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Drug interactions

Hydroxychloroquine + Mifepristone

Severity: Major

Hydroxychloroquine and Mifepristone: major interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Mifepristone, particularly at the higher doses used for Cushing syndrome, prolongs the QT interval, and combined with hydroxychloroquine this raises the risk of torsades de pointes. Mifepristone also inhibits CYP3A4, which may modestly alter exposure to some drugs.

What this interaction means in plain words

Hydroxychloroquine and Mifepristone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Hydroxychloroquine belongs to Musculoskeletal; Mifepristone belongs to Endocrine.

Evidence level: Low

Why it happens

Additive QT prolongation through inhibition of cardiac repolarizing currents.

What to do

Avoid the combination in patients on chronic higher-dose mifepristone; otherwise obtain a baseline ECG and correct hypokalemia and hypomagnesemia.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Hydroxychloroquine with Mifepristone?

MediHelp rates the interaction as major. Hydroxychloroquine and Mifepristone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Mifepristone, particularly at the higher doses used for Cushing syndrome, prolongs the QT interval, and combined with hydroxychloroquine this raises the risk of torsades de pointes. Mifepristone also inhibits CYP3A4, which may modestly alter exposure to some drugs.

How serious is the interaction between Hydroxychloroquine and Mifepristone?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination in patients on chronic higher-dose mifepristone; otherwise obtain a baseline ECG and correct hypokalemia and hypomagnesemia.

What other medicines interact with Hydroxychloroquine?

MediHelp also lists interactions of Hydroxychloroquine with, for example, Arsenic trioxide, Cisapride, Dronedarone. The full list is on the Hydroxychloroquine page.

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