Hydroxychloroquine Sulfate
Antimalarial drug used as anti-inflammatory and immunomodulating agent on tissue diseases such as arthritis or lupus.
It is excreted in breast milk in clinically non-significant amount which is much lower than the dose used in infants. Problems related to clinical features, development, vision or hearing issues have not been observed in infants whose mothers have received this medication.
When the mother takes 400 mg per day only 1 mg appears for every liter of milk, which is not considered dangerous to the infant, since a preventive dose for malaria in infants is 5 mg per kilo of weight once a week.
American Academy of Pediatrics states that it is usually compatible with breastfeeding medication.
Alternatives
We do not have alternatives for Hydroxychloroquine Sulfate since it is relatively safe.
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Low Risk
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
High Risk
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
Writings
- Υδροξυχλωροκίνη θειϊκή (Greek)
- Гидроксихлорохина Сульфат (Cyrillic)
- 硫酸ヒドロキシクロロキン (Japanese)
- C18H26ClN3O,H2SO4 (Molecular formula)
Drug trade names
References
- Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016Abstract Full text (link to original source) Full text (in our servers)
- Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016Abstract
- Flint J, Panchal S, Hurrell A, van de Venne M, Gayed M, Schreiber K, Arthanari S, Cunningham J, Flanders L, Moore L, Crossley A, Purushotham N, Desai A, Piper M, Nisar M, Khamashta M, Williams D, Gordon C, Giles I; BSR and BHPR Standards, Guidelines and Audit Working Group. BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford). 2016Abstract Full text (link to original source) Full text (in our servers)
- Levy RA, de Jesús GR, de Jesús NR, Klumb EM. Critical review of the current recommendations for the treatment of systemic inflammatory rheumatic diseases during pregnancy and lactation. Autoimmun Rev. 2016Abstract
- Costedoat-Chalumeau N, Dunogué B, Morel N, Le Guern V, Guettrot-Imbert G. Hydroxychloroquine: a multifaceted treatment in lupus. Presse Med. 2014Abstract
- Sammaritano LR, Bermas BL. Rheumatoid arthritis medications and lactation. Curr Opin Rheumatol. 2014Abstract
- Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
- Jain V, Gordon C. Managing pregnancy in inflammatory rheumatological diseases. Arthritis Res Ther. 2011Abstract
- Zrour-Hassen S, Jguirim M, Aouam K, Korbaa W, Younes M, Bejia I, Touzi M, Bergaoui N. [Safety of rheumatic disease drugs at childbearing age]. Therapie. 2010Abstract
- Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010Abstract Full text (link to original source) Full text (in our servers)
- Weber JC, Kuhnert C. Traitements de fond des affections inflammatoires systémiques au cours de l’allaitement. [Breastfeeding and drug management in connective tissue and rheumatic diseases]. Rev Med Interne. 2008Abstract
- Østensen M, Motta M. Therapy insight: the use of antirheumatic drugs during nursing. Nat Clin Pract Rheumatol. 2007Abstract
- Østensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H, Doria A, Rai R, Meroni P, Cetin I, Derksen R, Branch W, Motta M, Gordon C, Ruiz-Irastorza G, Spinillo A, Friedman D, Cimaz R, Czeizel A, Piette JC, Cervera R, Levy RA, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006Abstract Full text (link to original source) Full text (in our servers)
- Costedoat-Chalumeau N, Amoura Z, Huong DL, Lechat P, Piette JC. Safety of hydroxychloroquine in pregnant patients with connective tissue diseases. Review of the literature. Autoimmun Rev. 2005Abstract
- Costedoat-Chalumeau N, Amoura Z, Le Thi Huong D, Wechsler B, Piette JC. [Pleading to maintain hydroxychloroquine throughout Lupus pregnancies]. Rev Med Interne. 2005Abstract
- Motta M, Tincani A, Faden D, Zinzini E, Lojacono A, Marchesi A, Frassi M, Biasini C, Zatti S, Chirico G. Follow-up of infants exposed to hydroxychloroquine given to mothers during pregnancy and lactation. J Perinatol. 2005Abstract Full text (link to original source) Full text (in our servers)
- Temprano KK, Bandlamudi R, Moore TL. Antirheumatic drugs in pregnancy and lactation. Semin Arthritis Rheum. 2005Abstract
- Cimaz R, Brucato A, Meregalli E, Muscará M, Sergi P. Electroretinograms of children born to mothers treated with hydroxychloroquine during pregnancy and breast-feeding: comment on the article by Costedoat-Chalumeau et al. Arthritis Rheum. 2004Abstract Full text (in our servers)
- Al-Herz A, Schulzer M, Esdaile JM. Survey of antimalarial use in lupus pregnancy and lactation. J Rheumatol. 2002Abstract
- Motta M, Tincani A, Faden D, Zinzini E, Chirico G. Antimalarial agents in pregnancy. Lancet. 2002Abstract Full text (link to original source) Full text (in our servers)
- Tincani A, Faden D, Lojacono A et al. Hydroxychloroquine in pregnant patients with rheumatic disease. Arthritis Rheum. 2001;44 (Suppl 9):S397. Abstract 2065. 2001 Full text (in our servers)
- AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
- Canadian rheumatology association. Canadian Consensus Conference on hydroxychloroquine. J Rheumatol. 2000Abstract
- Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000Abstract Full text (link to original source) Full text (in our servers)
- Byron MA. Treatment of rheumatic diseases. Br Med J (Clin Res Ed). 1987Abstract Full text (link to original source) Full text (in our servers)
- Ostensen M, Brown ND, Chiang PK, Aarbakke J. Hydroxychloroquine in human breast milk. Eur J Clin Pharmacol. 1985Abstract
- Nation RL, Hackett LP, Dusci LJ, Ilett KF. Excretion of hydroxychloroquine in human milk. Br J Clin Pharmacol. 1984Abstract Full text (link to original source) Full text (in our servers)