Antimalarials

During World War II, doctors discovered that the drugs used to fight malaria also helped improve the symptoms of lupus. Antimalarials specifically help with the joint pain, skin rashes, fatigue, fever, and chest pain common to lupus, and may reduce flares by up to 50 percent.¹

By stopping or reducing flares, long-term use of antimalarial drugs helps slow or prevent lupus from damaging organs such as the kidneys and central nervous system.^1-4

Antimalarials are also prescribed for rheumatoid arthritis and Sjogren’s syndrome, two other autoimmune diseases that people with lupus sometimes have.¹

Examples

The antimalarials most often prescribed to people with lupus are:^1-4

• Hydroxychloroquine (Plaquenil^®)
• Chloroquine

Hydroxychloroquine is prescribed the most often because it is thought to have the fewest side effects. Chloroquine is prescribed when hydroxychloroquine cannot be used.^1-4

How do antimalarials work for lupus?

Antimalarials help control lupus symptoms, especially:^1-4

• Skin rashes
• Mouth
• Joint pain
• Inflammation
• Sun sensitivity

The exact way antimalarials work to treat lupus symptoms is not known. But researchers think that their anti-inflammatory and immunomodulatory effects may reduce cytokine production. Cytokines are proteins that help control and signal the immune system.^1-4

Hydroxychloroquine may also help lower blood glucose and cholesterol in some people with lupus. It may also help prevent blood clots in people with antiphospholipid syndrome.^2,3

Antimalarials are prescribed along with steroids and other medications, often to reduce the number of steroids required to control your flares. These drugs may take 1 to 3 months to make a noticeable difference in your lupus symptoms. You may need to take extra steroids to improve your symptoms until the antimalarials begin to work.^1-4

When lupus becomes more severe, antimalarials may not be enough to prevent complications in the kidneys, nervous system, or cardiovascular system. In these cases, immunosuppressants may be added to reduce the chances of lupus permanently damaging these organs.^1-4

Studies show that people with lupus who take antimalarials live longer than those who do not which is why many with lupus take one of these drugs for the rest of their life.¹

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. The most common side effects of antimalarials include:^3,4

• Nausea
• Vomiting
• Diarrhea
• Stomach pain

These are not all the possible side effects of antimalarials. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with antimalarials.

Other things to know

Antimalarial drugs should be taken with food to prevent stomach upset.¹

Do not smoke while taking an antimalarial drug. Smoking reduces the effectiveness of antimalarials.¹

Do not suddenly stop taking antimalarial drugs. This may cause a lupus flare.¹

Before beginning treatment for lupus, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.