Hydroxychloroquine sulfate for Sjögren's syndrome

Examples

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Brand Name	Generic Name
Plaquenil	hydroxychloroquine sulfate

How It Works

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

Hydroxychloroquine is one of a group of medicines that were used for years to treat malaria. These medicines 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 medicines.

Why It Is Used

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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

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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. But another study reported no improvements.¹

Side Effects

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Most people experience no major side effects from antimalarial drugs. Infrequent side effects include:

• Dizziness.
• Rash and itching.
• Nausea.
• Vomiting.
• Diarrhea.
• Abdominal cramps.

A very rare side effect is damage to the retina of the eye. Before taking an antimalarial, you will have an eye exam by an ophthalmologist. Eye damage can be caught early by self-testing your vision every month or by seeing an ophthalmologist every year. If you have any change in vision, contact your ophthalmologist or rheumatologist immediately.

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

What To Think About

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If you are breast-feeding, pregnant, or thinking about becoming pregnant, talk to your doctor before taking antimalarial medicine.

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 medicine. Be sure to take the medicine exactly as prescribed by your doctor.

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 medicine.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Jonsson R, et al. (2005). Sjögren's syndrome. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 1681–1705. Philadelphia: Lippincott Williams and Wilkins.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	May 6, 2008