Antimalarial medicines are used to treat malaria and are
also prescribed for
lupus (systemic lupus erythematosus, or SLE) and
These medicines reduce
inflammation. (They are also used to prevent or
treat malaria, but there is no known relationship between lupus and
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. And they may protect organs such as the kidneys.
may be used together with anti-inflammatory drugs (NSAIDs),
corticosteroids, or medicines that suppress the immune system. Using them may allow you to reduce
the dose of other medicines to a level that causes fewer or less bothersome side
A review of several studies shows that antimalarials reduce overall disease activity. They may have several other effects, including reducing disease flares and protecting organs such as the kidneys.1
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.3
Hydroxychloroquine may protect against lupus
Antimalarials are likely to help joint pain and reduce inflammation of the sac around the heart and the sac around the lungs.4
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
or other emergency services right away if you have:
Call your doctor right away if you have:
Common side effects of this medicine include:
See Drug Reference for a full list of
side effects. (Drug Reference is not available in all systems.)
It may take several months for
these medicines to work. If antimalarial treatment doesn't seem to be helping
within 6 months, your doctor may recommend that you stop taking
Some antimalarial medicines, such as hydroxychloroquine, can cause serious and permanent damage to
the retina of the eye. When appropriate doses are given, this is rare.
If it is found early, eye damage may be reversed and permanent damage may be prevented. So be sure to have an initial ophthalmic exam before you begin
antimalarial therapy. Then have your eyes examined if you notice a change in vision. Your doctor may recommend visits to the
ophthalmologist as often as every 3 to 12 months, depending on your vision and your doctor's level of
concern about eye disease.
dose of antimalarial medicine may be adjusted if you have kidney or liver
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments. And call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Ruiz-Irastorza G, et al. (2010). Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: A systematic review. Annals of the Rheumatic Diseases, 69(1): 20–28.
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.
Lockshin MD (2008). Systemic lupus erythematosus. In
DC Dale, DD Federman, eds., ACP Medicine, section 15,
chap. 4. New York: WebMD.
Madhok R, Wu O (2009). Systemic lupus erythematosus, search date December 2007. Online version of Clinical Evidence (7).
May 7, 2012
Anne C. Poinier, MD - Internal Medicine
& Anne C. Poinier, MD - Internal Medicine & Stanford M. Shoor, MD - Rheumatology & Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
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