hydroxychloroquine sulfate: clinical use

Prescribing considerations

• Review ocular history, renal and hepatic function, cardiac disease or QT-risk factors, blood disorders, psoriasis, porphyria, G6PD deficiency, diabetes and neuropsychiatric history.
• Review concomitant retinal-toxic, arrhythmogenic, glucose-lowering and seizure-threshold-lowering medicines.
• Account for renal or hepatic impairment and use an individualised monitoring plan.

Contraindications and cautions

• Hypersensitivity to hydroxychloroquine, other 4-aminoquinolines or product excipients.
• Pre-existing maculopathy.

Monitoring

• Before treatment, assess full blood count, renal and liver function, albumin, blood pressure, height, weight and vaccination status; infection screening may be appropriate according to risk.
• Follow current UK retinal-monitoring arrangements, starting earlier for higher-risk patients such as those with renal impairment or concomitant tamoxifen.
• Periodically review renal and hepatic function, weight, muscle strength and tendon reflexes where clinically appropriate.
• Investigate new visual, cardiac, hepatic, muscular, haematological, glycaemic or psychiatric symptoms promptly.

Clinical pharmacology

An aminoquinoline with immunomodulatory actions involving lysosomal function, enzyme activity, inflammatory mediators and immune-cell responses. It is widely distributed, has prolonged elimination and is cleared partly through the kidneys.

Formulation and product differences

• The selected product is a white, film-coated tablet containing lactose.
• Its score line assists swallowing but is not designed to divide the tablet into equal portions.
• Presentations include bottles and blister packs; not every pack size may be marketed.

Tablet

Route: Oral

Strengths: 200 mg, 300 mg