First-linePlaquenil
Hydroxychloroquine
Antimalarial / DMARD
Safe in pregnancy SLE/APS — continue throughout.
Oral
First-line for
- SLE in pregnancy
- Antiphospholipid syndrome
- Rheumatoid arthritis flare control
Mechanism
Lysosomal pH alteration → ↓ antigen processing & TLR signalling.
HCQ in pregnancy
- Continue — flare risk if stopped
- Protects against neonatal lupus / CHB
Dosing
- Maintenance
- 200–400 mg PO OD (≤5 mg/kg/day)
Contraindications
- AbsolutePre-existing retinopathy
- CautionG6PD deficiency, hepatic disease
Side effects
- Retinopathy (long-term)
- GI upset, rash
Fetal & maternal notes
- • Compatible pregnancy & BF.
- • Reduces congenital heart block in anti-Ro/La.
Key interactions
Digoxin
Caution↑ levels
QT-prolonging
CautionTorsades
Clinical pearls
- 💡 Annual ophthalmology screen.
- 💡 First-line APS + low-dose aspirin ± LMWH.
Content last reviewed: REPLACE_ME (e.g. 2026-07)
Spotted something out of date? See our disclaimer or use Report an Error above.