Hydroxychloroquine side effects

Posted by jonesc @jonesc, Jan 19, 2025

Hi! My name is Candy and I’m looking for some pros and cons of taking hydroxychloroquine. My rheumatologist gave me a paper explaining a ton of very scary side effects and honestly, I’m afraid to start it. Does anyone have any experience starting out treatment with this drug and do the benefits outweigh the side effects.

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Profile picture for mah7925 @mah7925

@tisme be careful with Meloxicam. It’s a NSAID and can damage kindeys. Up to 3000 mg Tylenol may work for you.
There always a trade off unfortunately

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@mah7925 my family doctor doesn't want me using it due to the risk of stomach ulcers. , if the illness doesn't get you the treatment will.

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Been taking it for 34 yrs.. 400 mg for Sjogrens and eventually needed additional meds for RA… occasionally. I try to keep off any cortisone due to bone density issues.
I must get field vision test each 6mo. Yet lately I question toxicity. I plan to call Sjogrens Disease Center for support tomorrow. Reston, VA
This Sjogens is basis for 4.0
AAA … according to Mayo.

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Profile picture for kforrest @kforrest

this drug seems to me to be attached politically. it's hard to get what you need. I would like to use it. how many mgs are you taking for 20 years?

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@kforrest so agree Candy. It’s been 34 yrs and greatly helps flares. Need field vision test b-annually. Political only during covid. Geez. Seem to be past that now. Methotrexate added for RA flares. No issue. Good point.

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Profile picture for naturalcranberry @naturalcranberry

@cptrayes Yes, I’m in the US. Here you have the eye exam the first year you start it, year 5, and then annually after that (or at least that’s what they do at Mayo, where I’m seen). Though I feel like that changed between when I started my meds and when I clarified this fall..? I seem to remember during the medication education appointment that it was every 3yrs, but that was in 2022. Could be they updated the standard recently or I was just getting incomplete info that was nonspecific to my case/circumstances.
I suppose my age could also factor in - I was quite young at the time of diagnosis (34), so it could be the age of my eyes, liver, kidneys, etc and ability to metabolize meds may impact the initial frequency of the eye tests.
It’s always interesting to hear how standards of care differ from one country to another!

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@naturalcranberry interesting I am supposed to have an eye exam every year but I have dry macular degeneration.

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I’ve been taking it for my Lupus for 6 months with no side effects. It has improved my energy level significantly!

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Profile picture for bswpb @bswpb

@naturalcranberry interesting I am supposed to have an eye exam every year but I have dry macular degeneration.

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@bswpb It certainly seems like many rheumatologists base the frequency of exams on a variety of factors in your health history! I’m glad to hear the approach is individualized to so many folks.

I have post traumatic vision syndrome after a concussion, but no macular degeneration or family history of it (and I’m 38), so following the general standard makes a lot of sense for me given my circumstances.

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Profile picture for cptrayes @cptrayes

@naturalcranberry I wouldn't be happy with that schedule of eye exams. If my memory serves me right, 1 in 13 people will have retinopathy at 5 years. If they are only being tested at 5 years, then some of those people could have been saved further eye damage at 2,3,4 years.

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@cptrayes Well, I’m sorry to hear that you’re unhappy with the care that I’m receiving. I, however, am incredibly happy with my care team and the balance we’ve struck between meeting my health/family planning goals and choosing medication to manage RA symptoms.

My care team has been extraordinarily mindful about treatment and monitoring for a variety of reasons, not least of which is that I have been ttc, pregnant, or breastfeeding for my entire treatment course.

I do sincerely hope that concerns over retinal toxicity don’t deter folks desiring to grow their families from at least trialing HCQ to see if it works for them - it’s one of the few DMARDs that’s considered safe for pregnancy and breastfeeding due to low/virtually no transfer of the meds across the placenta or into breastmilk. It’s also been great since it’s an immune modifier and not a suppressant, given I’m constantly exposed to childhood illnesses.

I’m sorry to hear so many folks have had retinal issues as a result of HCQ, but it is my understanding it’s considered a rare side effect in folks under 60 without other risk factors regarding kidney and liver function.

I’m sure I won’t be on it forever, but it’s been great for now! I also know quite a few other folks my age that have been on it during childbearing years and done well (including having successful pregnancies).

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Profile picture for naturalcranberry @naturalcranberry

@cptrayes Well, I’m sorry to hear that you’re unhappy with the care that I’m receiving. I, however, am incredibly happy with my care team and the balance we’ve struck between meeting my health/family planning goals and choosing medication to manage RA symptoms.

My care team has been extraordinarily mindful about treatment and monitoring for a variety of reasons, not least of which is that I have been ttc, pregnant, or breastfeeding for my entire treatment course.

I do sincerely hope that concerns over retinal toxicity don’t deter folks desiring to grow their families from at least trialing HCQ to see if it works for them - it’s one of the few DMARDs that’s considered safe for pregnancy and breastfeeding due to low/virtually no transfer of the meds across the placenta or into breastmilk. It’s also been great since it’s an immune modifier and not a suppressant, given I’m constantly exposed to childhood illnesses.

I’m sorry to hear so many folks have had retinal issues as a result of HCQ, but it is my understanding it’s considered a rare side effect in folks under 60 without other risk factors regarding kidney and liver function.

I’m sure I won’t be on it forever, but it’s been great for now! I also know quite a few other folks my age that have been on it during childbearing years and done well (including having successful pregnancies).

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@naturalcranberry I don't call 1 in 6 by 5 years rare. And there are others drugs, HCQ is being prescribed because it's cheap. The biologics are better because they are much more targeted, but in the NHS people have to prove the 3 cheap drugs won't work before they can have them.

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Profile picture for naturalcranberry @naturalcranberry

@bswpb It certainly seems like many rheumatologists base the frequency of exams on a variety of factors in your health history! I’m glad to hear the approach is individualized to so many folks.

I have post traumatic vision syndrome after a concussion, but no macular degeneration or family history of it (and I’m 38), so following the general standard makes a lot of sense for me given my circumstances.

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@naturalcranberry I think treatment plans have to be customized because no one has the same symptoms!

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