Hydroxychloroquine

Question 1

What conditions is hydroxychloroquine used to treat?

Answer 1

Hydroxychloroquine is used in the management of rheumatoid arthritis and systemic or discoid lupus erythematosus.

Question 2

How is hydroxychloroquine pharmacologically related to chloroquine?

Answer 2

It is pharmacologically very similar to chloroquine, which is used to treat certain types of malaria.

Question 3

What is the most important ocular adverse effect of hydroxychloroquine?

Answer 3

Bull’s eye retinopathy, which may cause severe and permanent visual loss.

Question 4

What recent guidance exists regarding hydroxychloroquine retinopathy screening?

Answer 4

Recent data show retinopathy is more common than previously thought, and RCOphth guidance (March 2018) recommends colour retinal photography and spectral domain optical coherence tomography scanning of the macula.

Question 5

What screening is recommended for patients on hydroxychloroquine?

Answer 5

Baseline ophthalmological examination and annual screening are recommended.

Question 6

Is hydroxychloroquine safe in pregnancy?

Answer 6

Yes, hydroxychloroquine may be used in pregnancy if needed.

Question 7

What monitoring does the BNF recommend for hydroxychloroquine?

Answer 7

Ask the patient about visual symptoms and monitor visual acuity annually using the standard reading chart.