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This document outlines essential safety information and warnings for the use of hydroxychloroquine (Plaquenil). It is crucial to familiarize yourself with these details and discuss any concerns with your healthcare provider.

• Serious Heart Rhythm Issues: Hydroxychloroquine can lead to severe heart rhythm problems, including QT prolongation, especially if you have certain risk factors like abnormal electrolyte levels, existing heart issues, or if you are taking medications like amiodarone or quetiapine that affect heart rhythm. Seek immediate medical attention if you experience symptoms such as chest pounding, shortness of breath, chest pain, faintness, or lightheadedness.

• Phospholipid Build-up: This medication may affect the processing of phospholipids in your body, potentially causing organ damage. Regular eye exams are recommended as hydroxychloroquine can lead to retinal damage, resulting in vision changes or loss. Report any vision changes to your healthcare provider promptly.

• Severe Skin and Allergic Reactions: Life-threatening allergic reactions, including anaphylaxis, and severe skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis, may occur. If you notice symptoms like facial swelling, rash, blisters, skin peeling, or difficulty breathing, discontinue use and seek medical help immediately.

• Blood Cell Count Reduction: The medication can lower red and white blood cells and platelets, increasing the risk of bleeding, anemia, and infections. Monitor for symptoms like fatigue, dizziness, or weakness and inform your provider.

• Suicidal Thoughts: Some individuals may experience suicidal thoughts or unusual behavior. Immediate medical attention is necessary if you or someone around you notices such symptoms, especially if there is a history of mental health conditions.

• Low Blood Sugar Levels: Hydroxychloroquine can cause significant drops in blood sugar, particularly for individuals with diabetes. Regular monitoring of blood sugar levels is advised. Carry fast-acting sugars like glucose tablets or candy to manage potential hypoglycemia symptoms such as shakiness, hunger, or confusion.

• Exacerbation of Specific Conditions: This medication may worsen conditions like psoriasis and porphyria. Discuss with your healthcare provider if you have these conditions to assess the benefits versus risks of treatment.

Contraindications: Hydroxychloroquine should not be used if you have allergies to similar medications, such as chloroquine. Always consult your healthcare provider before starting this medication if you have any contraindications.

When taking this medication, some individuals may experience common side effects such as nausea, vomiting, diarrhea, and bloating. These effects, occurring in up to 37% of users, are generally mild but should be discussed with a healthcare provider if they persist or worsen. Additionally, other side effects like rash, changes in hair, muscle weakness, and ringing in the ears have been reported.

While most people do not experience serious side effects, it is important to be aware of the potential for severe reactions. Serious side effects include abnormal heart rhythm, characterized by chest pounding, shortness of breath, and feeling faint. If you notice symptoms of a severe allergic reaction, such as rash, swelling of the face or tongue, or difficulty breathing, seek medical attention immediately. Other serious conditions include hemolytic anemia, which may present as tiredness and yellowing of the skin or eyes, and bleeding issues such as unexplained bruising or prolonged bleeding.

It is also crucial to monitor for signs of serious infections, such as fever and difficulty breathing, as well as any changes in mental health including suicidal thoughts or behaviors. Low blood sugar is another concern, particularly for individuals with diabetes, and symptoms like dizziness, shakiness, and extreme hunger should prompt immediate medical advice. Finally, prolonged use or high doses of this medication can lead to serious eye problems, including vision changes and sensitivity to light, requiring urgent medical evaluation. Always consult your healthcare provider if you experience any notable changes or concerning symptoms.

Hydroxychloroquine, also known as Plaquenil, can interact with various medications and supplements. It is essential to inform your doctor and pharmacist about all the medications and supplements, including prescription, over-the-counter, vitamins, and herbal products, that you are currently taking.

Certain medications should not be used in conjunction with hydroxychloroquine. These include aurothioglucose, bepridil, cisapride, dronedarone, mesoridazine, pimozide, piperaquine, saquinavir, sparfloxacin, terfenadine, thioridazine, and ziprasidone. Your doctor may choose to avoid prescribing hydroxychloroquine or alter your other medications.

Other drugs, such as acarbose, albiglutide, amiodarone, azithromycin, and many others, may typically not be recommended to use with hydroxychloroquine but may be necessary in specific situations. If these medications are prescribed together, your doctor might adjust the dosing or frequency of one or both medications to minimize the risk of side effects.

Additionally, using hydroxychloroquine with some medications, like ampicillin and digoxin, may increase the likelihood of certain side effects. However, in some cases, using both may be the most effective treatment. Again, your doctor may need to modify the dosage or administration schedule to ensure safety and efficacy.

Hydroxychloroquine can also affect heart rhythm, leading to QT prolongation. Drugs known to have this effect include amiodarone, azithromycin, disopyramide, and quinidine, among others. It's crucial to monitor for this interaction to prevent severe cardiac issues. Always follow your healthcare provider's guidance when taking hydroxychloroquine with other medications.