Hydroxychloroquine drug monitoring during COVID-19

The following advice is for the management of patients taking DMARDs for rheumatology related conditions. 

General guidance on management of rheumatology patients during COVID-19 is available from the British Society for Rheumatology.

This page gives advice on drug monitoring in primary care during COVID-19 for hydroxychloroquine in stable patients (stable patients defined as those who have been on current treatment for >12 months and at a stable dose for >6 weeks)

Advice on other medicines is here

For hydroxychloroquine, usual monitoring recommendations are:

  • annual eye assessment (ideally including optical coherence tomography) if continued for ≥5 years (see RCO advice)
  • No routine laboratory monitoring is required for hydroxychloroquine

During the COVID-19 pandemic, recommendations are:

  • Consider suspending annual eye assessment with ophthalmologist advice

For patients with symptoms of COVID-19, recommendations are:

  • NICE and the BSR recommend to continue hydroxychloroquine in patients known or suspected to have COVID‑19
  • refer patients to advice from Versus Arthritis for patient facing advice and guidance

This page was developed in conjunction with Kalveer Flora, Chair, Rheumatology Pharmacists UK (RPUK); Lead Pharmacist, Specialised Rheumatology CRG for NHS England.  We are hugely grateful for her input.

This advice has been developed quickly in response to the COVID-19 pandemic; if you spot anything that’s wrong report a concern to us.