Comprehensive medication guide to Hydroxychloroquine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic; Tier 1–2 on most commercial plans and Medicare Part D. Some plans require prior authorization. Medicare Part D $2,000 annual OOP cap (effective 2025) helps patients on multiple medications.
Estimated Cash Pricing
$100–$200 retail for generic hydroxychloroquine 200 mg (60 tablets, 30-day supply); as low as $15–$20 with GoodRx or SingleCare coupons. Brand-name Plaquenil costs approximately $1,000+ without insurance.
Medfinder Findability Score
78/100
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Hydroxychloroquine is an oral prescription medication classified as both a disease-modifying antirheumatic drug (DMARD) and an antimalarial. It is sold under the brand names Plaquenil and Sovuna, and is widely available as a generic. FDA-approved since 1955, it is on the World Health Organization's List of Essential Medicines.
Hydroxychloroquine is used to treat systemic lupus erythematosus (SLE), discoid lupus erythematosus (DLE), rheumatoid arthritis (RA), porphyria cutanea tarda, and for prevention and treatment of malaria. Off-label uses include Sjögren's syndrome and antiphospholipid syndrome. In 2023, more than 4 million prescriptions were written for hydroxychloroquine in the United States.
Unlike steroids or traditional immunosuppressants, hydroxychloroquine modulates rather than broadly suppresses the immune system. It does not significantly increase infection risk and is considered safe during pregnancy — making it unique among DMARDs. The medication is taken orally, typically once or twice daily with food.
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Hydroxychloroquine is a weak base that concentrates in acidic cellular compartments called lysosomes and endosomes. By raising the pH in these compartments, it disrupts how immune cells process and respond to inflammatory signals. This mechanism blunts the autoimmune responses that drive lupus and rheumatoid arthritis.
A second key mechanism involves blocking toll-like receptors 7 and 9 (TLR7 and TLR9) — cellular sensors that mistakenly detect the body's own DNA and RNA as threats in autoimmune diseases. By blocking this pathway, hydroxychloroquine reduces interferon production, lowers autoantibody levels, and decreases systemic inflammation. Additional benefits include cardiovascular protection, modest lipid lowering, and enhanced insulin sensitivity.
For malaria, hydroxychloroquine accumulates in the parasite's digestive vacuole and disrupts its ability to neutralize toxic heme — a byproduct of hemoglobin digestion. This kills the parasite. The drug has a very long half-life (40–50 days) due to extensive tissue accumulation, which is why it takes 3 to 6 months to reach full therapeutic effect and why retinopathy risk accumulates with long-term use.
200 mg — tablet
Most common form; used for lupus and RA at 1-2 tablets daily
400 mg — tablet (2x200 mg)
Common daily dose for lupus and RA maintenance
100 mg — tablet
Less common; used for lower-dose or pediatric adjustments
300 mg — tablet
Available from some manufacturers; used in certain weight-based dosing scenarios
As of 2026, there is no active FDA-declared national shortage of hydroxychloroquine. The major shortage caused by COVID-19 demand in 2020 has been fully resolved. Generic hydroxychloroquine is manufactured by multiple companies — including Dr. Reddy's, Mylan (Viatris), Amneal, Zydus, and Rising Pharmaceuticals — providing meaningful supply redundancy.
Despite stable national supply, individual pharmacies occasionally run out due to inconsistent ordering patterns, manufacturer-specific back orders, or regional demand spikes. Patients who take hydroxychloroquine long-term should start refill searches 7–10 days early and consider switching to 90-day supply via mail order to reduce the risk of gaps.
If you're struggling to find hydroxychloroquine at your pharmacy, medfinder calls pharmacies near you to find which ones have your medication in stock, and texts you the results — saving you hours of phone calls.
Hydroxychloroquine is not a controlled substance, so any licensed provider with prescriptive authority can prescribe it. No special DEA registration, special prescriber enrollment, or mandatory in-person visit is required. The following types of providers commonly prescribe hydroxychloroquine:
Telehealth is available for hydroxychloroquine prescribing in most states. Telehealth rheumatology services have expanded significantly since 2020 and are appropriate for established patients on stable maintenance therapy seeking refills or routine follow-up management.
No. Hydroxychloroquine is not a DEA-scheduled controlled substance. It has no special prescribing restrictions, no federal limits on prescription quantity or refills, and no requirement for in-person visits before prescribing (for non-malaria uses). Any licensed physician, nurse practitioner, or physician assistant with prescriptive authority can write a prescription for hydroxychloroquine.
Because it is not controlled, hydroxychloroquine can be prescribed via telehealth in most states, filled at any pharmacy, and transferred between pharmacies freely. This makes it more accessible than many other prescription medications. Some temporary state-level dispensing restrictions were enacted during the 2020 COVID-19 shortage (requiring diagnosis confirmation), but these have since expired.
Most patients tolerate hydroxychloroquine well. Common side effects include:
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Methotrexate
First-line DMARD for RA; often combined with hydroxychloroquine in triple therapy. Requires regular blood monitoring. Not safe during pregnancy.
Sulfasalazine (Azulfidine)
Conventional DMARD used for RA and as part of triple therapy. Requires periodic CBC monitoring. Avoid in sulfonamide allergy.
Leflunomide (Arava)
DMARD targeting T-cell proliferation; used for RA when HCQ is not tolerated. Contraindicated in pregnancy. Long washout period if discontinued.
Azathioprine (Imuran)
Immunosuppressant used for moderate-to-severe lupus, particularly lupus nephritis. Broader immune suppression than HCQ.
Belimumab (Benlysta)
Biologic DMARD FDA-approved for SLE and lupus nephritis. Targets BLyS proteins. Used when conventional DMARDs are insufficient.
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Azithromycin
majorBoth prolong QT interval; concurrent use significantly increases arrhythmia risk. Avoid combining. Choose alternative antibiotics.
Digoxin
majorHydroxychloroquine increases digoxin blood levels by unknown mechanism. Monitor digoxin levels and adjust dose as needed.
Antacids (aluminum/magnesium)
moderateAntacids bind hydroxychloroquine and reduce absorption. Space administration at least 4 hours apart.
Insulin and oral diabetes medications
moderateHydroxychloroquine enhances hypoglycemic effects. Monitor blood glucose closely; dose adjustment may be needed.
Cimetidine (Tagamet)
moderateIncreases hydroxychloroquine blood levels by reducing metabolism. Increased side effect risk. Avoid; use omeprazole instead.
Rifampin
majorReduces hydroxychloroquine effectiveness by inducing metabolism. Avoid concurrent use; may require alternative TB therapy.
Methotrexate
minorIntentional combination (triple therapy). Generally well-tolerated; additive beneficial effects in RA. Continue standard methotrexate monitoring.
Penicillamine
majorHydroxychloroquine increases penicillamine levels, increasing toxicity risk. Avoid or monitor closely.
Hydroxychloroquine is one of the most important medications in autoimmune disease management. Its unique combination of anti-inflammatory effects, organ-protective properties, cardiovascular benefits, and an excellent safety profile makes it truly irreplaceable for many patients with lupus and rheumatoid arthritis. It is also one of the most affordable DMARDs available, especially in generic form.
The 2020 COVID-19 shortage was a stark reminder of how disruptive supply gaps can be for patients who depend on this medication. As of 2026, supply has normalized with no active national shortage, but patients should stay proactive — maintaining a 90-day supply buffer, knowing their backup pharmacies, and never stopping the medication without medical guidance.
If you're having difficulty finding hydroxychloroquine in stock at your pharmacy, medfinder can call pharmacies near you and text you the results — helping you locate your medication without the frustrating phone-call marathon.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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