Hydroxychloroquine (hydroxychloroquine sulfate)

Dosage of hydroxychloroquine sulfate is expressed in terms of hydroxychloroquine sulfate or in terms of the base (hydroxychloroquine).

Each 200-mg tablet of hydroxychloroquine sulfate contains 155 mg of the base.

Hydroxychloroquine dosage may need to be reduced in patients with renal or hepatic impairment; the manufacturer makes no specific recommendations for such individuals.

Hydroxychloroquine sulfate is administered orally. The drug should be administered with food or milk.

The film-coated tablets of hydroxychloroquine should not be crushed or divided.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

The manufacturer states that decades of clinical experience with hydroxychloroquine and data available from published epidemiologic and clinical studies of the drug in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.

There are risks to the mother and fetus associated with untreated or increased disease activity from malaria, rheumatoid arthritis, and systemic lupus erythematosus during pregnancy. Malaria during pregnancy increases the risk for adverse pregnancy outcomes, including maternal anemia, prematurity, spontaneous abortion, and stillbirth. Published data suggest that increased disease activity in pregnant women with rheumatoid arthritis is associated with a risk of adverse pregnancy outcomes, including preterm delivery (before 37 weeks of gestation), low birth weight infants (less than 2.5 kg), and small for gestational age at birth. Pregnant women with systemic lupus erythematosus, especially those with increased disease activity, are at increased risk of adverse pregnancy outcomes, including spontaneous abortion, fetal death, preeclampsia, preterm birth, and intrauterine growth restriction, and passage of maternal auto-antibodies across the placenta may result in neonatal illness, including neonatal lupus and congenital heart block.

Hydroxychloroquine readily crosses the placenta with cord blood concentrations corresponding to maternal plasma concentrations. The manufacturer states that, although epidemiologic and clinical studies have methodological limitations including small sample size and study design, no retinal toxicity, ototoxicity, cardiotoxicity, or growth and developmental abnormalities have been observed in children who were exposed to hydroxychloroquine in utero.

CDC states that pregnancy is not a contraindication to use of hydroxychloroquine when the drug is indicated for prevention of malaria. In addition, CDC states that recommendations for use of hydroxychloroquine for the treatment of uncomplicated malaria in pregnant women are the same as those for other patients.

There is a pregnancy registry to monitor pregnancy outcomes in women exposed to hydroxychloroquine during pregnancy, and patients should be encouraged to enroll in the registry by calling 877-311-8972.

Hydroxychloroquine is distributed into human milk in low concentrations. It is not known whether the drug has any effects on milk production.

The manufacturer states that no adverse reactions have been reported in breast-fed infants of mothers who received hydroxychloroquine and no retinal toxicity, ototoxicity, cardiotoxicity, or growth and developmental abnormalities have been observed in children who were exposed to hydroxychloroquine through breast milk.

The developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for hydroxychloroquine and any potential adverse effects on the breast-fed child from the drug or from the underlying maternal condition.

CDC states that the amount of drug present in human milk is insufficient to provide adequate protection against malaria in breast-feeding infants. If prevention of malaria is necessary, such infants should receive recommended dosages of appropriate antimalarial agent(s).

No enhanced messaging available.