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Contraindications to use
retinopathy; children’s age – if long-term therapy is necessary (children have an increased risk of toxic effects);children under 6 years of age (200 mg tablets are not intended for children with an ideal body weight of less than 31 kg); pregnancy; hereditary lactose intolerance, lactase deficiency, galactosemia or glucose/ galactose malabsorption syndrome (due to the presence of lactose in the drug); hypersensitivity to 4-aminoquinoline derivatives.
With caution, the drug should be used for visual disorders (decreased visual acuity, impaired color vision, narrowing of the visual fields), simultaneous administration of drugs that can cause adverse ophthalmological reactions (danger of progression of retinopathy and visual disorders); with hematological diseases (including in the anamnesis); with severe neurological diseases, psychoses (including in the anamnesis); with late cutaneous porphyria (risk of exacerbation), psoriasis (risk of increased skin manifestations of the disease), simultaneous administration of drugs that can cause skin reactions; with renal insufficiency and / or liver failure, hepatitis, simultaneous administration of drugs that can adversely affect liver and / or kidney function (with severe renal or liver dysfunction, the dose should be selected under the control of the concentration of hydroxychloroquine in plasma); with glucose-6-phosphate dehydrogenase deficiency; with severe gastrointestinal intestinal diseases; with hypersensitivity to quinine (the possibility of cross-allergic reactions).
Use during pregnancy and lactation
Data on the use of the drug during pregnancy are limited. Hydroxychloroquine penetrates through the placental barrier. It should be noted that 4-aminoquinolines in therapeutic doses can cause intrauterine damage to the central nervous system, including the auditory nerve (hearing and vestibular disorders, congenital deafness), retinal hemorrhages and abnormal retinal pigmentation. Therefore, the use of hydroxychloroquine during pregnancy should be avoided, except in cases where the potential benefit of therapy for the mother exceeds the risk to the fetus.
It is necessary to carefully weigh the need for the use of the drug during lactation (breastfeeding), because it has been shown that hydroxychloroquine is excreted in small amounts with breast milk, and it is also known that infants are particularly sensitive to the toxic effects of 4-aminoquinolines.