If you live with lupus, you’ve probably learned there’s no one-size-fits-all treatment. Some days, you might feel all right, and other days, even getting out of bed can be hard. That’s the nature of autoimmune diseases like lupus — they can be unpredictable and affect many parts of the body. Because of this, it’s very important to find medication that works for you.

One medication that has helped many people is hydroxychloroquine (often called HCQ or by the brand name Plaquenil). It was first used to treat malaria and is considered an antimalarial, but it is now a cornerstone treatment for people with lupus.

Whether you’ve just been prescribed hydroxychloroquine or you’re trying to decide if it’s right for you, this article will explain what it does, how it helps, and what to keep an eye on.

What Is Hydroxychoroquine?

Hydroxychloroquine is a prescription medicine that comes as a pill. Doctors first used it to treat malaria, a disease spread by mosquitoes. But over time, they realized it also helps calm down the immune system. That makes it extremely helpful for people with autoimmune diseases, where the immune system becomes overactive and starts attacking the body’s own cells.

Today, hydroxychloroquine is commonly used to treat systemic lupus erythematosus (SLE). Most people take it once or twice a day and continue taking it for a long time.

What makes hydroxychloroquine special is that it works gently. It doesn’t completely shut down your immune system like some stronger medications do. Instead, it helps bring your immune system into balance, improving its function without making it too weak to fight off infections.

How Does It Help Lupus?

In lupus, the immune system becomes overactive and attacks healthy tissues in the skin, joints, kidneys, and other organs. This creates inflammation, which causes many of the symptoms people with lupus experience, such as fatigue, rashes, joint pain, and even damage to vital organs.

Hydroxychloroquine helps in several important ways. The drug:

• Calms immune activity so it doesn’t attack healthy tissue
• Reduces inflammation, which can help with joint pain, rashes, and swelling
• Lowers the number of flares, which are sudden bursts of disease activity
• Protects organs, like the kidneys and heart
• Improves skin problems caused by lupus, like rashes or sun sensitivity
• Makes other lupus treatments (especially steroids) more effective at a lower dose, which can help you lower your risk of side effects
• Helps control cholesterol and blood sugar, which are often higher in people with lupus

Research has shown that people who stop taking hydroxychloroquine are more likely to have flares, even if they were stable for a long time. Hydroxychloroquine has also been found to reduce the risk of long-term complications and may even improve fatigue, one of the most common lupus symptoms.

What Should You Know About Taking Hydroxychloroquine?

Hydroxychloroquine comes in pill form. Most people take it once or twice per day. The most common dose is between 200 and 400 milligrams daily, depending on your body weight and what your doctor recommends. It can take several weeks or even a few months to start working, so it’s important to stick with it even if you don’t feel better right away.

It’s considered safe for long-term use when taken as prescribed and monitored by your doctor. You’ll likely have regular checkups to make sure the medication is working and not causing any problems. If you’re pregnant or breastfeeding, hydroxychloroquine is usually safe, and many doctors recommend staying on it to keep lupus under control.

What Are the Side Effects?

Most people do well on hydroxychloroquine, especially compared to other lupus medications. But like any medicine, it can cause side effects. Common side effects include:

• Upset stomach or nausea
• Diarrhea
• Headache
• Skin rashes or itchy skin
• Feeling more tired than usual
• Mild vision changes (which usually go away on their own)
• Dizziness or ringing in the ears (in rare cases)

Most of these side effects are mild and go away after a short time. Taking your pill with food can help prevent stomach upset. Be sure to drink plenty of water and not skip meals when you take your medication.

Rare but Serious Side Effects

Although rare, some side effects of hydroxychloroquine are more serious. It’s important to know what to look for so you can catch problems early.

Eye Damage (Retinopathy)

Hydroxychloroquine can build up in the retina and cause damage over time. This is rare, especially during the first five years of use, but it becomes more likely with high doses or long-term use. Get a baseline eye exam when you start treatment and, after five years, start getting yearly eye exams with your ophthalmologist to catch any changes early.

Heart Rhythm Problems

In rare cases, hydroxychloroquine can interfere with electrical signals in your heart. This is more likely if you take certain other medications. Let your doctor know if you feel faint or dizzy or if your heartbeat feels fast or irregular.

Low Blood Sugar

Hydroxychloroquine can sometimes cause blood glucose (sugar) to drop too low, especially if you take insulin or other diabetes medicines. Symptoms of low blood sugar include shakiness, sweating, hunger, and confusion.

Severe Allergic Reactions

Seek medical help right away if you notice swelling of your face, lips, or tongue or if you have trouble breathing. Although rare, this can signal a serious allergic reaction.

Is It Safe During Pregnancy and Breastfeeding?

Yes. Many doctors recommend staying on hydroxychloroquine during pregnancy. Research shows that it helps keep the disease stable and reduces the chance of flares, protecting both you and your baby. It may also lower the risk of pregnancy complications like high blood pressure or early delivery.

If you’re breastfeeding, only tiny amounts of hydroxychloroquine pass into your breast milk, and studies haven’t shown harm to babies. Most doctors say it’s safe to continue while nursing.

Still, every pregnancy is different. Always talk to your healthcare provider about what’s best for your situation.

Hydroxychloroquine and You

Hydroxychloroquine is one of the most important and reliable treatments for lupus. It helps reduce inflammation, control symptoms of lupus, and prevent long-term damage. It’s also one of the few medications considered safe during pregnancy and breastfeeding.

Even though it works slowly, hydroxychloroquine can make a big difference in your daily life. Many people with lupus take it for years with good results and few side effects. Just be sure to follow your doctor’s guidance and stay on top of your checkups.

Remember, every step you take to manage lupus adds up. With the right treatment plan — including hydroxychloroquine — you can live well, take charge of your health, and plan for the future with confidence.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you take hydroxychloroquine as a treatment for lupus? Share your experience in the comments below, or start a conversation by posting on your Activities page.