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  • Writer's pictureTeresa Mendoza, PharmD

Med of the Week: Hydroxychloroquine



Hydroxychloroquine with arthritis warrior ribbon

Hydroxychloroquine is known for treating autoimmune disorders and malaria. Although its mechanism is unclear, it’s well established that Hydroxychloroquine has many drug interactions with narcotics, steroids, and antibiotics. Continue reading to find out more:


Generic Name: Hydroxychloroquine

Brand Name(s): Plaquenil

Pronunciation: hye drox ee KLOR oh kwin


About this drug:

  • Hydroxychloroquine is used for the treatment of Systemic Lupus Erythematosus and rheumatoid arthritis.

  • It is also used for the prevention and treatment of acute attacks of malaria.


Dentistry-related tidbits:

  • This medication may cause hypoglycemia. Dentists should have sugar sources available in case a patient becomes hypoglycemic.

  • This medication may cause extrapyramidal symptoms such as tremors, restlessness, or jerky movements that may make the dental procedure more challenging.

  • Refer the patient to their physician if they mention any visual symptoms.

  • The risk of QT prolongation and cardiac arrhythmias is increased when Hydroxychloroquine is combined with macrolide antibiotics (e.g. Erythromycin), quinolone antibiotics (e.g. Levofloxacin), the antifungal Fluconazole, the nitroimidazole antibiotic Metronidazole, and the narcotic Hydrocodone.

  • Combining Hydroxychloroquine with the antifolate antibiotic Trimethoprim or the oxazolidinone antibiotic Linezolid may increase the risk of myelosuppression.

  • The risk of seizures may increase when Hydroxychloroquine is combined with Penicillin antibiotics, cephalosporin antibiotics (e.g. Cefazolin, especially with high doses and/or renal problems), anticonvulsants (e.g. Carbamazepine), muscle relaxants, steroids, narcotics, benzodiazepines, the NSAID Ketorolac, and the anesthetic Lidocaine.

  • Narcotics in combination with Hydroxychloroquine may increase the risk of CNS and respiratory depression and diminished psychomotor function. Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.


Fun facts:

  • Rheumatoid arthritis is a chronic, progressive autoimmune disorder that primarily affects the joints bilaterally, in contrast with osteoarthritis which is a “wear and tear” type of arthritis that presents with unilateral symptoms. 

  • Hydroxychloroquine’s anti-inflammatory mechanism of action is unknown. However, it is known to interfere with parasitic function, leading to its antimalarial effects.

  • Grapefruit products combined with Hydroxychloroquine increase the risk of QT prolongation and cardiac arrhythmias.

  • This medication may cause the skin to burn more easily in the sunlight. Advise the patient to apply sunscreen SPF 30 or higher when outdoors.

  • Hydroxychloroquine was initially suggested to treat COVID-19 but clinical trials proved this medication to be ineffective in treating the viral infection. It also increased the mortality rate and resulted in adverse effects such as QT prolongation


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