Plaquenil (Hydroxychloroquine) for Lupus

What Members Say Top Tips Side Effects FAQs

Plaquenil (hydroxychloroquine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with systemic lupus erythematosus and chronic discoid lupus erythematosus.

What Members Say

MHT logo These insights are based on 25,991 comments about Plaquenil from MyLupusTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Symptom relief often includes less joint pain, fatigue, rash, and mouth sores.
Some members notice fewer flares or less symptom worsening after staying on treatment.
Benefits can build gradually over weeks or months.

Considerations:

Stomach side effects can include nausea, diarrhea, vomiting, and abdominal pain.
Eye monitoring is important because retinal toxicity and vision changes can occur.
Rare but serious risks include heart rhythm problems and cardiomyopathy.

How Plaquenil Works and How It’s Taken

Plaquenil is an antirheumatic medicine. It has effects on inflammation and the immune system.

In lupus, this may help reduce inflammation and calm an overactive immune response. The exact way it works is not fully known.

Doctors prescribe Plaquenil when adults have systemic lupus erythematosus or chronic discoid lupus erythematosus.

Plaquenil comes as a tablet taken by mouth. Take it with food or milk. Do not crush, chew, or divide the tablet.

Typical Dosing for Lupus

The recommended dose for systemic lupus erythematosus and chronic discoid lupus erythematosus is 200 milligrams once daily, or 400 milligrams once daily or in two divided doses.

Your doctor may lower the dose if you have kidney or liver disease.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Plaquenil

MHT logo These insights are based on 25,991 comments about Plaquenil from MyLupusTeam members.

Members who use Plaquenil often say it helps to set realistic expectations, keep up with eye monitoring, and pay attention to side effects. Many also mention that taking it consistently and staying in close contact with their rheumatologist can make it easier to manage lupus over time.

1

Keep up with regular eye exams.
“I have eye tests every year to monitor to make sure I do not get Plaquenil toxicity because this medication can affect your vision, which I do not have any signs of to date.”
2

Talk to your doctor before changing your dose or stopping treatment.
“Tried reducing the dose a few years ago, and that didn’t go well because my symptoms came roaring back.”
3

Take Plaquenil with food if it upsets your stomach.
“When I was first put on Plaquenil, it bothered me a bit. I found taking it with food and at night so I slept through any discomfort to be very helpful.”

Connect with others who understand life with lupus. Join MyLupusTeam for free.

Plaquenil Side Effects

Nausea
Vomiting
Diarrhea
Abdominal pain

Serious Side Effects and Warnings

Plaquenil can cause serious side effects that may require immediate medical attention. These include:

Cardiomyopathy and ventricular arrhythmias — Heart muscle disease and serious heart rhythm problems can lead to heart failure, fainting, or life-threatening abnormal rhythms, including QT prolongation and torsades de pointes.
Retinal toxicity — Damage to the retina in the back of the eye can be irreversible and affect vision.
Serious skin reactions — Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS syndrome, and acute generalized exanthematous pustulosis can cause blistering or peeling skin and may be life-threatening.
Hematologic toxicity — Severe blood disorders from bone marrow suppression can cause low blood cell counts, including aplastic anemia, agranulocytosis, leukopenia, or thrombocytopenia.
Hemolytic anemia in people with G6PD deficiency — Red blood cells can break down.
Muscle or nerve toxicity — Myopathy or neuropathy can cause progressive weakness, muscle wasting, or reduced reflexes.
Neuropsychiatric reactions, including suicidality — New or worsening depression, suicidal thoughts or behavior, hallucinations, or severe mood changes can occur.
Severe hypoglycemia — Dangerously low blood sugar can cause sweating, shakiness, confusion, fainting, or loss of consciousness.
Renal toxicity — Kidney injury can cause protein in the urine and reduced kidney function.
Worsening of psoriasis — Plaquenil can cause a severe psoriasis flare.
Worsening of porphyria — Plaquenil can worsen porphyria, including causing liver toxicity in people with porphyria cutanea tarda.

Get medical help right away if you think you are having a serious reaction.

If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or by using the online chat.

What To Know Before Taking Plaquenil

Your doctor will recommend a baseline eye exam within the first year of starting Plaquenil. More eye exams may be needed during treatment.

Tell your doctor if you have had an allergic reaction to hydroxychloroquine or other 4-aminoquinoline medicines. Do not take Plaquenil if you have a known allergy to these medicines.

Tell your doctor about all the medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Plaquenil is also FDA-approved to treat uncomplicated malaria, help prevent malaria in certain areas, and treat rheumatoid arthritis in adults.

A pregnancy exposure registry follows pregnancy outcomes in women who take Plaquenil. To register, call 877-311-8972.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Plaquenil, talk with your doctor about the risks and benefits.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Plaquenil for lupus?

Plaquenil is an FDA-approved treatment for systemic lupus erythematosus and chronic discoid lupus erythematosus in adults. It affects inflammation and the immune system, but the exact way it works and its overall response rate in lupus are not fully defined in the prescribing information. Treatment response can vary from person to person.

What tests or monitoring are needed with Plaquenil for lupus?

People taking Plaquenil for lupus need regular eye monitoring because the medicine can rarely damage the retina. A baseline eye exam is recommended within the first year of treatment. People at higher risk may need yearly eye exams, while those without major risk factors can usually wait until five years of treatment before starting annual retinal exams.

During long-term treatment, blood cell counts should be checked from time to time. Healthcare providers may also monitor muscle strength and reflexes. Heart monitoring may be needed if there are heart problems, abnormal rhythms, electrolyte problems, or medicines that can prolong the QT interval.

Blood sugar should be checked if symptoms of low blood sugar occur, and people with diabetes should monitor their glucose levels. Plaquenil does not require routine kidney or liver tests for everyone, but a lower dose may be needed in people with kidney or liver disease.