Plaquenil & Aralen for Lupus

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Antimalarial medications for systemic lupus erythematosus Examples

hydroxychloroquine sulfate (Plaquenil)

chloroquine hydrochloride (Aralen)

Although these antimalarial medications are not labeled by the U.S. Food and Drug Administration (FDA) for the treatment of lupus, they are often prescribed for people with lupus.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 may also 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 often the first choice for controlling lupus skin rash; it has long been used to control SLE-related muscle and joint pain.1

Hydroxychloroquine may also protect against SLE disease flares.1Side Effects

The most significant side effect of antimalarials is damage to the tissue that lines the eye (retina); this is rare when appropriate doses are used. Regular eye examinations with your doctor and possibly at home are critical to preventing eye damage.

An initial eye examination will be done if you are taking hydroxychloroquine (Plaquenil) or chloroquine (Aralen) for more than 3 months. After the initial eye examination, your doctor may ask you to check your eyesight regularly with an eye test at home (as with an Amsler grid) or may have you return for annual eye examinations. If there is a change in your eyesight, your doctor may reduce your dose or recommend that you stop taking the medication for a while 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.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.

Regular eye examinations or eye testing at home are critical when taking hydroxychloroquine or chloroquine to avoid permanent eye damage.

See a list of questions to ask your doctor about medications. References

Citations

Reveille J (2001). The treatment of systemic lupus erythematosus. In W Koopman, ed., Arthritis and Allied Conditions: A Textbook of Rheumatology, 14th ed., vol. 2, pp. 1533–1545.

Hahn B (2001). Management of systemic lupus erythematosus. In S Ruddy, et al., eds., 's Textbook of Rheumatology, 6th ed., vol. 2, pp. 1125–1143. Philadelphia: W.B. Saunders.Credits

Author

Kathe Gallagher, MSW

Editor

Geri Metzger

Associate Editor

Lila Havens

Associate Editor

Landauer

Primary Medical Reviewer

Adam Husney, MD- Family Practice

Specialist Medical Reviewer

Stanford M. Shoor, MD- Rheumatology

Last Updated

7/2/2002

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Last updated: July 02, 2002

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