Antimalarial drugs for rheumatoid arthritis

Examples

Generic Name	Brand Name
chloroquine phosphate	Aralen
hydroxychloroquine sulfate	Plaquenil, Quineprox

Antimalarial medications are taken orally in pill form.

How It Works

Antimalarial medications have been found to reduce pain and inflammation in some people who have rheumatoid arthritis. They are normally used in the prevention and treatment of malaria.

Why It Is Used

Antimalarials are used either alone or in combination with other disease-modifying antirheumatic drugs (DMARDs). They are used alone in milder cases or in combination for more severe rheumatoid arthritis.

How Well It Works

A review of studies of rheumatoid arthritis medications found antimalarials are effective in reducing swelling and pain in joints.¹

Side Effects

Most people experience no major side effects from antimalarial drugs. The most serious side effect, which is rare, is damage to the eye that may cause irreversible vision damage. Infrequent side effects include:

• Dizziness.
• Rash and itching.
• Nausea.
• Vomiting.
• Diarrhea.
• Abdominal cramps.

A very rare side effect is damage to the retina of the eye. Before taking an antimalarial, you will have an eye exam by an ophthalmologist. Eye damage can be caught early by self-testing your vision every month or by seeing an ophthalmologist every year. If you have any change in vision, contact your ophthalmologist or rheumatologist immediately.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Talk to your health professional before taking antimalarial medication if you are breast-feeding, pregnant, or thinking about becoming pregnant.

Antimalarials usually take from 3 to 6 months to work. They are safer than other DMARDs but also may be less effective if used alone or for more serious cases of rheumatoid arthritis.

This treatment is generally well-tolerated and requires no routine lab monitoring, although an initial eye exam is required. If you are also taking hydroxychloroquine (Plaquenil), you may be taught to perform monthly testing of your vision or you may be scheduled to return every 6 to 12 months to the ophthalmologist. If you are taking chloroquine (Aralen), you should be scheduled for exams every 6 to 12 months. If you notice a change in your vision at any time while taking an antimalarial, contact your health professional.

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Author:	Robin Parks, MS	Last Updated: August 23, 2006
Medical Review:	Kathleen Romito, MD - Family Medicine Stanford M. Shoor, MD - Rheumatology
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