Main indication in lupus

- Any lupus patient (cutaneous-articular and / or visceral lupus) should be put, in principle, on synthetic antimalarials (hydroxychloroquine or chloroquine) unless contraindicated.

- Chloroquine is usually given as a second line of treatment, in case of failure or intolerance to  hydroxychloroquine. These drugs belong to the group of synthetic antimalarials.

- Synthetic antimalarials are particularly effective on the different forms of cutaneous lupus, and they also reduce the risk of visceral involvement (renal damage in particular) and the risk of sequelae related to the disease.

Dosage

- 100 mg tablets

- Maximum dose: up to 3.5-4.5 mg/kg/day of ideal weight in one to two doses after the meal(s)

Main side effects

- Retinopathy (damage to the retina)

- Digestive (nausea, pain, vomiting)

- Agranulocytosis (significant decrease in white blood cells)

- Neuromuscular, with rare myocardial involvement

- Severe itching of the skin (pruritus) and rash

- Coloration of the skin and mucous membranes

- Hepatitis (rare)

- Mental disorders

In case of pregnancy

No contraindication to continued treatment. It has been shown that the risk of relapse of the disease is lower in women who maintain synthetic antimalarials and that antimalarials are not dangerous for the baby. They protect them particularly if the future mother has anti-SSA antibodies.

There are no relevant data assessing safety in breastfed children during long-term treatment with chloroquine.

Contraindications

- Retinopathy (damage to the retina)

- Hypersensitivity to the product

Precautions for use (situations where the drug can be used but with close monitoring)

- Psoriasis

- Hepatic and/or renal insufficiency

- Porphyria

- G6PD enzyme deficiency of congenital origin exposing a risk of accelerated destruction of red blood cells

Monitoring

- Regular blood count and liver test during the first 6 months

- Ophthalmological examination with a possible electroretinogram/SD OCT depending on the opinion of the ophthalmologist within the first year of use. Annual screening begins after 5 years of use but sooner if presence of major risk factors.

- Clinical monitoring