How It Works
Antimalarial medicines (normally used
to prevent and treat malaria) are sometimes used in an attempt to reduce
inflammation associated with
juvenile idiopathic arthritis (JIA).
Why It Is Used
Antimalarial medicines may be used
along with nonsteroidal anti-inflammatory drugs (NSAIDs) for
arthritis that has not responded to NSAIDs alone. This combination is more
commonly used to treat progressive
polyarticular arthritis but can be used for any form
How Well It Works
Although some people get better
with antimalarials, a large study of the effects of antimalarial treatment for
JIA showed them to be no better than a placebo.1 It
may take up to 16 weeks to see an effect from hydroxychloroquine. The medicine
is usually discontinued if no improvement is seen after 16 weeks.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine your child takes. Side effects are also listed in the information that comes with the medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after your child takes the medicine for a while.
- If side effects still bother your child and you wonder if he or she should keep taking the medicine, call your doctor. He or she may be able to lower the dose or change the medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call911or other emergency services right away if your child has:
- Trouble breathing.
- Swelling of his or her face, lips, tongue, or throat.
Call your doctor right away if your child has:
- Any blurred vision, problems seeing to read, or changes in vision. Your doctor may have you check your child's vision at least once a month using an Amsler grid . This is a chart with lines and a dot at the center. The chart lets you monitor
changes in vision. If you or your child notices any changes in vision or changes
in his or her view of the
Amsler grid, call your doctor.
Common side effects of this medicine include:
- Nausea or
- Stomach cramps.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Some antimalarial medicines, such as hydroxychloroquine, can cause serious and permanent damage to
the retina of the eye. When appropriate doses are given, this is rare.
If it is found early, eye damage may be reversed and permanent damage may be prevented. So your child
will need to have an initial ophthalmic examination before beginning
antimalarial therapy and examinations if and when you or your
child notices a change in vision. Your doctor may recommend visits to the
ophthalmologist as often as every 3 to 12 months, depending on your child's vision and your doctor's level of
concern about eye disease from JIA.
Medicine is one of the many tools your doctor has to treat a health problem. If your child takes medicine as your doctor suggests, it will improve your child's health and may prevent future problems. If your child doesn't take the medicines properly, his or her health (and perhaps life) may be at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Nistala K, et al. (2009). Juvenile idiopathic arthritis. In
GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1657–1675. Philadelphia: Saunders
Primary Medical ReviewerSusan C. Kim, MD - Pediatrics
Specialist Medical ReviewerJohn Pope, MD - Pediatrics
Current as ofSeptember 9, 2014