Anti-Malarials
What Are Some Side Effects of Anti-Malarials?
The side effects of anti-malarials include skin rashes and pigment (skin color) changes. Atabrine specifically can cause yellow pigmentation of the skin.
Other side effects can include:
- hair loss
- dry skin
- loss of appetite
- abdominal bloating
- upset stomach
- stomach cramps
- nausea, vomiting, and diarrhea
These side effects usually go away after the patient adjusts to the medication. If they continue, however, a physician should be consulted. Individuals who take generic hydroxychloroquine might try the brand Plaquenil before switching to a different anti-inflammatory drug.
Some people may experience headaches, muscle aches, and weakness as a result of taking anti-malarials. Nervousness, irritability, or dizziness can occur, but these side effects are uncommon. Major neurological side effects such as confusion and seizures, are quite rare. However, if any of these side effects occur, they should be reported immediately to a physician.
Vision
A major potential side effect of anti-malarial use is the possible damage to the retina at the back of the eye. It is important to note that retinal damage due to the use of anti-malarials is dose-related, and the low doses currently used in the treatment of lupus are rarely associated with this condition. Most cases of eye disease occur in people receiving more than 400 mg of Plaquenil or more than 250 mg of Aralen daily. Atabrine is not known to cause retinal damage.
Recent evidence shows that there is no irreversible eye damage with Plaquenil in doses of 5 mg/kg (2.3 mg/lb) per day. For the average-weight person, this is less than 400 mg per day, if used for less than 10 years.
Retinal damage that is caused by Plaquenil is sometimes reversible if it is detected early. However, damage due to the use of Chloroquine (Aralen) is irreversible.
- It is necessary to see an eye doctor or ophthalmologist prior to beginning treatment with anti-malarials in order to have a baseline examination.
- A follow-up examination every three to six months thereafter is also necessary. Eye exams of the macula to rule out fine pigmentary disturbances should be performed at least every year.
- On many occasions, an ophthalmologist can see mild changes in the retinal pigment that indicate early damage.
- In addition to regular eye check-ups to test visual acuity and eye pressure, tests for color vision and visual field might be necessary.