Did hydroxychloroquine make you nauseous with diarrhea?

@kmg218
I also have psoriatic arthritis, rheumatoid arthritis, and lupus. In addition, I have celiac disease. Because of my digestive issues, I’m unable to tolerate hydroxychloroquine.

I cannot take NSAIDs — not even Tylenol.

From time to time, I use regular TUMS to help calm my stomach symptoms.

I also discovered that taking standard oral vitamin B12 supplements was ineffective for me. Normally, dietary vitamin B12 is released from food in the stomach and binds to intrinsic factor, a glycoprotein secreted by parietal cells in the gastric mucosa. This intrinsic factor–B12 complex then travels to the terminal ileum, where it binds to specific receptors and is absorbed into the bloodstream.

Given my gastrointestinal challenges, I’ve switched to using a B12 oral spray to help calm down my recurring muscle weakness.

@kmg218 Welcome to Mayo Clinic Connect. This is a great group with great discussions. Have you always had a problem with oral pills and liquids? I can understand why that makes it so hard for you. Have you ever gone to a doctor just to figure out the nausea? And you are not a mess and failure! Are you being treated for the RLS? I have that and finally got treatment maybe 3 years ago. What a relief!
Now we’ll just have to put our heads together and solve the nausea. Becky

@kmg218, I add my welcome. Diarrhea is a known side effect of hydroxychloroquine. It sounds like you have additional issues with a sensitivity to medications along with IBS. There may be other treatment options. See Mayo Clinic's info here: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653

Being sensitive to medications is not a failure. Have you considered getting tested? There is something called pharmacogenomics testing. Pharmacogenetic testing can help determine how a person metabolizes potentially hundreds of common medications. Read more here:
- Mayo Clinic Q and A: What is pharmacogenomics? https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-what-is-pharmacogenomics/

It's important to get the right medication that works for you. I know it can be exhausting to keep trying different things and the multiple doctor visits. I hope you have a doctor who you can work well with.

@becsbuddy Thanks for your kindness....I have dealt with a senstive stomach my whole life. I've had multiple tests, nothing is amiss. I just have trouble taking most pharma meds. For the RLS I was given a low dose clonazapam which I do take and it helps a lot. I take half a 0.5 mg tab. They found my ferratin level low and gave me 325 mg iron pills ever other day and that was a disaster. that made me so sick the day I took it. They told me I would be constipated and of course I got the opposite. So no more of that. I had a great doctor who just left the state and so am trying to find a new one. I'm not on anything right now. Just trying to figure out what I can tolerate and a doctor who will listen and help...

@kmg218

I recently had stomach surgery, and meds were a problem. Could not take extended-release meds. Providers prescribed antacids and pills for nausea. Also, when I went through cancer treatment, they prescribed an anti-nausea pill prior to chemo. Like you, I cannot take NSAIDS, only Tylenol. The anti-nausea I took was ondansetron / Zofran.

I never want to add another medication to my current list of meds, but the anti-acid and nauseous meds helped.

Do you take anything for RLS? I take gabapentin at night so RLS does not keep me awake.

Have you talked to a pharmacist to see if they have any suggestions?

I was started on Hydroxychloroquine last fall and the first month was a bit rough, nausea, diarrhea mostly. I was taking it in the mornings, so started taking it at night. That was better, but I have noticed that if I take it right before bedtime, it seems to make me less sleepy so I am adjusting to early evening. I was recently diagnosed with chronic gastritis after an endoscopy, and I'm losing considerable weight. However, these symptoms started before I started on hydroxycoroquine so I don't think it's that. The trade-off is that it has noticeably improved my Sjogren's symptoms and arthritis. I am willing to try to work with this while it's so effective, the other meds apparently have more bothersome side effects. Hydroxychloroquine needs to be taken with food and I take a low dose. I can relate to your reaction to meds, I do that as well, always take a lower dose of things even like Tylenol or NSAIDS when I use them.

Can you and will your insurance allow to skip the pills and go right to an injectable like Humira? They have a Bio Similar now, Generic.

@roch I do take low dose of clonazapan but saw a neurologist who wants me off that and on Mirapex which is a dopamine agonist and everyone on the RLS page I'm on says its the devil itself. You just don't know what to do...pharmacist is of no help. Its frustrating to say the least...

@fairn Good to hear you are tolerating the hydroxychloroquine....I was going to try taking in the evening, maybe at dinner time? I want to get relief from joint swelling and pain and from the disease causing more problems for me in the future. Do you think your symptoms lessened the longer you took it?

@kmg218 Yes, they seemed to get better with time. I think dinner time is a good compromise. The main thing I noticed taking it at bedtime was I seem to have a new energy about 20 minutes after taking it and I don't fall asleep as easily. The upside is I don't wake up with severe back pain and as much dry mouth in the morning.