How toxic is an old friend? A review of the safety of hydroxychloroquine in clinical practice

Intern Med J. 2023 Mar;53(3):311-317. doi: 10.1111/imj.15908. Epub 2022 Aug 25.

Abstract

Hydroxychloroquine (HCQ) and its close relative chloroquine (CQ) were initially used as antimalarial agents but are now widely prescribed in rheumatology, dermatology and immunology for the management of autoimmune diseases. HCQ is considered to have a better long-term safety profile than CQ and is therefore more commonly used. HCQ has a key role in the treatment of connective tissue diseases including systemic lupus erythematosus (SLE), where it provides beneficial immunomodulation without clinically significant immunosuppression. HCQ can also assist in managing inflammatory arthritis, including rheumatoid arthritis (RA). Debate around toxicity of HCQ in COVID-19 has challenged those who regularly prescribe HCQ to discuss its potential toxicities. Accordingly, we have reviewed the adverse effect profile of HCQ to provide guidance about this therapeutic agent in clinical practice.

Keywords: adverse effects; cardiotoxicity; hydroxychloroquine; retinopathy; rheumatoid arthritis; safety; systemic lupus erythematosus.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents* / adverse effects
  • COVID-19 Drug Treatment
  • COVID-19*
  • Chloroquine / adverse effects
  • Friends
  • Humans
  • Hydroxychloroquine / adverse effects
  • Lupus Erythematosus, Systemic* / drug therapy

Substances

  • Hydroxychloroquine
  • Antirheumatic Agents
  • Chloroquine