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Hydroxychloroquine is a medication that has been in use since the 1940s and is classified as an antimalarial drug. It is primarily used for the treatment of malaria caused by Plasmodium species, but it also has applications in the treatment of autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. The drug works by interfering with the ability of the malaria parasite to process hemoglobin and by modulating the immune system's response in autoimmune conditions.
Hydroxychloroquine accumulates in the lysosomes of the malaria parasite, raising the pH of the vacuole. This activity interferes with the parasite's ability to proteolyze hemoglobin, which is essential for the parasite's normal growth and replication. In autoimmune diseases, hydroxychloroquine is believed to affect the function of lysosomes in human cells, altering the pH and reducing the presentation of self-antigens, which may help in suppressing the autoimmune response.
The dosage of hydroxychloroquine varies depending on the condition being treated. For malaria prophylaxis, it is typically taken once per week, while for autoimmune diseases, it is usually taken once or twice a day.
Common side effects may include nausea, vomiting, diarrhea, stomach pain, and headache. More serious side effects can involve the eyes, potentially leading to retinopathy and vision problems, and the heart, with the risk of QT interval prolongation and cardiac arrhythmias.
Hydroxychloroquine can cause serious side effects, particularly related to the eyes and the heart. Regular eye exams are recommended for long-term use, and patients should be monitored for signs of heart problems, especially if they have a history of heart disease or are taking other medications that can affect heart rhythm.