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Hydroxychloroquine Sulfate side effects: what 90,536 FDA adverse event reports show

Hydroxychloroquine Sulfate · 1,262 reaction terms · 887,624 drug–reaction co-reports · data 2026-09-14
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Drug class

Antimalarial and antirheumatic

FDA label, Indications wording

Who reports

90,536 reports · 75% serious · 6,265 with death outcome · 86% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Hydroxychloroquine sulfate is an antimalarial and antirheumatic indicated for the: Treatment of uncomplicated malaria due to Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax in adult and pediatric patients. ( 1.1 ) Prophylaxis of malaria in geographic areas where chloroquine resistance is not reported in adult and pediatric patients.

FDA label, Indications and Usage

What it is

Hydroxychloroquine is an aminoquinoline that is chloroquine in which one of the N-ethyl groups is hydroxylated at position 2. An antimalarial with properties similar to chloroquine that acts against erythrocytic forms of malarial parasites, it is mainly used as the sulfate salt for the treatment of lupus...

PubChem CID 3652 (ChEBI)

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 3Likely indication confounding 1Reporting / coding artifact 3Lab value / disease marker 10Not in label — unassessed 23
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,222 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Synovial fluid analysis67802.1
481.9–1,334.9ROR 802.7 · calibrated p 1e-14 ✓
169.5 EB05 138.1 · IC025 +5.9
3/3 methods agree
Reporting / coding artifactserious n=67 · 100% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody positive4,768482.7
459.2–507.3ROR 509.4 · calibrated p 5e-14 ✓
155.2 EB05 151.5 · IC025 +7.2
3/3 methods agree
Lab value / disease markerserious PRR 118.8 · 93% cliniciannot reported in cached trials
Red blood cell sedimentation rate181424.4
331.7–543.1ROR 425.3 · calibrated p 6e-13 ✓
146.5 EB05 129.4 · IC025 +6.5
3/3 methods agree
Lab value / disease markerserious n=181 · 100% cliniciannot reported in cached trials
Rheumatoid factor positive3,584386.2
366.1–407.3ROR 402.0 · calibrated p 5e-13 ✓
143.7 EB05 139.8 · IC025 +7.1
3/3 methods agree
Lab value / disease markerserious n=3,580 · 91% cliniciannot reported in cached trials
Rheumatoid factor negative109375.7
276.7–509.9ROR 376.1 · calibrated p 3e-12 ✓
138.9 EB05 118.3 · IC025 +6.1
3/3 methods agree
Reporting / coding artifactserious n=109 · ♀ 0% (drug 86%) · 100% cliniciannot reported in cached trials
Pemphigus7,446351.1
338.8–363.8ROR 382.4 · calibrated p 9e-13 ✓
138.6 EB05 136.0 · IC025 +7.1
3/3 methods agree
Not in label — unassessedserious PRR 106.1not reported in cached trials
Swollen joint count increased1,793317.1
295.3–340.6ROR 323.5 · calibrated p 5e-12 ✓
132.9 EB05 127.8 · IC025 +6.9
3/3 methods agree
Lab value / disease markerserious n=1,792 · 94% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody376302.2
259.0–352.6ROR 303.5 · calibrated p 1e-11 ✓
129.5 EB05 118.9 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=375 · 93% cliniciannot reported in cached trials
Rheumatic fever2,381280.5
264.2–297.7ROR 288.0 · calibrated p 1e-11 ✓
126.0 EB05 121.8 · IC025 +6.9
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=2,379 · 94% cliniciannot reported in cached trials
Duodenal ulcer perforation3,870260.7
249.1–272.9ROR 272.3 · calibrated p 2e-11 ✓
121.9 EB05 118.8 · IC025 +6.9
3/3 methods agree
Not in label — unassessedserious PRR 93.0 · 94% cliniciannot reported in cached trials
Lupus vulgaris626259.4
231.3–290.8ROR 261.2 · calibrated p 4e-11 ✓
121.3 EB05 113.5 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious n=626 · 94% cliniciannot reported in cached trials
Human antichimeric antibody positive177254.8
205.6–315.7ROR 255.3 · calibrated p 7e-11 ✓
119.2 EB05 105.2 · IC025 +6.2
3/3 methods agree
Lab value / disease markerserious n=177not reported in cached trials
C-reactive protein473254.3
223.1–289.9ROR 255.7 · calibrated p 5e-11 ✓
120.0 EB05 111.2 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=473 · 95% cliniciannot reported in cached trials
Deep vein thrombosis postoperative1,022254.3
232.7–278.0ROR 257.2 · calibrated p 4e-11 ✓
120.3 EB05 114.3 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious n=1,022 · 93% cliniciannot reported in cached trials
Hepatic enzyme72248.1
177.7–346.5ROR 248.3 · calibrated p 2e-10 ✓
115.6 EB05 94.9 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious n=72 · 100% cliniciannot reported in cached trials
Red blood cell sedimentation rate abnormal1,197247.5
228.1–268.6ROR 250.8 · calibrated p 5e-11 ✓
118.8 EB05 113.3 · IC025 +6.7
3/3 methods agree
Lab value / disease markerserious n=1,196not reported in cached trials
Hand deformity6,673243.2
235.1–251.6ROR 262.5 · calibrated p 3e-11 ✓
118.0 EB05 115.7 · IC025 +6.8
3/3 methods agree
Not in label — unassessedserious PRR 97.7not reported in cached trials
Musculoskeletal deformity120241.5
186.8–312.3ROR 241.9 · calibrated p 1e-10 ✓
115.5 EB05 99.2 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=120 · 100% cliniciannot reported in cached trials
Swollen joint count119218.3
169.8–280.7ROR 218.6 · calibrated p 3e-10 ✓
109.9 EB05 94.3 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=119 · 100% cliniciannot reported in cached trials
Grip strength111214.0
165.1–277.2ROR 214.2 · calibrated p 4e-10 ✓
108.7 EB05 92.8 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=111 · 100% cliniciannot reported in cached trials
Synovitis8,328199.7
194.1–205.5ROR 219.9 · calibrated p 2e-10 ✓
106.8 EB05 104.9 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious PRR 85.0not reported in cached trials
C-reactive protein abnormal2,946198.4
188.9–208.3ROR 205.0 · calibrated p 3e-10 ✓
106.4 EB05 103.2 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=2,945not reported in cached trials
Granuloma skin364182.4
158.9–209.3ROR 183.1 · calibrated p 1e-9 ✓
101.1 EB05 92.7 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=364not reported in cached trials
X-ray abnormal722157.9
143.6–173.6ROR 159.2 · calibrated p 3e-9 ✓
93.4 EB05 87.8 · IC025 +6.3
3/3 methods agree
Lab value / disease markerserious n=722 · 92% cliniciannot reported in cached trials
Facet joint syndrome1,242151.1
140.7–162.3ROR 153.2 · calibrated p 4e-9 ✓
91.1 EB05 86.9 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious n=1,242 · 95% cliniciannot reported in cached trials
Adjustment disorder with depressed mood787148.8
136.0–162.8ROR 150.1 · calibrated p 5e-9 ✓
90.2 EB05 85.0 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=787 · 96% cliniciannot reported in cached trials
Helicobacter infection3,923145.4
139.7–151.2ROR 151.9 · calibrated p 4e-9 ✓
89.0 EB05 86.7 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious PRR 71.7 · 93% cliniciannot reported in cached trials
Dislocation of vertebra854144.7
132.9–157.7ROR 146.1 · calibrated p 6e-9 ✓
88.7 EB05 83.8 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=854 · 94% cliniciannot reported in cached trials
Anticipatory anxiety102140.6
109.9–180.0ROR 140.8 · calibrated p 1e-8 ✓
85.9 EB05 72.8 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious n=102not reported in cached trials
Folliculitis3,344111.0
106.6–115.7ROR 115.2 · calibrated p 4e-8 ✓
74.9 EB05 72.8 · IC025 +6.2
3/3 methods agree
Not in label — unassessedserious PRR 67.1 · 94% cliniciannot reported in cached trials
Joint laxity98110.9
87.1–141.2ROR 111.0 · calibrated p 8e-8 ✓
73.8 EB05 62.4 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=97 · 100% cliniciannot reported in cached trials
Retinitis537109.9
99.2–121.8ROR 110.6 · calibrated p 6e-8 ✓
74.3 EB05 69.1 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=537 · 93% cliniciannot reported in cached trials
Contraindicated product administered9,646109.0
106.5–111.6ROR 121.9 · calibrated p 2e-8 ✓
74.0 EB05 72.8 · IC025 +6.2
3/3 methods agree
Reporting / coding artifactage-adj. PRR 90.2 · serious PRR 70.2not reported in cached trials
Bone erosion1,129108.4
101.1–116.4ROR 109.8 · calibrated p 6e-8 ✓
73.7 EB05 70.1 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious n=1,126not reported in cached trials
Presbyacusis98106.7
83.9–135.6ROR 106.8 · calibrated p 1e-7 ✓
71.9 EB05 60.8 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=98 · 100% cliniciannot reported in cached trials
Subcutaneous drug absorption impaired170105.1
87.6–126.0ROR 105.3 · calibrated p 1e-7 ✓
71.6 EB05 63.0 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious n=170 · 100% cliniciannot reported in cached trials
Pericarditis5,077101.6
98.3–104.9ROR 107.5 · calibrated p 6e-8 ✓
70.5 EB05 68.9 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious PRR 54.2 · 93% cliniciannot reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Interstitial lung disease3,1897.97.7–8.2signal
Liver injury9,9977.97.8–8.1signal
Opportunistic infection2,2063.83.6–4.0signal
Serious infection12,1613.73.6–3.8signal
Tendon disorder5613.43.2–3.7signal
Hyperglycaemia / diabetes4,0012.72.6–2.8signal
Depression2,6412.22.1–2.3signal
Fall / fracture3,3782.12.0–2.1raised
Anaphylaxis / angioedema1,0792.01.9–2.1raised
Pancreatitis5511.61.5–1.7raised
Rhabdomyolysis / myopathy4981.41.3–1.6raised
Venous thromboembolism1,2921.41.3–1.5raised
Anaemia1,7791.41.3–1.4raised
Malignancy2,1971.41.3–1.4raised
Arrhythmia / qt1,0781.31.2–1.4raised
Severe cutaneous reaction3791.21.1–1.3raised

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Hydroxychloroquine as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (0 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)29,2395.2
5.2–5.3ROR 7.3 · calibrated p 0.089
5.1 EB05 5.1 · IC025 +2.3
3/3 methods agree
Reporting / coding artifactage-adj. PRR 5.8 · serious PRR 10.0not reported in cached trials
Rheumatoid arthritis20,47651.1
50.4–51.8ROR 65.8 · calibrated p 2e-6 ✓
41.9 EB05 41.4 · IC025 +5.4
3/3 methods agree
Likely indication confounding
term in indications
age-adj. PRR 40.7 · serious PRR 37.9not reported in cached trials
Pain16,7086.4
6.3–6.5ROR 7.7 · calibrated p 0.076
6.3 EB05 6.2 · IC025 +2.6
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 5.9 · serious PRR 7.0not reported in cached trials
Fatigue (tiredness)14,2204.3
4.2–4.4ROR 4.9 · calibrated p 0.244
4.2 EB05 4.2 · IC025 +2.1
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.7 · serious PRR 5.6not reported in cached trials
Arthralgia (joint pain)13,9328.0
7.9–8.1ROR 9.3 · calibrated p 0.041 ✓
7.8 EB05 7.7 · IC025 +2.9
3/3 methods agree
Not in label — unassessedage-adj. PRR 7.1 · serious PRR 9.9not reported in cached trials
Drug intolerance12,43434.3
33.7–34.9ROR 39.6 · calibrated p 6e-5 ✓
29.9 EB05 29.5 · IC025 +4.9
3/3 methods agree
Reporting / coding artifactage-adj. PRR 36.8 · serious PRR 36.5not reported in cached trials
Joint swelling12,34026.3
25.9–26.8ROR 30.3 · calibrated p 2e-4 ✓
23.7 EB05 23.4 · IC025 +4.5
3/3 methods agree
Not in label — unassessedage-adj. PRR 22.2 · serious PRR 30.1not reported in cached trials
Off label use (used outside approved label)11,3713.1
3.0–3.1ROR 3.4 · calibrated p 0.521
3.0 EB05 3.0 · IC025 +1.6
3/3 methods agree
Reporting / coding artifactage-adj. PRR 3.0 · serious PRR 4.1not reported in cached trials
Rash10,7715.9
5.8–6.0ROR 6.5 · calibrated p 0.120
5.7 EB05 5.7 · IC025 +2.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 5.4 · serious PRR 9.1not reported in cached trials
Abdominal discomfort9,74614.3
14.0–14.6ROR 15.9 · calibrated p 0.005 ✓
13.5 EB05 13.3 · IC025 +3.7
3/3 methods agree
Not in label — unassessedage-adj. PRR 11.5 · serious PRR 22.3not reported in cached trials
Contraindicated product administered9,646109.0
106.5–111.6ROR 121.9 · calibrated p 2e-8 ✓
74.0 EB05 72.8 · IC025 +6.2
3/3 methods agree
Reporting / coding artifactage-adj. PRR 90.2 · serious PRR 70.2not reported in cached trials
Alopecia (hair loss)9,60211.8
11.6–12.1ROR 13.1 · calibrated p 0.012 ✓
11.3 EB05 11.1 · IC025 +3.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 8.8 · serious PRR 17.6not reported in cached trials
Nausea9,4802.8
2.8–2.9ROR 3.0 · calibrated p 0.621
2.8 EB05 2.7 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.5 · serious PRR 3.6not reported in cached trials
Systemic lupus erythematosus8,92878.2
76.4–80.0ROR 86.6 · calibrated p 3e-7 ✓
58.4 EB05 57.4 · IC025 +5.8
3/3 methods agree
Likely indication confounding
term in indications
age-adj. PRR 61.1 · serious PRR 45.5not reported in cached trials
Arthropathy8,89243.8
42.9–44.8ROR 48.5 · calibrated p 2e-5 ✓
36.9 EB05 36.3 · IC025 +5.2
3/3 methods agree
Not in label — unassessedage-adj. PRR 38.8 · serious PRR 34.0not reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Hydroxychloroquine ↔ Retinopathy.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Hydroxychloroquine?

In FDA FAERS, the most frequently co-reported reaction terms for Hydroxychloroquine are rheumatoid arthritis, pain, fatigue, arthralgia, joint swelling, rash. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Hydroxychloroquine have an FDA boxed warning?

No. The FDA label retrieved for Hydroxychloroquine has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Hydroxychloroquine causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.