Are also useful for treatment of systemic symptoms such as fever and fatigue. May combine with a low-dose steroid to minimize side effects of both. Watch for adverse renal effects especially in those who already have lupus nephritis. Hydroxychloroquine is the most commonly used. Effective for cutaneous, musculoskeletal, and mild systemic symptoms.
Mechanism of action is unknown.
Begin 400 mg PO daily for 4 weeks and then taper to maintenance dose. Relapse is frequent with discontinuation of drug, but control can be maintained at a low dose. Having patient view an Ansler grid every day may give an early indication of eye disease. Topical preparations are effective for cutaneous manifestations. Low-dose oral prednisone can be used for minor disease activity.