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Hydroxychloroquine (Plaquenil)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Hydroxychloroquine

What it is

Hydroxychloroquine is an antimalarial that also calms the immune system, by interfering with how immune cells process signals inside their lysosomes. Today it is used mostly for lupus and rheumatoid arthritis, and still for some kinds of malaria. Long-term use needs regular eye checks. It is sold as Plaquenil, among other names.

How genes come into it

The US FDA lists G6PD for hydroxychloroquine, because antimalarials of this family can cause haemolysis, the breakdown of red blood cells, in people with G6PD deficiency, although with hydroxychloroquine this appears rare. It is broken down by CYP2C8, CYP2D6 and CYP3A4. There is no CPIC or DPWG guideline, and the studies on this page, on these enzymes and on immune and folate genes in rheumatoid arthritis, are single findings.

Published guidelines

Clinical guidelines that name a gene for Hydroxychloroquine. They sort people into groups by the gene copies they carry.

US FDA: G6PD. Deficient with CNSHA · Deficient · Variable.

What research found

Every published finding on gene variants and Hydroxychloroquine. Upload your DNA file to see which of these rows apply to you.

Rated evidence (1 rated variant)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

MTR rs1805087: Level 3. Efficacy: Rheumatoid arthritis. 1.

Metabolism (5 findings)

Studies of how quickly the body processes this medication.

CYP2C8 rs10882521: Allele T is associated with decreased concentrations of desethylchloroquine or hydroxychloroquine in people with Lupus Erythematosus, Systemic as compared to allele G.

CYP2C8 rs7910936: Allele C is associated with increased concentrations of desethylchloroquine or hydroxychloroquine in people with Lupus Erythematosus, Systemic as compared to allele T.

CYP2D6 CYP2D6*1, CYP2D6*10: CYP2D6 *1/*10 + *10/*10 is associated with increased concentrations of hydroxychloroquine in people with Cutaneous lupus erythematosus as compared to CYP2D6 *1/*1.

CYP2D6 rs1065852: Genotype AA is associated with decreased concentrations of desethylchloroquine and hydroxychloroquine in people with Lupus Erythematosus, Systemic as compared to genotypes AG + GG.

Response (17 findings)

Studies of how well it worked in people carrying a variant.

C18orf56, TYMS rs45445694: Genotype (CCGCGCCACTTGGCCTGCCTCCGTCCCG)3/(CCGCGCCACTTGGCCTGCCTCCGTCCCG)3 is associated with increased response to folic acid, hydroxychloroquine, methotrexate and sulfasalazine in people with Arthritis, Rheumatoid as compared to genotypes (CCGCGCCACTTGGCCTGCCTCCGTCCCG)2/(CCGCGCCACTTGGCCTGCCTCCGTCCCG)2 + (CCGCGCCACTTGGCCTGCCTCCGTCCCG)2/(CCGCGCCACTTGGCCTGCCTCCGTCCCG)3.

MTR rs1805087: Allele A is associated with increased response to folic acid, hydroxychloroquine, methotrexate and sulfasalazine in people with Arthritis, Rheumatoid as compared to allele G.

SLC19A1 rs1051266: Allele T is associated with increased response to folic acid, hydroxychloroquine, methotrexate and sulfasalazine in people with Arthritis, Rheumatoid as compared to allele C.

ATIC rs2372536: Allele C is not associated with response to folic acid, hydroxychloroquine, methotrexate and sulfasalazine in people with Arthritis, Rheumatoid as compared to allele G.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

Artemether (Antimalarials)

Artesunate (Antimalarials)

Chloroquine (Antimalarials)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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