Hydroxychloroquine and Gas: GI Side Effects and Relief

Medically reviewed by Seena Chokshi, Pharm.D.

Written by Emily Brown and Kate Harrison

Updated on October 1, 2026

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Key Takeaways

Many people taking hydroxychloroquine (HCQ) for lupus report experiencing gastrointestinal (GI) issues like gas, bloating, and stomach discomfort, though research on gas as a direct side effect of the medication is limited.
GI side effects of HCQ, including nausea, diarrhea, and abdominal discomfort, are recognized and often improve as the body adjusts to the medication. Other factors like lupus itself, food sensitivities, and other medications can also play a role in causing gas and digestive symptoms.
There are several ways that may help manage GI symptoms while taking HCQ, such as taking the medication with food, tracking what you eat, and making dietary changes, but it is important to talk to your doctor before trying any new over-the-counter remedies, as some can interact with HCQ.

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Dealing with excess gas can be both embarrassing and uncomfortable. If you’ve felt extra gassy since starting hydroxychloroquine (HCQ), you may wonder if the medication is to blame. Many MyLupusTeam members report experiencing gastrointestinal (GI) issues, like gassiness and bloating, when taking HCQ — sold under brand names like Plaquenil and in generic forms.

Gas and bloating can have many causes, so it can be hard to know exactly what’s behind your symptoms. Research on gas as a side effect of HCQ is limited, but many MyLupusTeam members report experiencing it.

In this article, we’ll discuss whether hydroxychloroquine causes gas or other GI symptoms, as well as tips to help manage them.

🗳️ Have you experienced gas with hydroxychloroquine?

Yes

Hydroxychloroquine and Side Effects

HCQ is a disease-modifying antirheumatic drug (DMARD) that falls under the umbrella of antimalarials. It’s an immunomodulatory medication, which means it changes how your immune system works. It does this by “turning off” certain immune receptors that trigger inflammation.

HCQ is generally well tolerated. Only around 10 percent of people who take antimalarial medications have side effects. Most of these are mild and short-lived.

GI issues like bloating, stomach pain, diarrhea, and nausea are potential side effects of HCQ. “I have all sorts of GI issues on Plaquenil,” one MyLupusTeam member wrote. “Nausea, vomiting, bloating, diarrhea. It depends on what I eat.”

GI side effects of HCQ often improve as your body adjusts to the treatment. However, everyone responds differently. It’s important not to stop taking HCQ abruptly. Talk to your rheumatologist if you have side effects while taking HCQ.

Is Gas a Side Effect of Hydroxychloroquine?

Gas isn’t listed as a common side effect of HCQ, and there’s no specific research showing that it causes gas in people with lupus. However, symptoms that often accompany gas, like bloating, stomach cramps, and an upset stomach, are recognized as potential side effects.

Some MyLupusTeam members attribute gas, including flatulence and burping, to HCQ. “I just started Plaquenil last week … I have noticed that I have SO MUCH GAS after I eat and for a very long period of time afterward. I can’t stop burping or passing gas other ways (sorry!).”

It’s common for HCQ side effects to improve after a few days as your body gets used to the medication. However, some MyLupusTeam members have reported stomach issues, including gas, lasting longer or not resolving.

Other Possible GI Side Effects of Hydroxychloroquine

Although gas isn’t a formally recognized side effect of HCQ, some GI symptoms are. These other side effects can contribute to gassiness.

Diarrhea

Diarrhea (liquid or loose stools) is one of the listed side effects of HCQ. So, if your stool consistency has changed or you’ve been passing stool more often since starting HCQ, the medication could be to blame. Diarrhea can also occur with cramping and bloating, which can contribute to gassiness.

If your diarrhea is mild, it may improve as your body adjusts to HCQ. Taking your medication with food is recommended to help reduce stomach-related side effects.

Persistent or severe diarrhea can have many causes, including infections, food sensitivities, and underlying GI conditions. Talk to your rheumatologist if you have diarrhea that:

Appears black or contains blood
Lasts three days or longer without improving
Is accompanied by a fever or intense pain in the abdomen or rectum

Bloating

Bloating — feeling like your stomach is unusually full — is another GI symptom some people experience while taking HCQ. If you’re bloated, you may feel a pressure or tightness in your stomach.

Bloating is most often due to an excess of gas in your digestive system. This can happen if you have a lot of carbonated drinks, inhale too much air while eating, or if your gut bacteria have trouble digesting your food.

Since bloating is commonly caused by gas, you’re likely to also pass gas (burp or fart). These symptoms are often most noticeable after eating. If certain foods seem to make your bloating worse, tracking what you eat and when symptoms occur may help you and your doctor identify potential triggers.

Talk to your doctor if bloating is severe, persists longer than a week, or occurs with red flag symptoms like vomiting, bleeding, fever, muscle weakness, or unintentional weight loss.

Nausea

Nausea — or feeling like you’re going to vomit — is one of the more common GI side effects reported with HCQ. You may experience nausea on its own or with vomiting or loss of appetite.

For many people with nausea due to HCQ, the symptom is temporary and improves the longer you take the medication. Taking HCQ with food may also help prevent stomach upset.

If nausea is severe, happens often, or disrupts your daily life, check in with your rheumatologist. Lupus and other medications can also cause nausea. Your doctor can help determine the likely cause.

Abdominal Discomfort

Abdominal discomfort is another recognized GI side effect of HCQ. This symptom can take many forms, such as stomach pain or cramping that feels like aching, burning, twisting, or pulsing. Pain may be in one specific spot or affect a large area.

Abdominal discomfort can occur with other GI symptoms like gas, bloating, and diarrhea. The good news is that if abdominal discomfort is due to HCQ, it’s often temporary and goes away after your body gets used to the medication.

There are a variety of reasons why you might be experiencing abdominal discomfort, such as illness, digestive conditions, and menstruation. Talk to your doctor if your pain is intense or persistent, if you’re pregnant or breastfeeding, or if it began after an injury.

Seek medical care if abdominal discomfort occurs with red flag symptoms, such as:

Persistent nausea or vomiting
Abdominal swelling with sensitivity to touch
Bloody stools, urine (pee), or vomit
Fever that’s not getting better
Shortness of breath
Yellow-looking eyes or skin
Other types of pain

What Else Can Cause Gas and GI Symptoms?

Digestive problems can be related to lupus in different ways. Issues may be due to how the condition affects different systems of the body, while others can be caused by the condition’s treatments.

For example, some people with lupus have intestinal problems, like irritable bowel syndrome (IBS). IBS can cause symptoms like gas, stomach pain, constipation, and diarrhea. Other conditions, such as lactose intolerance, can also cause gas.

Aside from HCQ, other medications can potentially cause excess gas or GI symptoms. Any medication that slows down your digestive process can cause gassiness.

Certain antibiotics, antidepressants, opiates, and allergy and blood pressure medications can contribute as well. Always check the potential side effects in the drug information of your medications before use.

How To Manage GI Side Effects

Taking HCQ can help reduce the number of lupus flares you experience and curb long-term damage caused by lupus. The good news is that it may be possible to manage gas and other GI symptoms so that you can continue taking HCQ.

Dietary Changes

Changing what you eat may help decrease the amount of gas your body produces. Dairy, carbonated beverages, and foods high in fiber like beans and veggies can contribute to excess gas. Limiting these may help to reduce the overall amount of gas you experience.

Food sensitivities may also be contributing to GI symptoms and discomfort. Tracking what you eat and when you experience symptoms can help you identify specific problem foods.

Take Your Medication With Food

It’s important not to take HCQ on an empty stomach. This is especially important if you’re experiencing stomach upset. Taking HCQ with food is recommended to help reduce GI side effects.

Over-the-Counter Medications

Several over-the-counter (OTC) medications can help manage gas and other GI symptoms. However, some medications can interact with HCQ or may not be appropriate for everyone. For example, cimetidine usually isn’t safe to take with HCQ.

Talk to your doctor before taking OTC medication for GI symptoms while taking HCQ. They can help you choose an option that’s safe to take with your other medications and health conditions.

Different Types of Hydroxychloroquine

Different formulations of HCQ contain different inactive ingredients, some of which may cause stomach irritation. Consider talking to your doctor about switching to a different kind of HCQ to see if that reduces your GI issues.

However, keep in mind that some MyLupusTeam members have said that name-brand HCQ can be difficult to get covered by insurance.

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