What is Hydroxychloroquine?

It is a quinolone medicine that is useful in the treatment or prevention of malaria. Malaria is a disease caused by parasites that enter the body through a mosquito bite. This disease is common in areas such as Southern Asia, Africa, and South America. Hydroxychloroquine is not effective against all strains of malaria.

It is on the World Health Organization (WHO) ‘s list of essential medicines. Hydroxychloroquine belongs to the antimalarial and 4-aminoquinoline families of medication.

What is the use of Hydroxychloroquine?

It is useful in the prevention of or treatment of malaria. The US Center for Disease Control provides updated guidelines and travel recommendations worldwide to prevent and treat malaria. Certain types of malaria and resistant strains require different or additional medication.

It is also useful in treating certain auto-immune diseases such as lupus, rheumatoid, and arthritis. It belongs to the disease-modifying antirheumatic drugs (DMARDs) class of medications. It can help in the reduction of skin problems in lupus and prevent swelling/pain in arthritis.

It comes under consideration in the case of first-line treatment for systemic lupus erythematosus.

It is not under recommendation for coronavirus infection, also known as COVID-19 unless your enrollment is not in a study. It would be considerable if you talked to your doctor regarding it.

Hydroxychloroquine dosage

Doctors recommend taking it orally, often in the form of hydroxychloroquine sulfate. Your dosage, format, and schedule to take this medicine to depend upon your age, treatment condition, the seriousness of your situation, other medical conditions, and your reaction to the first dose.

Dosage for Malaria

Adult dosage (ages 18 years and older)

In case of an acute attack, the typical starting dose is 800 mg. Then 400 mg three times: after 6 hours of the first dose, 24 hours after the first dose, and after 48 hours of the first dose.

Continue taking medicine during exposure and for four weeks after leaving the area that has malaria.

Child dosage (ages 0-17 years)

In case of an acute attack, the dosage is based on age. The typical starting dose is 13mg/kg that means the maximum dosage will be 800 mg.

An additional dosage of 6.5 mg/kg (maximum dose of 400 mg): 6 hours after the first dose, 24 hours, and 48 hours after the first dose.

Continue taking medicine during exposure and for four weeks after leaving the area that has malaria.

Dosage for lupus erythematosus

Adult dosage (ages 18 years and older)

The typical dosage will be 200 mg to 400 mg per day; give it a single daily dose or two divided doses. The maximum dosage is 400 mg/day.

Dosage for rheumatoid arthritis

Adult dosage (ages 18 years and older)

The typical starting dosage will be 400 mg to 600 mg per day; consume it as a single daily dose/two divided doses.

Your doctor will gradually lower your dosage to 200-400 mg per day.

Don’t take more than 600 mg/day or 6.5mg/kg per day. The risk of eye problems will increase if you do this.

How do Hydroxychloroquine works?

It increases Lysosomal pH in antigen-presenting cells by:

  • Working as a weak base, it is a proton acceptor, and due to this, its accumulation in lysosomes raises the intralysosomal pH.
  • In parasites, it interferes with the endocytosis and proteolysis of hemoglobin, leading to lysosomal enzyme activities and increasing the lysosomal pH by more than two orders of magnitude over the weak base effect alone.

In the case of other quinoline antimalarial drugs, there is no full resolution of the antimalarial mechanism of action of quinine. The most acceptable model of this treatment is Hydroxychloroquine, and it involves the inhibition of hemozoin biocrystallization. It further leads to the facilitation of aggregation of cytotoxic heme. Accumulation of free cytotoxic heme in parasites causes death.

Hydroxychloroquine increases the uncertainty of low blood sugar levels. It includes decreased insulin resistance from the blood, increased insulin sensitivity, and increased insulin release from the pancreas.

Hydroxychloroquine’s suggestion is to be a zinc ionophore, and it may derive an anti-cancer action from increasing intracellular zinc update.

It can decrease tumor growth by cutting off the ammunition that promotes mitochondrial function.

What to know before using Hydroxychloroquine?

One must not use this medicine if the person is allergic to Hydroxychloroquine or chloroquine.

High dose or long-term use of this medicine may cause irreversible damage to the retina. It may progress to permanent vision problems. The risk of retinal damage is higher if those with pre-existing eye problems, kidney disease, or people are also using tamoxifen.

Inform your doctor if you ever had:

  • Vision changes/damage to your retina
  • Heart disease, heart rhythm disorder
  • Diabetes
  • A stomach disorder
  • An allergy to quinine
  • Psoriasis
  • liver/kidney disease
  • Alcoholism
  • Porphyria, i.e., a genetic enzyme disorder that causes symptoms affecting the skin or nervous system.
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency (genetic enzyme deficiency)

Tell your doctor about your pregnancy or plan to become pregnant before starting this medication. Malaria can cause severe illness or death in a pregnant woman. While pregnant, malaria increases the risk of miscarriage, stillbirth, premature delivery, and low birth weight.

It is still a question whether Hydroxychloroquine will harm an unborn baby or not. Ask your doctor before traveling to malaria-prone regions if you are pregnant.

Approvement for treating lupus or rheumatoid arthritis in people younger than 18 years old is still in wait.

Avoid taking Kaopectate (kaolin-pectin) or an antacid 4 hours before or 4 hours after taking Hydroxychloroquine.

Hydroxychloroquine side effects

Seek medical help if you have signs of an allergic reaction due to the consumption of Hydroxychloroquine. The allergic reactions include hives, difficult breathing, swelling in the throat or face, or a severe skin reaction causing fever, burning eyes, sore throat, skin pain, blistering, and skin peeling with red or purple skin rash.

Ask for medical attention if you have symptoms of a severe heart problem such as fast or pounding heartbeats, shortness of breath, sudden dizziness, and fluttering in the chest.

Call the doctor if you have:

  • A seizure
  • Yellowing of eyes
  • Unusual mood swings
  • Severe muscle weakness
  • Underactive reflexes
  • Loss of coordination
  • Low blood cell counts- fever, tiredness, chill, sore throat, mouth sores, easy bruising, pale skin, and unusual bleeding.
  • Low blood sugar levels- hunger, sweating, irritability, headache, rapid heart rate, feeling anxious or shaky.
  • A severe drug reaction that affects many parts of the body.

Long term use of this medicine is not under recommendation. Consult your doctor if you have:

  • Blurred vision, trouble in reading and focusing
  • Blind spots, distorted vision
  • Changes in color vision
  • Cloudy or hazy vision
  • Seeing halos around eyes
  • Seeing light flashes or streaks
  • Increase in sensitivity to light

Common side effects of this medicine may include:

  • Nausea, vomiting, stomach pain
  • Dizziness, headache
  • Weight loss and loss of appetite
  • Feeling nervous
  • Increase in irritability
  • Skin rash or itching
  • Hair loss

Leave a Reply

Your email address will not be published. Required fields are marked *

Main Menu