . Talk to your doctor about how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Liver disease: If you have liver disease, you may need a lower dose of . Talk to your doctor about how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Muscle weakness: Call your doctor if you notice any signs of unusual or unexpected muscular weakness.

Other medical conditions: If you have Epilepsy, stomach, nerve, blood, or skin disorders, talk to your doctor about how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Suicidal behaviour: Rarely, people taking may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after starting . If you experience these side effects or notice them in a family member who is taking , contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking .

Pregnancy: Hydroxychloroquine crosses the placenta during pregnancy and may cause harm to the developing baby if it is taken by the mother during pregnancy. should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking , contact your doctor immediately.

Breast-feeding: passes in small amounts into breast milk. Infants are extremely sensitive to its side effects. If you are a breast-feeding mother and are taking hydroxychloroquine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using have not been established for children when used for the treatment of rheumatoid arthritis or systemic lupus erythematosus. Children are especially sensitive to the side effects of hydroxychloroquine.

<p>Hydroxychloroquine belongs to a group of medications known as <i>anti-inflammatories</i> and <i>antimalarials.</i> It is used alone or in combination with other anti-arthritic medications to <b>treat Rheumatoid Arthritis.</b> It helps to reduce pain, stiffness, and swelling in joints. It may take several weeks before the beneficial effects of hydroxychloroquine for the treatment of rheumatoid arthritis are seen.</p><p>Hydroxychloroquine is also used to <b>treat and prevent certain types of Malaria.</b> It may also be used for the <b>treatment of Lupus.</b></p><p><b> may be available under multiple brand names and/or in several different forms.</b> Any specific brand name of may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of may not be used for all of the conditions discussed here.</p><p><b>Your doctor may have suggested for conditions other than those listed in these drug information articles.</b> If you have not discussed this with your doctor or are not sure why you are taking , speak to your doctor. <b>Do not stop taking without consulting your doctor.</b></p><p><b>Do not give to anyone else, even if they have the same symptoms as you do.</b> It can be harmful for people to take if their doctor has not prescribed it.</p>