Contains the active ingredient, hydroxychloroquine sulfate
Consumer Medicine Information
What is in this leaflet
Read this leaflet carefully before taking your medicine. Ask your doctor or pharmacist if you do not understand anything or are worried about taking your medicine.
This leaflet answers some common questions about hydroxychloroquine.
It does not contain all the available information.
It does not take the place of talking to your doctor or pharmacist.
The information in this leaflet was last updated on the date listed on the last page. Some more recent information on your medicine may be available. Speak to your pharmacist or doctor to obtain the most up-to-date information.
All medicines have risks and benefits. Your doctor has weighed the risks of you using this medicine against the benefits they expect it will have for you.
Pharmaceutical companies cannot give you medical advice or an individual diagnosis.
Keep this leaflet with your medicine. You may want to read it again.
What this medicine is used for
The name of your medicine is APO- Hydroxychloroquine. It contains the active ingredient hydroxychloroquine sulfate.
It may be used for any of the following conditions:
Rheumatoid arthritis is a form of arthritis with inflammation of the joints, characterized by stiffness, swelling and pain. Hydroxychloroquine may be used for short or long-term rheumatoid arthritis treatment.
In treating rheumatoid arthritis, hydroxychloroquine may slow down the substances which harm the joints.
Systemic Lupus Erythematous (SLE)
SLE is a disease in which a person's normal immunity is upset. The body produces an excess of blood proteins called antibodies and these antibodies may cause problems in any organ of the body.
These antibodies may end up, for example, in the skin causing a variety of skin rashes or deposit in the kidney, brain, lung and joints causing injury.
Discoid Lupus Erythematous (DLE)
DLE is similar to SLE except it only affects the skin and is characterized by a scaling, red rash.
Malaria (treatment and control of symptoms)
Malaria is an infectious disease caused by the presence of parasites in red blood cells.
The disease is characterized by chills, fever and sweats.
In malaria, hydroxychloroquine destroys the harmful parasite which causes the illness.
Your doctor may have prescribed hydroxychloroquine for another reason.
Ask your doctor if you have any questions about why this medicine has been prescribed for you.
This medicine is available only with a doctor's prescription.
Hydroxychloroquine is not addictive.
Before you take this medicine
When you must not take it
Do not take this medicine if you have had an allergic reaction to hydroxychloroquine, chloroquine or related products or any of the ingredients listed at the end of this leaflet.
If you are uncertain whether you have had an allergic reaction to a related product ask your doctor or pharmacist.
Symptoms of an allergic reaction may include an asthma attack, facial swelling, skin rash or hay fever.
Ask your doctor about the risks and benefits of taking this medicine while you are pregnant.
When hydroxychloroquine is taken for long periods of time, there is an increased risk to the unborn child. It may cause problems with brain function, hearing, balance and vision.
Ask your doctor about the risks and benefits of taking this medicine while you are breastfeeding.
Do not take this medicine if you have previously experienced changes in your eyesight when taking medicines for rheumatoid arthritis or malaria.
Hydroxychloroquine should not be used in children under 6 years.
Hydroxychloroquine should not be used in children over 6 years for long periods.
Do not take this medicine after the expiry date (EXP) printed on the pack.
If you take this medicine after the expiry date has passed, it may not work as well.
Do not take this medicine if the packaging is torn, shows signs of tampering or if it does not look quite right.
If it has expired or is damaged, return it to your pharmacist for disposal.
Before you start to take it
You must tell your doctor if:
You are allergic to quinine.
You have allergies to any ingredients listed under "Product Description" at the end of this leaflet.
You have any pre-existing eye disorders
You have experienced low blood sugar levels (hypoglycaemia - a "hypo"). Hydroxychloroquine may increase the risk of you having a hypo.
You have any of these medical conditions:
liver or kidney problems
stomach, brain or blood disorders
disease of the heart muscle
skin diseases, in particular psoriasis which is a kind of itchy rash.
Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency which is a lack of a chemical substance which causes the breakdown of sugar in the body.
Porphyria, which is a rare disease of blood pigments.
You plan to become pregnant or breastfeed.
If you have not told your doctor about any of the above, tell them before you start taking this medicine.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.
Some medicines and hydroxychloroquine may interfere with each other. These include:
any medicine to treat depression
digoxin - a medicine used to treat heart disease
medicines to treat diabetes
medicines used to suppress the immune system such as cyclosporin
antiarrythmic drugs such as amiodarone, which control heart rhythm
other drugs to treat malaria
medicines to treat epilepsy.
These medicines may be affected by hydroxychloroquine or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.
Your doctor and pharmacist can tell you if you are taking any of these medicines.
Other interactions not listed above may also occur.
How to take this medicine
Follow all directions given to you by your doctor or pharmacist carefully.
They may be different to the information in this leaflet.
If you do not understand any written instructions, ask your doctor or pharmacist for help.
How much to take
Your doctor or pharmacist will tell you how many tablets you will need to take. This depends on your condition and whether or not you are taking any other medicines.
The dosage will depend on why you are being treated with hydroxychloroquine.
The usual doses are:
2-3 tablets daily. Your doctor may later reduce this to 1-2 tablets daily.
SLE and DLE
2-4 tablets daily. Your doctor may later reduce this to 1-2 tablets daily.
Control of Malaria Symptoms
2 tablets once a week. The tablets should be taken on exactly the same day of each week.
For example, if your first dose is taken on a Monday, then each weekly dose should be taken on a Monday.
Treatment of Malaria
The starting dose is 4 tablets. Take another 2 tablets six to eight hours later and 2 further tablets on each of the next two days.
Always follow the instructions given to you by your doctor.
Dosages for children are calculated according to the child's body weight.
Your doctor will work out the correct dose for children.
Hydroxychloroquine should not be used in children for long periods.
Your doctor may ask you to take a different dose. You should follow the instructions on the label.
If you are unsure what dose to take ask your doctor.
How to take it
Swallow tablets whole with a little water or other liquid.
When to take it
It is best to take hydroxychloroquine at meal times.
How long to take it for
Continue taking your medicine for as long as your doctor tells you.
Make sure you have enough to last over weekends and holidays.
If you forget to take it
If you are being given hydroxychloroquine for rheumatoid arthritis or SLE or DLE, do not take a double dose to make up for the dose missed. Just continue with the appropriate dose on the next day.
If you are being given hydroxychloroquine for suppression or treatment of malaria, you should take your tablets as soon as you remember, and go back to taking it as you would normally.
If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
If you think that you or anyone else may have taken too much of this medicine, immediately telephone your doctor or go to the Accident and Emergency department at your nearest hospital.
Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you take too much hydroxychloroquine, you may experience headaches, drowsiness, visual disturbances or fits.
These symptoms may occur within 30 minutes of overdose.
While you are taking this medicine
Your doctor will need to perform the following tests during treatment with hydroxychloroquine:
Your doctor will need to perform some eye tests every few months to check that your eyesight is not changing.
In extremely rare cases, hydroxychloroquine has been associated with blindness. This can be avoided by having regular eye tests.
It is recommended you wear sunglasses when out in the sun.
Your doctor will need to perform occasional blood tests to check for any blood reactions.
Things you must do
Tell any other doctors, dentists, and pharmacists who are treating you that you are taking hydroxychloroquine.
Tell your doctor immediately if you become pregnant.
If you are about to have any blood tests, tell your doctor that you are taking this medicine.
Go to your doctor regularly for a check-up.
Your doctor may occasionally do tests to make sure the medicine is working and to prevent side effects.
Tell your doctor if you experience any of the following symptoms including:
trembling or shaking
lack of concentration
tearfulness or crying
numbness around the lips and fingers.
These symptoms may be associated with hypoglycaemia.
If you experience any of the symptoms of hypoglycaemia, you need to raise your blood glucose urgently. You can do this by taking one of the following:
5-7 jelly beans
3 teaspoons of sugar or honey
1/2 can of ordinary (non-diet) soft drink
2-3 concentrated glucose tablets
Unless you are within 10 to 15 minutes of your next meal or snack, follow up with extra carbohydrates e.g. plain biscuits, fruit or milk - when over the initial symptoms.
Taking this extra carbohydrate will prevent a second drop in your blood glucose level.
Make sure you, your friends, family and work colleagues can recognise the symptoms of hypoglycaemia and know how to treat them.
Things you must not do
Do not give this medicine to anyone else, even if their symptoms seem similar to yours.
Do not take your medicine to treat any other complaints unless your doctor or pharmacist tells you to.
Do not stop taking your medicine, or change the dosage, without checking with your doctor.
Things to be careful of
Be careful while driving or operating machinery until you know how hydroxychloroquine affects you.
Hydroxychloroquine may cause problems with the eyesight of some people. Make sure you know how you react to hydroxychloroquine before you drive a car, operate machinery, or do anything else that could be dangerous with blurred vision.
Hydroxychloroquine may cause hypoglycaemia,which can impair your ability to drive or operate machinery. Make sure you are aware of the symptoms of hypoglycaemia and avoid dangerous activities until your blood sugar returns to normal (see 'Treating hypoglycaemia' under 'Things you must do').
Possible side effects
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking hydroxychloroquine.
All medicines may have some unwanted side effects. Sometimes they are serious, but most of the time, they are not. Your doctor has weighed the risks of using this medicine against the benefits they expect it will have for you.
Hydroxychloroquine helps most people with rheumatoid arthritis, SLE, DLE, treatment of malaria and the control of malaria symptoms, but it may have unwanted side effects in a few people.
You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Following is a list of possible side effects. Do not be alarmed by this list. You may not experience any of them.
Tell your doctor if you notice any of the following and they worry you:
Stomach problems such as:
Other problems such as:
Loss of appetite
Ringing in the ears
Skin rash and itching
If you already have psoriasis, you are more likely to experience skin reactions than other people when taking hydroxychloroquine.
Tell your doctor as soon as possible if you notice any of the following:
Any hearing loss
Frequent fevers, severe chills, bruising, sore throat or mouth ulcers (these may be signs of blood reactions)
More severe symptoms of hypoglycaemia, including:
seizures, fits or convulsions
loss of consciousness
Movement problems, such uncontrolled movements, stiffness or tremors
Wide spread rash with blisters, with or without fever, which can indicate a severe drug induced allergic reaction. It can involve blood changes and internal organs.
These are serious side effects. You may need medical attention.
Serious side effects are rare.
Other side effects not listed above may occur in some patients.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
Storage and disposal
Keep your medicine in its original packaging until it is time to take it.
If you take your medicine out of its original packaging it may not keep well.
Keep your medicine in a cool dry place where the temperature will stay below 25°C.
Do not store your medicine, or any other medicine, in the bathroom or near a sink. Do not leave it on a window sill or in the car. Heat, sunlight and dampness can destroy some medicines.
Keep it where children cannot reach it.
Children are particularly sensitive to the unwanted effects of hydroxychloroquine.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking this medicine or it has passed its expiry date your pharmacist can dispose of the remaining medicine safely.
What APO- Hydroxychloroquine looks like
White to off-white, capsule-shaped tablets, embossed "HCQS" on one side, plain on the other side.
* Not all strengths, pack types and/or pack sizes may be available.
Packaged in bottles of 100 tablets.
Each tablet contains 200 mg of hydroxychloroquine sulfate as the active ingredient (equivalent to 155 mg hydroxychloroquine).
It also contains the following inactive ingredients:
anhydrous calcium hydrogen phosphate
pregelatinised maize starch
colloidal anhydrous silica
Opadry II White 85F18422.
This medicine is gluten-free, lactose-free and free of other azo dyes.