Systemic Lupus Erythematosus - Treatment for Severe SLE

(Page 2)

Antimalarial Drugs

A doctor may prescribe antimalarial drugs for mild SLE when skin problems and joint pains are the predominant symptoms:

• Hydroxychloroquine (Plaquenil, generic) is the most common antimalarial drug used for lupus. This drug is effective as maintenance therapy to reduce flares in patients with mild or inactive disease. Hydroxychloroquine may help protect against blood clots in people with antiphospholipid syndrome, high cholesterol levels, and bone loss.
• Other antimalarial drugs include chloroquine (Aralen, generic) or quinacrine (Atabrine, generic).

Treatment may start initially with high doses in order to accumulate high levels of the drug in the bloodstream. It is not known exactly why antimalarials work. Some researchers believe they inhibit the immune response, and others think they interfere specifically with inflammation.

---

---

Side Effects. Side effects of antimalarials may include:

• Skin rash
• Change in skin color (yellow in the case of quinacrine)
• Gastrointestinal problems
• Headache
• Hair loss
• Muscle aches
• Eye damage

The most serious side effect is damage to the retina, although this is very uncommon at low doses. Eye damage after taking hydroxychloroquine is reversible when caught in time and treated, but it is not reversible if the damage develops after taking chloroquine. An eye exam is advisable about every 6 months.

Antimalarials may also be used in combination with other anti-SLE drugs, including immunosuppressants and corticosteroids. It should be noted that smoking significantly reduces the effectiveness of antimalarial drugs.

Review Date: 02/18/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).