Antimalarial·Musculoskeletal & Rheumatology

Hydroxychloroquine

SLE, Rheumatoid Arthritis, Malaria

Authority requiredPBSDMARDPlaquenil200 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

400 mg/day

Caution: Half-life

40-50 DAYS

High risk: Retinopathy

CRITICAL

Pregnancy

SAFE

Cautions

Avoid / Cautions

Pre-existing maculopathy. Pregnancy Category D (historically), but modern rheumatology guidelines mandate continuing HCQ during pregnancy for SLE, as a flare is much more dangerous to the fetus.

Where it stands

Rapid Summary

Overview

Antimalarial agent with potent immunomodulatory effects. The foundational, life-saving baseline drug for Systemic Lupus Erythematosus (SLE).

Clinical Focus

Chronic use causes irreversible retinal toxicity. Annual optometry reviews are legally/clinically mandatory.

Bottom Line

Hydroxychloroquine is a well-tolerated DMARD essential in SLE and useful in RA, but requires baseline and annual eye screening for irreversible retinal toxicity.

Formulation & Access

Brand Names

Plaquenil

Oral Routes

Tablets (200 mg).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

SLE, Rheumatoid Arthritis, Malaria.

Clinical Place

The only drug proven to improve overall survival and prevent organ damage in SLE. Mild DMARD for RA.

Quick reference

Class & Role

Antimalarial — Antimalarial agent with potent immunomodulatory effects.

Route / Formulation

Tablets (200 mg). (Plaquenil)

Usual Dose & Max

PO 200-400 mg OD (or divided BD with food). Max 5 mg/kg/day to prevent retinal damage.

Best Uses

Hydroxychloroquine is a well-tolerated DMARD essential in SLE and useful in RA, but requires baseline and annual eye screening for irreversible retinal toxicity.

Key Risks

Ocular: 'Bulls-eye' maculopathy/retinopathy. Bilateral, irreversible blindness. Risk skyrockets after 5 years of use or cumulative doses > 1000g. Cardiovascular: QTc prolongation, rare cardiomyopathy. Gastrointestinal: Nausea, abdominal cramps (take with milk/food). Dermatological: Hyperpigmentation (blue-black skin staining).

Key Interactions

Other QTc prolonging drugs (e.g., Amiodarone, Macrolides). Antacids reduce absorption (separate by 4 hours).

Monitoring

Baseline complete ophthalmology exam (OCT and visual fields) within 6 months of starting, then annually after 5 years of use. Routine FBC and U&E.

Clinical Pearl

Retinal toxicity is directly tied to overdosing. A 50 kg woman taking 400 mg/day is receiving 8 mg/kg/day (way over the 5 mg/kg limit) and will go blind. Calculate doses strictly on actual body weight.

Access

Authority requiredPlaquenil200 mg tablet

Brand: Plaquenil
PBS status: Authority required
Formulation: Tablets (200 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Antimalarial·Musculoskeletal & Rheumatology

Hydroxychloroquine

SLE, Rheumatoid Arthritis, Malaria

Authority requiredPBSDMARDPlaquenil200 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

400 mg/day

Caution: Half-life

40-50 DAYS

High risk: Retinopathy

CRITICAL

Pregnancy

SAFE

Cautions

Avoid / Cautions

Pre-existing maculopathy. Pregnancy Category D (historically), but modern rheumatology guidelines mandate continuing HCQ during pregnancy for SLE, as a flare is much more dangerous to the fetus.

Where it stands

Rapid Summary

Overview

Antimalarial agent with potent immunomodulatory effects. The foundational, life-saving baseline drug for Systemic Lupus Erythematosus (SLE).

Clinical Focus

Chronic use causes irreversible retinal toxicity. Annual optometry reviews are legally/clinically mandatory.

Bottom Line

Hydroxychloroquine is a well-tolerated DMARD essential in SLE and useful in RA, but requires baseline and annual eye screening for irreversible retinal toxicity.

Formulation & Access

Brand Names

Plaquenil

Oral Routes

Tablets (200 mg).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

SLE, Rheumatoid Arthritis, Malaria.

Clinical Place

The only drug proven to improve overall survival and prevent organ damage in SLE. Mild DMARD for RA.

Quick reference

Class & Role

Antimalarial — Antimalarial agent with potent immunomodulatory effects.

Route / Formulation

Tablets (200 mg). (Plaquenil)

Usual Dose & Max

PO 200-400 mg OD (or divided BD with food). Max 5 mg/kg/day to prevent retinal damage.

Best Uses

Hydroxychloroquine is a well-tolerated DMARD essential in SLE and useful in RA, but requires baseline and annual eye screening for irreversible retinal toxicity.

Key Risks

Key Interactions

Other QTc prolonging drugs (e.g., Amiodarone, Macrolides). Antacids reduce absorption (separate by 4 hours).

Monitoring

Baseline complete ophthalmology exam (OCT and visual fields) within 6 months of starting, then annually after 5 years of use. Routine FBC and U&E.

Clinical Pearl

Access

Authority requiredPlaquenil200 mg tablet

Brand: Plaquenil
PBS status: Authority required
Formulation: Tablets (200 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.