Hydroxychloroquine sulfate for Sjögren's syndrome

Examples

Generic Name	Brand Name
hydroxychloroquine sulfate	Plaquenil

How It Works

Hydroxychloroquine appears to slow the immune system's attack on the moisture-producing glands.

Hydroxychloroquine is one of a group of medications that were used for years to treat malaria. These medications are now also used in the treatment of autoimmune diseases such as lupus, rheumatoid arthritis, and Sjögren's syndrome.

Hydroxychloroquine is available only by prescription as a tablet to be taken by mouth. It is often given with one or more other medications.

Why It Is Used

Sjögren's syndrome is an autoimmune disorder in which the immune system attacks the body's moisture-producing glands and may eventually cause problems with the function of vital organs, such as the lungs, bladder, kidneys, and liver. Hydroxychloroquine reduces immune system action.

How Well It Works

Results from studies with hydroxychloroquine for Sjögren's syndrome have been mixed. In one study, people experienced sustained improvement in joint and muscle pain and inflammation as well as in their painful eye and mouth symptoms. However, another study reported no improvements.¹

Side Effects

Hydroxychloroquine is prescribed in low doses and is usually well-tolerated. Mild side effects may include:

• Skin rash.
• Diarrhea.
• Difficulty reading.
• Headache.
• Itching.
• Loss of appetite.
• Nausea or vomiting.
• Stomach cramps or pain.
• Ringing or buzzing in ears (tinnitus) or any loss of hearing.

Serious side effects from hydroxychloroquine are rare but include:

• Blurred vision or any other change in vision. This side effect may also occur or get worse after you stop taking this medication.
• Damage to the retina of the eye resulting in loss of visual acuity.
• Convulsions (seizures).
• Muscle weakness (myopathy).
• Mood changes or mild difficulty in memory or concentration.
• Lowered blood counts.
• Unusual bleeding or bruising.

All side effects except for vision problems disappear once the drug is stopped. While taking hydroxychloroquine, it is recommended that you have a retina examination prior to taking the medication and that you continue with ophthalmologist visits every 1 to 5 years, depending on your age, kidney and liver function, and dose of the medication. If you are taking hydroxychloroquine and develop any changes in vision, contact your health professional immediately.

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

What To Think About

You must take hydroxychloroquine regularly for it to help. It may take up to several weeks before you feel any results and up to 6 months before you feel the full benefit from the medication. Be sure to take the medication exactly as prescribed by your health professional.

Sjögren's syndrome causes dry mouth, which in turn can make it hard to swallow pills. Your pharmacist can crush the hydroxychloroquine tablets and put each dose in a capsule, and you can then mix the contents of the capsule with a teaspoonful of jam, jelly, or gelatin for easier swallowing. Be sure to take all the food in order to get the full dose of medication.

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Author:	Jan Nissl, RN, BS	Last Updated: May 18, 2006
Medical Review:	Adam Husney, MD - Family Medicine Stanford M. Shoor, MD - Rheumatology
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