Antimalarial medications for lupus

Examples

Generic NameBrand Name
chloroquine hydrochlorideAralen
hydroxychloroquine sulfatePlaquenil

Antimalarial medications are used to treat malaria and are also prescribed for lupus (systemic lupus erythematosus, or SLE) and rheumatoid arthritis.

How It Works

These medications reduce inflammation. (While they are also used to prevent or treat malaria, there is no known relationship between lupus and malaria.)

Why It Is Used

These medications are used to control skin rash in people who have lupus. They also may help relieve muscle and joint pain, fatigue, and fever that are not controlled with nonsteroidal anti-inflammatory drugs (NSAIDs).

These medications may be used together with anti-inflammatory drugs or corticosteroids. Using them may allow you to reduce the dose of steroids to a level that causes fewer or less bothersome side effects.

How Well It Works

Antimalarial medication is used with corticosteroid creams to control lupus skin rash, and it has long been used to control lupus-related muscle and joint pain.1 For skin rash, this treatment works best when it is combined with protecting the skin from the sun.

Hydroxychloroquine may protect against lupus disease flares.1

Side Effects

The most significant side effect of antimalarials is damage to the tissue that lines the eye (retina). This is rare when hydroxychloroquine is given at appropriate doses. Monitoring of vision is essential to prevent eye damage.2

Other side effects include occasional rash, nausea, or diarrhea. These medications are generally well tolerated.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

It may take several months for these medications to work. If antimalarial treatment doesn't seem to be helping within 6 months, your doctor will probably recommend that you stop taking it.

An initial eye examination will be done if you are taking hydroxychloroquine (Plaquenil) or chloroquine (Aralen).2 After the initial eye examination, your doctor may require eye exams every year or may ask you to check your eyesight regularly with an eye test at home (as with an Amsler gridClick here to see an illustration.). If there is a change in your eyesight, your doctor may reduce your dose or recommend that you stop taking the medication to prevent permanent eye damage. If antimalarial medication is effective, the dose may be tapered or taken less often to reduce the risk of permanent eye damage.

The dose of antimalarial medication may be adjusted if you have kidney or liver disease.

One study reports that hydroxychloroquine is probably safe to use during pregnancy. Talk to your doctor about this medication if you are pregnant or are considering pregnancy and have lupus.3

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.



Author: Shannon Erstad, MBA/MPH
Ralph Poore
Last Updated: May 17, 2006
Medical Review: Kathleen Romito, MD - Family Medicine
Stanford M. Shoor, MD - Rheumatology

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Topic Contents
 Examples
 How It Works
 Why It Is Used
 How Well It Works
 Side Effects
 What To Think About
 References