# Hydroxychloroquine in Nigeria

- Source: https://ogbogwu.com/drugs/hydroxychloroquine/
- Drug class: 4-aminoquinoline antimalarial and immunomodulator (Antimalarials)
- Also known as: HCQ, Hydroxychloroquine sulfate, Plaquenil
- Prescription required: yes
- On the WHO Model List of Essential Medicines
- Last updated: September 2026

## Price in Nigeria

Hydroxychloroquine prices in Nigeria vary by brand, strength, and where you buy it. Confirm the current price with a licensed pharmacy, and always check the product is NAFDAC-registered before you pay.

## What is Hydroxychloroquine?

Hydroxychloroquine is a tablet originally developed as an antimalarial, a close relative of chloroquine, that is now prescribed in Nigeria almost entirely for autoimmune disease. For a person with systemic lupus erythematosus (SLE) it is the one medicine rheumatologists want them to stay on indefinitely: it reduces flares, protects the kidneys and skin, lowers the long-term dose of steroids needed, and improves survival. It is also a standard first-line disease-modifying drug for rheumatoid arthritis. It works by damping the immune signalling that drives these diseases rather than by suppressing the immune system wholesale, which is why it is better tolerated than most alternatives and why it is on the WHO Model List of Essential Medicines.

In Nigeria the drug is sold as 200 mg tablets. In our copy of the NAFDAC register the only hydroxychloroquine product with a registration is HCQS Tablets 200 mg, made by IPCA Laboratories in India and registered through IPCA Pharma Nigeria (04-7590, Active). Plaquenil, the original Sanofi brand many patients read about online, does not appear in our register copy; packs of it and of other Indian generics on Nigerian shelves have come in through unregistered channels, which is not the same as being fake but does mean nobody has vouched for them here. Lupus patients typically buy a month's supply at a time from hospital pharmacies attached to rheumatology clinics or from the larger pharmacy chains.

Nigeria had an unhappy episode with this medicine in 2020, when it was promoted worldwide as a COVID-19 treatment. Demand spiked, prices multiplied, patients with lupus could not find their tablets, and NAFDAC and the Lagos State government issued warnings after cases of poisoning from self-medication. That use was never supported by evidence and is not a reason to take it. The people who need hydroxychloroquine are the people whose doctors have prescribed it for an autoimmune condition, and for them a steady, affordable supply matters more than for almost any other tablet on this site.

## What is Hydroxychloroquine used for?

- Systemic lupus erythematosus (SLE) — taken long term by nearly every lupus patient, including during pregnancy, to reduce flares and organ damage
- Rheumatoid arthritis — as a first-line disease-modifying antirheumatic drug (DMARD), often combined with methotrexate
- Discoid and other forms of cutaneous lupus, and some photosensitive skin diseases
- Sjögren's syndrome and mixed or undifferentiated connective-tissue disease, to ease joint pain and fatigue
- Malaria prevention and treatment in the past — no longer recommended in Nigeria, where the parasite is resistant to the chloroquine family; artemisinin combinations are used instead

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: For lupus and rheumatoid arthritis the usual dose is 200 mg to 400 mg once a day, taken with food or a glass of milk. Since 2016 the standard advice is not to exceed 5 mg per kilogram of actual body weight per day, because eye toxicity rises above that: a 60 kg adult should not take more than 300 mg daily, which in practice usually means 200 mg one day and 400 mg the next, or 200 mg daily. Benefit builds slowly — allow 6 to 12 weeks to judge the effect, and do not stop because nothing seems to have changed in the first month.
- Children: Used in children with lupus and juvenile arthritis under a paediatric rheumatologist, at no more than 5 mg per kilogram of body weight per day. The 200 mg tablet cannot be split accurately enough for small children, so it is generally avoided below about 31 kg body weight unless a pharmacist can prepare a suitable dose.
- Elderly: No routine dose change, but kidney and liver function decline with age and the drug is cleared by both, so lower doses are often chosen and eye checks matter more. Older patients are also more likely to be on other medicines that prolong the heart's QT interval, which hydroxychloroquine can add to.

Take it at the same time each day with food to reduce nausea. Keep every rheumatology appointment: an eye examination at the start of treatment and yearly after five years of use is how the rare but permanent retinal damage is caught early. Do not stop suddenly on your own — lupus flares can follow weeks later. If you miss a dose, take it when you remember unless the next dose is due, then skip it; never double up.

## Side effects

Common: Nausea, stomach upset and loss of appetite, usually in the first weeks and eased by taking the tablet with food; Headache and dizziness; Skin rash or itching, and darkening of the skin or gums with long use; Blurred vision from the drug's effect on focusing, which is different from retinal damage and settles as the eyes adjust; Hair thinning or lightening in some patients.

Serious (seek medical help immediately): Retinal toxicity — irreversible damage to the back of the eye, uncommon but the reason for dose limits and yearly eye screening after five years; Heart rhythm disturbance (QT prolongation) and, rarely, cardiomyopathy with prolonged high doses; Low blood sugar, occasionally severe, especially in diabetics on insulin or glibenclamide; Haemolysis in people with G6PD deficiency, which is common in Nigeria — ask your doctor whether you have been tested; Muscle weakness or nerve damage with years of use; Severe skin reactions and, rarely, bone-marrow suppression.

When to see a doctor: See a doctor promptly if you notice any change in vision — blurred central vision, difficulty reading, light flashes or missing patches — as these need an eye examination, not a wait. Seek urgent care for fainting, palpitations, severe muscle weakness, dark urine or yellowing of the eyes, or signs of low blood sugar such as sweating, shaking and confusion. A new rash with fever or blistering also needs same-day review.

## Warnings

Do not take if: Known allergy to hydroxychloroquine or chloroquine; Existing damage to the retina (maculopathy) from any cause; Use with great care in G6PD deficiency, psoriasis, porphyria, epilepsy, and significant liver or kidney disease; Long QT syndrome or a history of serious heart rhythm problems.

Interactions: Antacids and kaolin reduce absorption — take them at least four hours apart from hydroxychloroquine; Digoxin — hydroxychloroquine can raise digoxin levels; monitoring is needed; Medicines that prolong the QT interval, including amiodarone, azithromycin, ciprofloxacin, some antipsychotics and antidepressants — the combination raises the risk of dangerous rhythms; Insulin, glibenclamide, metformin and other diabetes medicines — hydroxychloroquine lowers blood sugar, so doses may need adjusting; Tamoxifen — combined use increases the risk of eye toxicity; Ciclosporin and methotrexate — levels or toxicity may rise; these combinations are common in rheumatology but need monitoring; Rabies vaccine given into the skin may be less effective while on hydroxychloroquine; Antiepileptic drugs — seizure control may be reduced.

Pregnancy & breastfeeding: Hydroxychloroquine is one of the few lupus medicines that should usually be continued through pregnancy: stopping it raises the risk of flares and of complications for both mother and baby, and long experience has not shown harm to the unborn child at the doses used for autoimmune disease. It passes into breast milk in small amounts and is considered compatible with breastfeeding. Any decision to start, continue or stop should be made with the rheumatologist and obstetrician together, not alone.

## Brands in Nigeria

Well-known NAFDAC-registered brands: HCQS (IPCA Laboratories, made in India).
Full searchable brand list: https://ogbogwu.com/drugs/hydroxychloroquine/brands/

## How to verify it is genuine

1. Check the NAFDAC number on the pack — HCQS Tablets 200 mg carries 04-7590 in our copy of the register, held by IPCA Pharma Nigeria, and it is the only hydroxychloroquine registration we can see
2. Confirm any number free with our NAFDAC checker; a hydroxychloroquine pack showing a number that belongs to a different product, or none, has not been registered here
3. Plaquenil and most other imported brands do not appear in our register copy — that is not proof they are fake, but you are relying on the importer rather than on NAFDAC
4. Buy from a hospital pharmacy or a licensed pharmacy that keeps the brand in stock month after month — lupus is a lifelong condition and continuity of the same brand matters
5. Be wary of anyone selling hydroxychloroquine for COVID-19, flu or 'immune boosting' — it does not work for those and the sales pitch is a warning sign in itself

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### Is hydroxychloroquine (HCQS) NAFDAC-registered in Nigeria?

Yes, one product is. HCQS Tablets 200 mg, made by IPCA Laboratories of India and registered through IPCA Pharma Nigeria, holds registration number 04-7590, which was Active in our copy of the NAFDAC register at the last update. It is the only hydroxychloroquine registration we can find. Plaquenil, the Sanofi brand, and the other Indian generics sometimes seen in Nigerian pharmacies do not appear in our copy. You can check the number printed on any pack against the register with our free NAFDAC checker.

### Why does my rheumatologist insist I stay on hydroxychloroquine even when I feel well?

Because in lupus it does its most important work quietly. Large studies show that patients who stay on hydroxychloroquine have fewer flares, less kidney and organ damage, fewer blood clots, lower steroid doses over their lifetime and better survival than those who stop. Feeling well is partly the drug working. Stopping it, even for a few months because of cost or a stock-out, is one of the commonest reasons for a serious flare. If supply or price is the problem, tell your clinic before you run out rather than after.

### Does hydroxychloroquine damage the eyes?

It can, but rarely, and the risk is managed. Over many years the drug can accumulate in the retina and cause permanent damage to central vision. The risk is low in the first five years at doses under 5 mg per kilogram of body weight per day, and rises with higher doses, longer use, kidney disease and tamoxifen. The standard precaution is an eye examination when you start and then yearly from the fifth year, so any early change is caught before you notice it. The blurred vision some people get in the first weeks is a different, harmless focusing effect that settles.

### Can I take hydroxychloroquine to prevent or treat malaria?

Not in Nigeria. Hydroxychloroquine and chloroquine belong to the same family, and the malaria parasite here has been resistant to that family for decades, which is why chloroquine was withdrawn as first-line treatment. Taking your lupus tablet does not protect you from malaria, and you still need an artemisinin-based combination if you get it. Some malaria drugs and antibiotics prolong the heart's QT interval, as hydroxychloroquine does, so tell whoever treats your malaria that you are on it.

### What happened with hydroxychloroquine and COVID-19 in Nigeria?

In early 2020 the drug was promoted internationally as a COVID-19 treatment, before trials had tested it. In Nigeria that led to panic buying, prices rising several times over, lupus and arthritis patients unable to find their tablets, and hospital admissions for poisoning after people took it without prescription; NAFDAC and the Lagos State government both issued public warnings. The large trials that followed found no benefit against COVID-19. The episode is worth remembering for one reason: this is a medicine with a narrow set of real uses and a real toxicity, not a general tonic.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- WHO Model List of Essential Medicines
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)