Antimalarial Medicines for Lupus

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Antimalarial Medicines for Lupus

Examples

Generic NameBrand Name
chloroquineAralen
hydroxychloroquinePlaquenil

Antimalarial medicines are used to treat malaria and are also prescribed for lupus (systemic lupus erythematosus, or SLE) and rheumatoid arthritis.

How It Works

These medicines reduce inflammation. (While they are also used to prevent or treat malaria, there is no known relationship between lupus and malaria.)

Why It Is Used

These medicines are used to control skin rash in people who have lupus. They also may help relieve muscle and joint pain, fatigue, and fever that are not controlled with non-steroidal anti-inflammatory drugs (NSAIDs).

These medicines may be used together with anti-inflammatory drugs or corticosteroids. Using them may allow you to reduce the dose of steroids to a level that causes fewer or less bothersome side effects.

How Well It Works

Antimalarial medicine is used with corticosteroid creams to control lupus skin rash, and it has long been used to control lupus-related joint pain.2 For skin rash, this treatment works best when it is combined with protecting the skin from the sun.

Hydroxychloroquine seems to help reduce fatigue and malaise (generally not feeling well). But it can take a few months to notice this effect.1

Hydroxychloroquine may protect against lupus disease flares.2

Side Effects

Most people experience no major side effects from antimalarial drugs. Infrequent side effects include:

  • Dizziness.
  • Rash and itching.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Abdominal cramps.

A very rare side effect is damage to the retina of the eye. Before taking an antimalarial, you will have an eye examination by an ophthalmologist. Eye damage can be caught early by self-testing your vision every month or by seeing an ophthalmologist regularly. Your doctor will tell you how often you need eye examinations. If you have any change in vision, contact your ophthalmologist or rheumatologist immediately.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

It may take several months for these medicines to work. If antimalarial treatment doesn't seem to be helping within 6 months, your doctor will probably recommend that you stop taking it.

An initial eye examination will usually be done before you start taking hydroxychloroquine (Plaquenil) or chloroquine (Aralen). After the initial eye examination, your doctor may require eye examinations every 6 to 12 months. Your doctor may also ask you to check your eyesight regularly with an eye test at home (as with an Amsler grid). If there is a change in your eyesight, your doctor may reduce your dose or recommend that you stop taking the medicine to prevent permanent eye damage. If antimalarial medicine is effective, the dose may be tapered or taken less often to reduce the risk of permanent eye damage.

The dose of antimalarial medicine may be adjusted if you have kidney or liver disease.

Talk to your doctor about this medicine if you are pregnant or are considering pregnancy and have lupus.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Lockshin MD (2005). Systemic lupus erythematosus. In DC Dale, DD Federman, eds., ACP Medicine, section 15, chap. 4. New York: WebMD.
  2. Wofsy D (2005). Therapy of systemic lupus erythematosus. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 1561–1574. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Primary Medical Reviewer Andrew Swan, MD, CCFP, FCFP - Family Medicine
Specialist Medical Reviewer Stanford M. Shoor, MD - Rheumatology
Last Revised July 8, 2010

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