Hydroxychloroquine-Associated Electrolyte Disturbances and Adverse Effects

Electrolyte Disturbances

The American Heart Association and American College of Cardiology identify hypokalemia as a modifiable risk factor when using hydroxychloroquine, particularly because it increases the risk of QT prolongation and cardiac arrhythmias 1, 2
The American Society of Clinical Oncology recommends monitoring serum potassium levels in patients taking hydroxychloroquine, especially when combined with other medications that affect electrolyte balance (corticosteroids, diuretics, chemotherapeutic agents) 2

The American College of Rheumatology notes that hydroxychloroquine can cause ocular toxicity, including irreversible retinopathy, which requires ophthalmologic screening after 5 years, and yearly thereafter 4
The American Heart Association identifies cardiac effects of hydroxychloroquine, including QT interval prolongation and cardiomyopathy (rare) 1
The American Academy of Dermatology reports that hydroxychloroquine can cause dermatologic effects, including skin rash and increased pigmentation 3
The American College of Rheumatology notes that hydroxychloroquine can cause musculoskeletal effects, including muscle weakness and toxic myopathy 4
The American Society of Hematology reports that hydroxychloroquine can cause hematologic effects, including anemia, when combined with other immunosuppressants 4

The American Heart Association lists diuretics (thiazides, loop diuretics) as common causes of hyponatremia 6
The American Psychiatric Association notes that antidepressants (SSRIs, tricyclics) can cause hyponatremia 1
The American Academy of Neurology reports that antiepileptics can cause hyponatremia 1
The American Heart Association lists certain antihypertensives as common causes of hyponatremia 6
The Infectious Diseases Society of America notes that antibiotics can cause hyponatremia 3