Examples
| Brand Name | Chemical Name |
| Aralen | chloroquine hydrochloride |
| Plaquenil | hydroxychloroquine sulfate |
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 grid). 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
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References
Citations
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.
Hahn BH (2005). Management of systemic lupus erythematosus. In ED Harris et al., eds., Kelley's Textbook of Rheumatology, 7th ed., vol. 2, pp. 1225–1247. Philadelphia: Elsevier Saunders.
Costedoat-Chalumeau N, et al. (2003). Safety of hydroxychloroquine in pregnant patients with connective tissue diseases. Arthritis and Rheumatism, 48(11): 3207–3211.
Credits
| Author | Shannon Erstad, MBA/MPH |
| Author | Ralph Poore |
| Editor | Kathleen M. Ariss, MS |
| Associate Editor | Michele Cronen |
| Associate Editor | Pat Truman |
| Associate Editor | Terrina Vail |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Stanford M. Shoor, MD - Rheumatology |
| Last Updated | May 17, 2006 |
Ralph Poore
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