Rx Prescription Required
Classes: Aminoquinoline, Antimalarials, DMARDs, Immunosuppressants, Cytochrome P-450 CYP2D6 Inhibitors
Uses: Uncomplicated malaria, rheumatoid arthritis, chronic discoid lupus erythematosus, systemic lupus erythematosus, COVID-19*
Administration: Oral (Take with a meal or a glass of milk)
Dosages ›
Interactions ›
Adverse Effects ›
Warnings ›
Safety Advice ›
Pharmacology ›
General Considerations ›
Monitoring Parameters ›
Auto Q 200mg Tablet
Manufacturer: Regenix Drugs Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 60.25 (10 tablets in 1 strip) ₹6.02/Tablet
Axemal Tablet
Manufacturer: Obsurge Biotech Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 64.95 (10 tablets in 1 strip) ₹6.49/Tablet
Bioquin 200mg Tablet
Manufacturer: Ipca Laboratories Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 68 (10 tablets in 1 strip) ₹6.8/Tablet
Cartiquin 200mg Tablet
Manufacturer: Overseas Healthcare Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 65.4 (10 tablets in 1 strip) ₹6.5/Tablet
Cartiquin 300mg Tablet
Manufacturer: Overseas Healthcare Pvt Ltd
Salt Composition: Hydroxychloroquine (300mg)
Price: Rs 132.5 (10 tablets in 1 strip) ₹13.2/Tablet
Cartiquin 400mg Tablet
Manufacturer: Overseas Healthcare Pvt Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 107.7 (10 tablets in 1 strip) ₹10.7/Tablet
CoviQ Tablet
Manufacturer: Zydus Cadila
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 55.9 (10 tablets in 1 strip) ₹5.59/Tablet
Chloro QS 200mg Tablet
Manufacturer: Cmg Biotech Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 69.5 (10 tablets in 1 strip) ₹6.95/Tablet
Deng 200mg Tablet
Manufacturer: East West Pharma
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 57.75 (10 tablets in 1 strip) ₹5.7/Tablet
Dmd 200mg Tablet
Manufacturer: Zoic Lifesciences
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 59 (10 tablets in 1 strip) ₹5.9/Tablet
Dxq 200mg Tablet
Manufacturer: Nahren Lifesciences
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 62.2 (10 tablets in 1 strip) ₹6.2/Tablet
Dxq 300mg Tablet
Manufacturer: Nahren Lifesciences
Salt Composition: Hydroxychloroquine (300mg)
Price: Rs 115 (10 tablets in 1 strip) ₹11.5/Tablet
Era-H 200mg Tablet
Manufacturer: TBG pharma ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 62 (10 tablets in 1 strip) ₹6.2/Tablet
Had Q 200mg Tablet
Manufacturer: UHC Life Sciences
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 65.45 (10 tablets in 1 strip) ₹6.54/Tablet
HCQS 200 Tablet
Manufacturer: Ipca Laboratories Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 99.29 (15 tablets in 1 strip) ₹6.62/Tablet
HCQS 300 Tablet
Manufacturer: Ipca Laboratories Ltd
Salt Composition: Hydroxychloroquine (300mg)
Price: Rs 152.95 (10 tablets in 1 strip) ₹15.29/Tablet
HCQS 400 Tablet
Manufacturer: Ipca Laboratories Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 133 (10 tablets in 1 strip) ₹13.34/Tablet
Hikem Tablet
Manufacturer: Bioceutics Inc
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 70 (10 tablets in 1 strip) ₹7/Tablet
HQ 200mg Tablet
Manufacturer: Vasu Organics Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 55 (10 tablets in 1 strip) ₹5.5/Tablet
HQ 400mg Tablet
Manufacturer: Vasu Organics Pvt Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 10.3 (10 tablets in 1 strip) ₹10/Tablet
Hqra 200mg Tablet
Manufacturer: Rhumasafe Pharmaceutical
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 62 (10 tablets in 1 strip) ₹6.2/Tablet
Hqra 300mg Tablet
Manufacturer: Rhumasafe Pharmaceutical
Salt Composition: Hydroxychloroquine (300mg)
Price: Rs 110 (10 tablets in 1 strip) ₹11/Tablet
Hqra 400mg Tablet
Manufacturer: Rhumasafe Pharmaceutical
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 120 (10 tablets in 1 strip) ₹12/Tablet
Hqtor Tablet
Manufacturer: Torrent Pharmaceuticals Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 64.9 (10 tablets in 1 strip) ₹6.49/Tablet
Hqtor 400 Tablet
Manufacturer: Torrent Pharmaceuticals Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 130 (10 tablets in 1 strip) ₹13/Tablet
H-Quine 200mg Tablet
Manufacturer: Ankaa Pharmaceutical
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 58 (10 tablets in 1 strip) ₹5.8/Tablet
Hqwin 200mg Tablet
Manufacturer: Orsim Pharma
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 59 (10 tablets in 1 strip) ₹5.9/Tablet
Hydrocad 200mg Tablet
Manufacturer: Cadila Pharmaceuticals Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 60.48 (10 tablets in 1 strip) ₹60/Tablet
Hydroquin 200mg Tablet
Manufacturer: Sun Pharmaceutical Industries Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 60 (10 tablets in 1 strip) ₹6/Tablet
Hydroquin 400mg Tablet
Manufacturer: Sun Pharmaceutical Industries Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 125 (10 tablets in 1 strip) ₹12.5/Tablet
Hydrowin 200mg Tablet
Manufacturer: Ikon Remedies Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 59.22 (10 tablets in 1 strip) ₹5.92/Tablet
Hydrowin 400mg Tablet
Manufacturer: Ikon Remedies Pvt Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 106.26 (10 tablets in 1 strip) ₹10.6/Tablet
HYQ 400 Tablet
Manufacturer: Ipca Laboratories Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 133 (10 tablets in 1 strip) ₹13.34/Tablet
Imulast 200mg Tablet
Manufacturer: Cipla Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 65.8 (10 tablets in 1 strip) ₹6.5/Tablet
Imulast 400mg Tablet
Manufacturer: Cipla Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 125 (10 tablets in 1 strip) ₹12.5/Tablet
Kaiquin 200mg Tablet
Manufacturer: Kaizen Research Labs India Pvt Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 51 (10 tablets in 1 strip) ₹5.1/Tablet
Ketor 200mg Tablet
Manufacturer: Chemo Healthcare Pvt Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 60 (10 tablets in 1 strip) ₹6/Tablet
Latvitor 200 Tablet
Manufacturer: Osiante Biotech
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 90.38 (15 tablets in 1 strip) ₹6.03/Tablet
Mcqs 200mg Tablet
Manufacturer: Molekule India Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 69.9 (10 tablets in 1 strip) ₹6.99/Tablet
Nid-Q 200mg Tablet
Manufacturer: Nidus Pharma Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 56 (10 tablets in 1 strip) ₹5.6/Tablet
Numi HQ 200mg Tablet
Manufacturer: Nusmith Pharma Pvt. Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 67.5 (10 tablets in 1 strip) ₹6.75/Tablet
Orthokind 200mg Tablet
Manufacturer: Mankind Pharma Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 69.9 (10 tablets in 1 strip) ₹6.99/Tablet
Oxcq 200 Tablet
Manufacturer: Wallace Pharmaceuticals Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 66.14 (10 tablets in 1 strip) ₹6.61/Tablet
Oxcq 300 Tablet
Manufacturer: Wallace Pharmaceuticals Pvt Ltd
Salt Composition: Hydroxychloroquine (300mg)
Price: Rs 111.87 (10 tablets in 1 strip) ₹11/Tablet
P Hyd 200mg Tablet
Manufacturer: Parry Pharma Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 60 (10 tablets in 1 strip) ₹6/Tablet
Paxoquin 200mg Tablet
Manufacturer: Pax Healthcare
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 68 (10 tablets in 1 strip) ₹6.8/Tablet
Plaquenil
Manufacturer: Sanofi‐Synthelabo Inc
Salt Composition: Hydroxychloroquine (200mg)
Price: $96.38 (30 tablets in 1 strip)
Qcq 200mg Tablet
Manufacturer: Femgrace Formulations
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 62.5 (10 tablets in 1 strip) ₹6.25/Tablet
Qdmrd 200 Tablet
Manufacturer: Alembic Pharmaceuticals Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 64.92 (10 tablets in 1 strip) ₹6.49/Tablet
Qdmrd 400 Tablet
Manufacturer: Alembic Pharmaceuticals Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 126 (10 tablets in 1 strip) ₹12.6/Tablet
Qslera 200mg Tablet
Manufacturer: Renauxe Pharma India Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 60 (10 tablets in 1 strip) ₹6/Tablet
Qurion 200mg Tablet
Manufacturer: Ernst Pharmacia
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 90.39 (15 tablets in 1 strip) ₹6.03/Tablet
Qyn 200mg Tablet
Manufacturer: FDC Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 58.4 (10 tablets in 1 strip) ₹5.84/Tablet
Q-Rado 400mg Tablet
Manufacturer: El-Dorado Bio-Tech Pvt Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 94.3 (10 tablets in 1 strip) ₹9.4/Tablet
Racq 200mg Tablet
Manufacturer: Doctors Choice Health Care India Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 93 (15 tablets in 1 strip) ₹6.2/Tablet
Ra Quin 200mg Tablet
Manufacturer: Sun Pharmaceutical Industries Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 67.5 (10 tablets in 1 strip) ₹6.7/Tablet
Rarex 200mg Tablet
Manufacturer: Molekule India Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 56.4 (10 tablets in 1 strip) ₹5.6/Tablet
Rhq 200mg Tablet Discontinued
Manufacturer: Abbott Laboratories
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 60.48 (10 tablets in 1 strip) ₹6.04/Tablet
RHQ 400mg Tablet Discontinued
Manufacturer: Abbott Laboratories
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 114 (10 tablets in 1 strip) ₹11/Tablet
Riva QS 200mg Tablet
Manufacturer: Achilles Healthcare Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 97 (15 tablets in 1 strip) ₹6.47/Tablet
Rumawill 200mg Tablet
Manufacturer: Mediwill Life Sciences
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 56 (10 tablets in 1 strip) ₹5.6/Tablet
Rutor 200mg Tablet
Manufacturer: Chemo Biological
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 80 (10 tablets in 1 strip) ₹8/Tablet
Vohq 200mg Tablet
Manufacturer: Vasu Organics Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 64.9 (10 tablets in 1 strip) ₹6.49/Tablet
Vohq 400mg Tablet
Manufacturer: Vasu Organics Pvt Ltd
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 118.65 (10 tablets in 1 strip) ₹11.8/Tablet
Winflam 200mg Tablet
Manufacturer: Micro Labs Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 65 (10 tablets in 1 strip) ₹6.5/Tablet
Yadrox 200mg Tablet
Manufacturer: Trireme Life Sciences Pvt Ltd
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 62.5 (10 tablets in 1 strip) ₹6.25/Tablet
Ydro 200mg Tablet
Manufacturer: Arvincare Pharma
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 62.5 (10 tablets in 1 strip) ₹6.25/Tablet
Ydro 400mg Tablet
Manufacturer: Arvincare Pharma
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 160 (10 tablets in 1 strip) ₹16/Tablet
Zhquine 200mg Tablet
Manufacturer: Ambience Pharma
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 56.3 (10 tablets in 1 strip) ₹5.63/Tablet
Zhquine 400mg Tablet
Manufacturer: Ambience Pharma
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 112 (10 tablets in 1 strip) ₹11.2/Tablet
Zy-Q 200 Tablet
Manufacturer: Zydus Cadila
Salt Composition: Hydroxychloroquine (200mg)
Price: Rs 167.87 (30 tablets in 1 bottle) ₹5.6/Tablet
Zy-Q 300 Tablet
Manufacturer: Zydus Cadila
Salt Composition: Hydroxychloroquine (300mg)
Price: Rs 425.1 (30 tablets in 1 strip) ₹14.17/Tablet
Zy-Q 400 Tablet
Manufacturer: Zydus Cadila
Salt Composition: Hydroxychloroquine (400mg)
Price: Rs 392.72 (30 tablets in 1 strip) ₹13.09/Tablet
No drug combination found
Dosages
Rheumatoid Arthritis
- Oral dose: 400 mg OD dose or in 2 divided doses 200mg BD, with or without concomitant non-biologic disease-modifying antirheumatic drugs
- Maintenance: 300 mg OD (usually after 3 months of initial dosing) and continue maintenance dose of 200-400 mg/day (155-310 mg base/day) PO as a qDay or in BID; not exceed 600 mg or 6.5 mg/kg (5 mg/kg base) per day due to the risk of retinal toxicity
Coronavirus disease 2019 (COVID-19) Treatment
- Oral Initial dose: 400 mg BID, for 1 day in combination with azithromycin
- Maintenance dose: 200 mg BID, for 4 days
- In patients with severe disease and requiring ICU management (MoHFW India, March 2020). It should be administered under close medical supervision, with monitoring for side effects, including QTc interval prolongation. Not recommended in pregnant and lactating women
Coronavirus disease 2019 (COVID-19) Prophylaxis (ICMR 22 May 2020)
- Oral Initial dose: 400 mg BID, on day 1
- Maintenance dose: 400 mg once weekly for the next 7 weeks, taken with a meal
- Asymptomatic healthcare workers involved in containment and treatment of COVID-19 or working in non-COVID hospitals/non-COVID areas of COVID hospitals/blocks as well as asymptomatic frontline workers deployed in containment zones and paramilitary/police personnel involved in COVID-19 related-activities
Coronavirus disease 2019 (COVID-19) Prophylaxis for Asymptomatic household contacts of laboratory-confirmed cases
- Oral Initial dose: 400 mg BID, on day 1
- Maintenance dose: 400 mg once weekly for the next 3 weeks taken with meals
Malaria Prophylaxis
- Oral dose: 400 mg (310 mg base) PO weekly, starting 2 weeks before exposure and continued for 4 weeks after departure from endemic area OR
- Weight-based dosing: 6.5 mg/kg (5 mg/kg base) PO once weekly, not to exceed 400 mg (310 mg base), starting 2 weeks before exposure and continued for 4 weeks after leaving the endemic area
Acute treatment for Uncomplicated Malaria due to P falciparum, P malariae, P ovale, and P viva
- Oral dose: 800 mg (620 mg base) OD, then 400 mg (310 mg base) OD at 6 hr, 24 hr, and 48 hr after initial dose OR
- Weight-based dosing: 13 mg/kg (10 mg/kg base), not to exceed 800 mg (620 mg base) followed by 6.5 mg/kg (5 mg/kg base), not to exceed 400 mg (310 mg base), PO at 6 hr, 24 hr, and 48 hr after initial dose
Systemic Lupus Erythematosus
- Oral dose: 200-400 mg/day (155-310 mg base/day) OD as a single daily dose or in two divided doses
- Doses >400 mg/day are not recommended. Incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded
Porphyria cutanea tarda (off-label use)
- Oral dose: 100 mg twice weekly continue until plasma porphyrin levels are normal for at least one month
Primary Sjögren syndrome (extra-glandular manifestations) (off-label use)
- Oral dose: 200–400 mg OD, or in two divided doses
- Due to the risk of retinal toxicity, do not exceed a daily dose of 5 mg/kg/day using actual body weight or 400 mg
Q fever, chronic (off-label use)
- Oral dose: 600 mg/day in 1 or 3 divided doses in combination with doxycycline for ≥18 months depending on site of infection and serologic response
Prevention of persistent infection following acute Q fever
- Oral dose: 600 mg/day in 1 or 3 divided doses in combination with doxycycline for 12 months
Lupus erythematosus (off-label dose)
- Oral dose: 200–400 mg OD or in 2 divided doses
Juvenile rheumatoid arthritis (JRA) or systemic lupus erythematosus (SLE)
- Oral dose: 3–5 mg/kg/day divided 1–2 times/day to a maximum of 400 mg/day, not to exceed 7 mg/kg/day
Coronavirus disease 2019 (COVID-19) Treatment for adolescents >12 years with severe disease and requiring ICU management (MoHFW India, March 2020)
- Oral Initial dose: 400 mg BID, for 1 day in combination with azithromycin
- Maintenance dose: 200 mg BID, for 4 days
- Should be administered under close medical supervision, with monitoring for side effects, including QTc interval prolongation
Acute attack of Uncomplicated Malaria treatment for Infants, children, and adolescents
- Oral dose: 13 mg/kg/dose (maximum initial dose: 800 mg/dose), followed by 6.5 mg/kg at 6, 24, and 48 hours after the initial dose (maximum dose: 400 mg/dose)
Malaria Chemoprophylaxis for Infants, children, and adolescents
- Oral dose: 6.5 mg/kg once weekly on the same day each week; maximum dose: 400 mg/dose, begin 1–2 weeks before exposure
- Continue for at least 4 weeks after leaving the endemic area
- If the initiation of chemoprophylaxis is delayed (i.e. 2 weeks of therapy not completed prior to the exposure), initiate therapy by doubling the initial dose (13 mg/kg) and administering in 2 divided doses 6 h apart; maximum single dose: 400 mg/dose; continue for 8 weeks after leaving the endemic area
Interactions
Contraindicated
- lefamulin
Serious
- adalimumab
- alefacept
- alfuzosin
- amiodarone
- amitriptyline
- amoxapine
- anakinra
- anthrax vaccine
- antithymocyte globulin equine
- antithymocyte globulin rabbit
- apomorphine
- arformoterol
- arsenic trioxide
- artemether/lumefantrine
- asenapine
- azathioprine
- azithromycin
- basiliximab
- BCG vaccine live
- bedaquiline
- canakinumab
- chlorpromazine
- ciprofloxacin
- cisapride
- citalopram
- clarithromycin
- clofazimine
- clomipramine
- clozapine
- crizotinib
- cyclosporine
- dapsone topical
- dasatinib
- degarelix
- desipramine
- deutetrabenazine
- digoxin
- diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine
- disopyramide
- dofetilide
- dolasetron
- dronedarone
- droperidol
- encorafenib
- entrectinib
- eribulin
- erythromycin base
- erythromycin ethylsuccinate
- erythromycin lactobionate
- erythromycin stearate
- escitalopram
- etanercept
- everolimus
- ezogabine
- flecainide
- fluconazole
- fluoxetine
- fluphenazine
- formoterol
- foscarnet
- gemifloxacin
- gemtuzumab
- glasdegib
- glatiramer
- golimumab
- haloperidol
- hepatitis A vaccine inactivated
- hepatitis a/b vaccine
- hepatitis a/typhoid vaccine
- hepatitis b vaccine
- human papillomavirus vaccine, nonavalent
- human papillomavirus vaccine, quadrivalent
- ibutilide
- iloperidone
- indacaterol (Inhaled)
- indapamide
- infliximab
- influenza virus vaccine quadrivalent
- influenza virus vaccine quadrivalent, intranasal
- influenza virus vaccine trivalent
- inotuzumab
- isradipine
- Japanese encephalitis virus vaccine
- lapatinib
- leflunomide
- levofloxacin
- lofexidine
- lopinavir
- maprotiline
- measles (rubeola) vaccine
- measles mumps and rubella vaccine, live
- measles, mumps, rubella and varicella vaccine, live
- mefloquine
- meningococcal A C Y and W-135 polysaccharide vaccine combined
- methadone
- mifepristone
- moxifloxacin
- muromonab CD3
- mycophenolate
- nilotinib
- nortriptyline
- octreotide
- ofloxacin
- olanzapine
- ondansetron
- osimertinib
- paliperidone
- panobinostat
- pasireotide
- pazopanib
- pentamidine
- perphenazine
- pimavanserin
- pimozide
- pitolisant
- pneumococcal vaccine 13-valent
- pneumococcal vaccine heptavalent
- pneumococcal vaccine polyvalent
- posaconazole
- procainamide
- propafenone
- protriptyline
- quetiapine
- quinidine
- quinine
- rabies vaccine
- rabies vaccine (chick embryo cell derived)
- ranolazine
- remdesivir
- ribociclib
- rilonacept
- rilpivirine
- risperidone
- ritonavir
- romidepsin
- rotavirus oral vaccine, live
- rubella vaccine
- saquinavir
- sertraline
- sirolimus
- smallpox vaccine (live)
- solifenacin
- sorafenib
- sotalol
- sunitinib
- tacrolimus
- telavancin
- temsirolimus
- tetanus toxoid adsorbed or fluid
- tetrabenazine
- thioridazine
- thiothixene
- tick borne encephalitis vaccine
- tocilizumab
- tofacitinib
- tongkat ali
- toremifene
- travelers diarrhea and cholera vaccine inactivated
- trimipramine
- typhoid polysaccharide vaccine
- typhoid vaccine live
- ustekinumab
- vandetanib
- vardenafil
- varicella virus vaccine live
- vemurafenib
- vilanterol/fluticasone furoate inhaled
- voriconazole
- vorinostat
- yellow fever vaccine
- ziprasidone
- zoster vaccine live
Monitor Closely
- astragalus
- cholera vaccine
- dengue vaccine
- denosumab
- echinacea
- influenza virus vaccine quadrivalent, recombinant
- influenza virus vaccine trivalent, recombinant
- maitake
- mercaptopurine
- methotrexate
- osilodrostat
- ozanimod
- selpercatinib
- siponimod
- sipuleucel-T
- tobramycin inhaled
- zoster vaccine recombinant
Minor
- chloroquine
- praziquantel
Adverse Effects
Frequency Not Defined
- Blood and lymphatic system disorders: Bone marrow failure, anemia, aplastic anemia, agranulocytosis, leukopenia, and thrombocytopenia; hemolysis reported in individuals with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency
- Cardiovascular disorders: Cardiomyopathy, QT interval prolongation, and ventricular arrhythmias and torsade de pointes
- Ear and labyrinth disorders: Vertigo, tinnitus, nystagmus, nerve deafness, deafness
- Eye disorders: Irreversible retinopathy with retinal pigmentation changes (bull’s eye appearance), visual field defects (paracentral scotomas) and visual disturbances (visual acuity), maculopathies (macular degeneration), decreased dark adaptation, color vision abnormalities, corneal changes (edema and opacities) including corneal deposition of drug with or without accompanying symptoms (halo around lights, photophobia, blurred vision)
- Gastrointestinal disorders: Nausea, vomiting, diarrhea, abdominal pain
- Hepatobiliary disorders: Liver function tests abnormal, Acute hepatic failure
- Immune system disorders: Urticaria, angioedema, bronchospasm
- Metabolism and nutrition disorders: Decreased appetite, hypoglycemia, porphyria, weight decreased
- Musculoskeletal and connective tissue disorders: Sensorimotor disorder, skeletal muscle myopathy or neuromyopathy leading to progressive weakness and atrophy of proximal muscle groups, depression of tendon reflexes and abnormal nerve conduction
- Nervous system disorders: Headache, dizziness, seizure, ataxia and extrapyramidal disorders such as dystonia, dyskinesia, tremor
- Psychiatric disorders: Affect/emotional lability, nervousness, irritability, nightmares, psychosis, suicidal behaviour
- Skin and subcutaneous tissue disorders: Rash, pruritus, pigmentation disorders in skin and mucous membranes, hair color changes, alopecia; dermatitis bullous eruptions including erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS syndrome), photosensitivity, dermatitis exfoliative, acute generalized exanthematous pustulosis (AGEP)
Contraindications & Warnings
Contraindicated in
- Hypersensitivity to HCQ and related components
- Long-term use in children
- Retinal or visual field changes due to similar compounds
- Pre-existing cardiomyopathy and cardiac rhythm disorders
- G6PD deficiency
Increased risk for
- QT prolongation
- Exacerbation of psoriasis
- Retinal damage
- Loss of visual acuity
- Exacerbation of porphyria
- Dermatitis outbreaks
- Cardiomyopathy
- Aplastic anaemia
- Agranulocytosis
- Myopathy
- Suicidal behaviour
- In patients with cardiovascular disorders
- In patients with hepatic and renal impairment
- In concomitant use with antidiabetic agent
Safety Advice
🍺 Alcohol: Caution
🤰🏻 Pregnancy: Category C
🤱🏻 Breastfeeding: Unsafe
🚗 Driving: Unsafe
Kidney: Caution
Liver: Caution
Pharmacology
Mechanism of Action
- In Malaria: HCQ interfere with the digestive vacuole function within susceptible malarial parasites by increasing pH and interrupting with the lysosomal degradation of Hb, thereby impeding the normal cell function of sensitive parasites
- In COVID-19: The antiviral activity of HCQ in COVID-19 might be exerted by changing the pH at the cell membrane surface and inhibiting viral fusion. It can also inhibit nucleic acid replication, glycosylation of viral proteins, as well as viral assembly and release
- In Rheumatoid arthritis and systemic lupus erythematosus: Mechanisms underlying the anti-inflammatory and immunomodulatory effects of hydroxychloroquine are unknown
Pharmacokinetic
- Bioavailability: Variable (74% on average); Tmax = 2–4.5 hours
- Protein binding: 45%
- Metabolism: Liver
- Elimination half-life: 32–50 days
- Excretion: Mostly kidney (23–25% as unchanged drug), also biliary (<10%)
Pharmacodynamics
- Hydroxychloroquine affects the function of lysozomes in humans as well as plasmodia.
- Altering the pH of the lysozomes reduces low affinity self antigen presentation in autoimmue diseases and interferes with the ability of plasmodia to proteolyse hemoglobin for their energy requirements
General Considerations
- Advise patients to take with food or milk
- Alcohol must be avoided
- Toxicity: Patients experiencing an overdose may present with headache, drowsiness, visual disturbances, cardiovascular collapse, convulsions, hypokalemia, rhythm and conduction disorders including QT prolongation, torsades de pointes, ventricular tachycardia, and ventricular fibrillation. This may progress to sudden respiratory and cardiac arrest. Overdose should be treated with immediate gastric lavage and activated charcoal at a dose of at least 5 times the hydroxychloroquine dose within 30 minutes. Parenteral diazepam may be given to treat cardiotoxicity, transfusion may reduce serum concentrations of the drug, patients should be monitored for at least 6 hours, fluids should be given, and ammonium chloride should be given to acidify urine and promote urinary excretion. Patients may also be given epinephrine. Patients with severe toxicity should be intubated and sedated with high doses of benzodiazepines, and circulatory support should be provided with fluids and vasopressors (e.g. epinephrine). Consider early intravenous lipid therapy for patients with ventricular dysrhythmias or hypotension. Orotracheal intubation for airway protection should be performed early in cases of severe psychomotor agitation, repeated seizure activity, coma, or evidence of severe quinidine-like cardiotoxicity
General Monitoring Parameters
- ECG for estimation of QT interval
- CBC at baseline with periodic tests for liver function, renal function, blood glucose level, and muscle strength during long-term therapy
- Ophthalmologic examination
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