AdultPediatricDosage Forms & Strengths tablet 200mg Malaria Prophylaxis Indicated for prophylaxis of malaria in geographic areas where chloroquine resistance is not reported 400 mg (310 mg base) PO weekly, starting 2 weeks before exposure and continued for 4 weeks after departure from endemic area OR Weight-based dosing: 6.5 mg/kg (5 mg/kg base) PO once weekly, not to exceed 400 mg (310 mg base), starting 2 weeks before exposure and continued for 4 weeks after leaving the endemic area Acute treatment Indicated for treatment of uncomplicated malaria due to P falciparum, P malariae, P ovale, and P vivax 800 mg (620 mg base) PO, then 400 mg (310 mg base) PO at 6 hr, 24 hr, and 48 hr after initial dose Weight-based dosing: 13 mg/kg (10 mg/kg base), not to exceed 800 mg (620 mg base) followed by 6.5 mg/kg (5 mg/kg base), not to exceed 400 mg (310 mg base), PO at 6 hr, 24 hr, and 48 hr after initial dose Rheumatoid Arthritis Indicated for treatment of acute and chronic rheumatoid arthritis 400-600 mg/day (310-465 mg base/day) PO as a qDay or in BID When a good response is obtained, reduce dosage by 50% and continue maintenance dose of 200-400 mg/day (155-310 mg base/day) PO as a qDay or in BID; not exceed 600 mg or 6.5 mg/kg (5 mg/kg base) per day, whichever is lower, as the incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded Use corticosteroids and salicylates in conjunction with hydroxychloroquine; gradually decrease dosage or eliminate after a maintenance dose has been achieved Systemic Lupus Erythematosus Indicated for treatment of chronic discoid lupus erythematosus and systemic lupus erythematosus 200-400 mg/day (155-310 mg base/day) PO as a single daily dose or in two divided doses Doses >400 mg/day are not recommended Incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded Coronavirus Disease 2019 (COVID-19) (Off-label) FDA revoked the emergency use authorization (EUA) for hydroxychloroquine on June 15, 2020 Based on its ongoing analysis of the EUA and emerging scientific data, the FDA determined that hydroxychloroquine is unlikely to be effective in treating COVID-19 for the authorized uses in the EUA; additionally, in light of ongoing serious cardiac adverse events and other potential serious side effects, the known and potential benefits of hydroxychloroquine no longer outweigh the known and potential risks for the EUA While additional clinical trials may continue to evaluate potential benefit, the FDA determined the EUA was no longer appropriate The NIH COVID-19 Treatment Guidelines recommend against the use of chloroquine or hydroxychloroquine and/or azithromycin for the treatment of COVID-19 in hospitalized patients and in nonhospitalized patients For more information, see the FDA news release: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine Additional Medscape COVID-19 references are available Coronavirus Disease 2019 (COVID-19) (link https://emedicine.medscape.com/article/2500114-overview) Novel Coronavirus Resource Center (link https://www.medscape.com/resource/coronavirus) Porphyria Cutanea Tarda (Off-label) 100-200 mg (77.5-155 mg base) PO 2-3 times/wk Dosing Considerations A reduction in dosage may be necessary for patients with hepatic or renal disease Before prescribing hydroxychloroquine for treatment or prophylaxis of malaria, consult the Centers for Disease Control and Prevention (CDC) Malaria website (link http://www.cdc.gov/malaria) Limitations of use in malaria Not recommended for treatment of complicated malaria Not effective against chloroquine or hydroxychloroquine-resistant strains of Plasmodium species Not recommended for treatment of malaria acquired in geographic areas where chloroquine resistance occurs or when the Plasmodium species has not been identified Not recommended for malaria prophylaxis in geographic areas where chloroquine resistance occurs Does not prevent relapses of P vivax or P ovale because it is not active against the hypnozoite forms of these parasites For radical cure of P vivax and P ovale infections, concomitant therapy with an 8-aminoquinoline compound is necessary Dosage Forms & Strengths tablet 200mg Malaria Prophylaxis Indicated for prophylaxis of malaria in geographic areas where chloroquine resistance is not reported. 6.5 mg/kg (5 mg/kg base) PO once weekly, not to exceed 400 mg (310 mg base), starting 2 weeks before exposure and continued for 4 weeks after leaving the endemic area Acute treatment Indicated for treatment of uncomplicated malaria due to P falciparum, P malariae, P ovale, and P vivax 13 mg/kg (10 mg/kg base), not to exceed 800 mg (620 mg base) followed by 6.5 mg/kg (5 mg/kg base), not to exceed 400 mg (310 mg base), PO at 6 hr, 24 hr, and 48 hr after initial dose Porphyria Cutanea Tarda (Off-label) Dosing schedules not well established in children A case report describes 3 mg/kg PO twice weekly over 14 months reported as safe and effective in a child aged 4 yr Dosing Considerations Before to prescribing hydroxychloroquine for treatment or prophylaxis of malaria, consult the Centers for Disease Control and Prevention (CDC) Malaria website (link http://www.cdc.gov/malaria) Limitations of use in malaria Not recommended for treatment of complicated malaria Not effective against chloroquine or hydroxychloroquine-resistant strains of Plasmodium species Not recommended for treatment of malaria acquired in geographic areas where chloroquine resistance occurs or when the Plasmodium species has not been identified Not recommended for malaria prophylaxis in geographic areas where chloroquine resistance occurs Does not prevent relapses of P vivax or P ovale because it is not active against the hypnozoite forms of these parasites For radical cure of P vivax and P ovale infections, concomitant therapy with an 8-aminoquinoline compound is necessary Interaction CheckerEnter a drug name and hydroxychloroquine sulfateNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (1)lefamulinlefamulin will increase the level or effect of hydroxychloroquine sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.Serious - Use Alternative (210)adagrasibadagrasib, hydroxychloroquine sulfate. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.adalimumabadalimumab and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.albuterolalbuterol and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.alefaceptalefacept and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.alfuzosinhydroxychloroquine sulfate and alfuzosin both increase QTc interval. Avoid or Use Alternate Drug.alfuzosin and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.amiodaronehydroxychloroquine sulfate and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amisulprideamisulpride and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylinehydroxychloroquine sulfate and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.amoxapinehydroxychloroquine sulfate and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.anagrelideanagrelide and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.anakinraanakinra and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.anthrax vaccinehydroxychloroquine sulfate decreases effects of anthrax vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin equineantithymocyte globulin equine and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.antithymocyte globulin rabbitantithymocyte globulin rabbit and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.apomorphinehydroxychloroquine sulfate and apomorphine both increase QTc interval. Avoid or Use Alternate Drug.arformoterolhydroxychloroquine sulfate and arformoterol both increase QTc interval. Avoid or Use Alternate Drug.aripiprazolearipiprazole and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.arsenic trioxidehydroxychloroquine sulfate and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherartemether and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrinehydroxychloroquine sulfate and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.asenapinehydroxychloroquine sulfate and asenapine both increase QTc interval. Avoid or Use Alternate Drug.asenapine transdermalasenapine transdermal and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.atomoxetineatomoxetine and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.axicabtagene ciloleucelhydroxychloroquine sulfate, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.azathioprineazathioprine and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.azithromycinhydroxychloroquine sulfate and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.basiliximabbasiliximab and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.BCG vaccine livehydroxychloroquine sulfate decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.bedaquilinehydroxychloroquine sulfate and bedaquiline both increase QTc interval. Avoid or Use Alternate Drug.brexucabtagene autoleucelhydroxychloroquine sulfate, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.buprenorphinebuprenorphine and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalbuprenorphine transdermal and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionbuprenorphine, long-acting injection and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.canakinumabcanakinumab and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ceritinibceritinib and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.chlorpromazinehydroxychloroquine sulfate and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.ciltacabtagene autoleucelhydroxychloroquine sulfate, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ciprofloxacinhydroxychloroquine sulfate and ciprofloxacin both increase QTc interval. Avoid or Use Alternate Drug.cisapridehydroxychloroquine sulfate increases toxicity of cisapride by QTc interval. Avoid or Use Alternate Drug.citalopramhydroxychloroquine sulfate and citalopram both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinhydroxychloroquine sulfate and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.clofaziminehydroxychloroquine sulfate and clofazimine both increase QTc interval. Avoid or Use Alternate Drug.clomipraminehydroxychloroquine sulfate and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.clozapinehydroxychloroquine sulfate and clozapine both increase QTc interval. Avoid or Use Alternate Drug.crizotinibhydroxychloroquine sulfate and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.dapsone topicalhydroxychloroquine sulfate, dapsone topical. unspecified interaction mechanism. Avoid or Use Alternate Drug. Avoid coadministration of dapsone topical with oral dapsone or antimalarial medications because of the potential for hemolytic reactions.dasatinibhydroxychloroquine sulfate and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.degarelixhydroxychloroquine sulfate and degarelix both increase QTc interval. Avoid or Use Alternate Drug.desfluranedesflurane and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.desipraminehydroxychloroquine sulfate and desipramine both increase QTc interval. Avoid or Use Alternate Drug.digoxinhydroxychloroquine sulfate increases levels of digoxin by unknown mechanism. Avoid or Use Alternate Drug.diphtheria & tetanus toxoidshydroxychloroquine sulfate decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.diphtheria & tetanus toxoids/ acellular pertussis vaccinehydroxychloroquine sulfate decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccinehydroxychloroquine sulfate decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.disopyramidehydroxychloroquine sulfate and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.dofetilidehydroxychloroquine sulfate and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.dofetilide increases toxicity of hydroxychloroquine sulfate by QTc interval. Avoid or Use Alternate Drug.dolasetronhydroxychloroquine sulfate and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.donepezildonepezil and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.doxepindoxepin and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.dronedaronehydroxychloroquine sulfate and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.droperidolhydroxychloroquine sulfate and droperidol both increase QTc interval. Avoid or Use Alternate Drug.efavirenzefavirenz and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.eliglustateliglustat and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.encorafenibencorafenib and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug. Encorafenib is associated with dose-dependent QTc interval prolongation. Avoid with drugs known to prolong QT interval.hydroxychloroquine sulfate and encorafenib both increase QTc interval. Avoid or Use Alternate Drug.entrectinibhydroxychloroquine sulfate and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.eribulinhydroxychloroquine sulfate and eribulin both increase QTc interval. Avoid or Use Alternate Drug.erythromycin basehydroxychloroquine sulfate and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinatehydroxychloroquine sulfate and