In October 2024 we published a practical guide that lists nine alternatives to hydroxychloroquine and compares them side by side. If hydroxychloroquine doesn’t work for you, causes side effects, or isn’t appropriate because of other health issues, the post breaks down what else doctors might consider and why.
The article walks through drugs such as Quinacrine, Methotrexate, Chloroquine, Sulfasalazine, Azathioprine, Leflunomide, Mycophenolate, low-dose corticosteroids, and select biologics. For each medicine we explain the common uses (for example, rheumatoid arthritis, lupus, or off-label COVID-19 use), typical effectiveness, typical side effects, and key safety checks your clinician should run.
One practical tool in the post is a compact comparison table that shows quick differences: how fast the drug works, whether blood tests or liver checks are needed, main risks to watch for, and common drug interactions. That table helps you and your clinician match a treatment to your health profile and goals without wading through dense medical papers.
Quinacrine can be an option when retinal risk is a concern, but it has its own side effects like skin discoloration and digestive upset. Methotrexate is a workhorse for many autoimmune conditions, but it needs regular liver and blood monitoring and birth-control counseling for people who can become pregnant. Chloroquine is chemically similar to hydroxychloroquine and may be considered in specific cases, though it carries similar retinal and cardiac considerations. Immunosuppressants like azathioprine and mycophenolate can be powerful when disease activity is high, but they raise infection risk and require close blood-work follow-up. Biologics offer targeted options for many patients but often come with higher cost and infection-screening steps before starting.
The post doesn’t push one single answer. Instead, it shows trade-offs so you can weigh speed of benefit, monitoring burden, cost, and safety. For example, if you need a fast anti-inflammatory effect, a short steroid course may help while a slower agent like methotrexate begins to work. If pregnancy is planned, certain drugs are safer than others and the guide flags those choices.
If you’re reading this because you or someone you care for needs a new option, bring the comparison table to your next visit. Ask your clinician which alternatives match your medical history, what baseline tests they’ll run, and how soon you should expect to see improvement. If side effects start, know which symptoms require urgent care (fever, signs of infection, severe stomach pain, yellowing of skin, new heart palpitations) and which can be reported at follow-up.
Want the full breakdown? Read the full October post for the complete comparison table, a short checklist to bring to appointments, and practical notes on monitoring and interactions. That article is the go-to if you need clear, actionable comparisons rather than vague opinions.
