Introduction

Hydroxychloroquine(Hcqs 200) has been used for decades as a reliable medication for preventing and treating malaria, a mosquito-borne disease that continues to affect millions around the world. Once considered a frontline therapy, hydroxychloroquine's popularity has shifted over time due to emerging resistance, changes in treatment protocols, and newer alternatives.

So, the pressing question is: Does hydroxychloroquine still work for malaria today? This article explores its history, mechanism, current status, and the reasons for its decline in some parts of the world.

What Is Hydroxychloroquine?

Hydroxychloroquine is a synthetic derivative of chloroquine, developed to be less toxic while maintaining its antimalarial effectiveness. Originally created to prevent and treat malaria, it has also become widely used in the management of autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. You can also buy Hydroxychloroquine online from DosePharmacy and save 5% on your order.

Hydroxychloroquine is marketed under brand names such as Plaquenil, and it is available in oral tablet form, often taken once or twice daily, depending on the medical condition.

How Does It Work Against Malaria?

Hydroxychloroquine targets the Plasmodium parasites—the organisms responsible for malaria. It works primarily by:

• Accumulating in the parasite’s food vacuole
  
  

• Disrupting heme detoxification, which is essential for the parasite’s survival
  
  

• Killing the parasite in red blood cells during its asexual replication stage
  
  

It is particularly effective against Plasmodium vivax and Plasmodium ovale, and was once used extensively against Plasmodium falciparum—the most dangerous and deadly strain of the parasite.

Hydroxychloroquine vs. Chloroquine: What's the Difference?

Though both medications are similar in structure and function, hydroxychloroquine has fewer side effects and a better safety profile, making it a preferred option for long-term use. That’s why it's more commonly used in autoimmune diseases today.

However, in malaria treatment, both drugs historically played a significant role in preventing and treating uncomplicated malaria, especially in non-resistant regions.

Why Has Hydroxychloroquine Fallen Out of Favor in Malaria Treatment?

The primary reason is drug resistance. Over the years, Plasmodium falciparum—the most severe strain—has developed widespread resistance to chloroquine and hydroxychloroquine, especially in:

• Sub-Saharan Africa
  
  

• Southeast Asia
  
  

• South America
  
  

• Parts of the Indian subcontinent
  
  

Due to this, most health authorities no longer recommend hydroxychloroquine or chloroquine as first-line treatments for falciparum malaria. Instead, newer artemisinin-based combination therapies (ACTs) are now the gold standard.

Where Does Hydroxychloroquine Still Work?

Hydroxychloroquine may still be effective and used in certain limited settings, such as:

1. Regions without drug-resistant malaria – Some areas in Central America and parts of the Middle East still report susceptibility to hydroxychloroquine.
   
   

2. P. vivax or P. ovale infections – Hydroxychloroquine remains effective against these less severe strains. However, primaquine is often needed as follow-up treatment to prevent relapse due to dormant liver stages (hypnozoites).
   
   

3. Travelers going to non-resistant regions – In some cases, hydroxychloroquine is used for malaria prophylaxis (prevention) for short-term travelers visiting areas where the drug is still effective.
   
   

Always consult the CDC (Centers for Disease Control and Prevention) or WHO (World Health Organization) guidelines and your local healthcare provider to determine if hydroxychloroquine is appropriate for your region or travel plans.

Current Recommended Treatments for Malaria

For uncomplicated Plasmodium falciparum malaria, the WHO recommends:

• Artemisinin-based combination therapies (ACTs) such as:
  
  

  • Artemether-lumefantrine (Coartem)
    
    

  • Artesunate-amodiaquine
    
    

  • Artesunate-mefloquine
    
    

  • Artesunate-pyronaridine
    
    

For P. vivax and P. ovale, chloroquine or hydroxychloroquine may still be used, followed by primaquine to eliminate liver stages.

In severe cases, intravenous artesunate is preferred over older treatments like quinine.

Side Effects and Safety Considerations

Hydroxychloroquine is generally well-tolerated, especially when used short-term for malaria prevention or treatment. However, some possible side effects include:

• Nausea and stomach cramps
  
  

• Headache
  
  

• Dizziness
  
  

• Skin rashes
  
  

• Vision problems (rare but serious with long-term use)
  
  

Because of the risk of retinal toxicity, long-term use—such as in lupus or arthritis—requires regular eye exams. However, this is not usually a concern for short-term malaria treatment.

Hydroxychloroquine in the COVID-19 Era

Hydroxychloroquine gained media attention during the COVID-19 pandemic. While it was initially proposed as a possible treatment, multiple studies later showed it offered no significant benefit for COVID-19 and might increase risks, particularly in patients with heart conditions.

This controversy had no impact on its role in malaria, but it did influence public perception and created confusion regarding its actual medical uses.

The Bottom Line: Does It Still Work for Malaria?

Yes—but with limitations. Hydroxychloroquine remains effective only in areas without resistance and only for certain malaria strains like P. vivax or P. ovale. It is no longer recommended for widespread use against P. falciparum, the most deadly species of the malaria parasite.

In most parts of the world, artemisinin-based combination therapies (ACTs) have replaced hydroxychloroquine and chloroquine as the first-line treatment due to rising resistance.

✅ Summary of Key Points

Final Thoughts

Hydroxychloroquine has played a historic and critical role in the fight against malaria. While it’s no longer a frontline treatment in most regions due to resistance, it still has a place in specific cases and for particular strains of the parasite.

If you're considering hydroxychloroquine for malaria prevention or treatment, consult a healthcare provider or check the CDC malaria map to ensure it’s appropriate for your location or travel destination.