Antimalarial medicines (normally used
to prevent and treat malaria) are sometimes used in an attempt to reduce
inflammation associated with
juvenile idiopathic arthritis (JIA).
Antimalarial medicines may be used
along with nonsteroidal anti-inflammatory drugs (NSAIDs) for
arthritis that has not responded to NSAIDs alone. This combination is more
commonly used to treat progressive
polyarticular arthritis but can be used for any form
Although some people get better
with antimalarials, a large study of the effects of antimalarial treatment for
JIA showed them to be no better than a placebo.1 It
may take up to 16 weeks to see an effect from hydroxychloroquine. The medicine
is usually discontinued if no improvement is seen after 16 weeks.
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 your child takes. Side effects are also listed in the information that comes with the medicine.
Here are some important things to think about:
or other emergency services right away if your child has:
Call your doctor right away if your child has:
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.)
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 your child
will need to have an initial ophthalmic examination before beginning
antimalarial therapy and examinations if and when you or your
child notices a change in vision. Your doctor may recommend visits to the
ophthalmologist as often as every 3 to 12 months, depending on your child's vision and your doctor's level of
concern about eye disease from JIA.
Medicine is one of the many tools your doctor has to treat a health problem. If your child takes medicine as your doctor suggests, it will improve your child's health and may prevent future problems. If your child doesn't take the medicines properly, his or her health (and perhaps life) may be 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.
Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Nistala K, et al. (2009). Juvenile idiopathic arthritis. In
GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1657–1675. Philadelphia: Saunders
June 5, 2012
Susan C. Kim, MD - Pediatrics
& John Pope, MD - Pediatrics
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