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Drug interactions

Hydroxychloroquine + Paliperidone

Severity: Major

Hydroxychloroquine and Paliperidone: 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

Paliperidone can prolong the QT interval, and hydroxychloroquine adds to this effect, increasing the chance of torsades de pointes. Risk is higher with renal impairment, which raises paliperidone exposure, and with electrolyte abnormalities.

What this interaction means in plain words

Hydroxychloroquine and Paliperidone 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; Paliperidone belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive hERG-mediated QT prolongation.

What to do

Avoid if an alternative exists; otherwise obtain a baseline ECG, correct electrolytes and adjust the paliperidone dose to renal function.

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 Paliperidone?

MediHelp rates the interaction as major. Hydroxychloroquine and Paliperidone 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. Paliperidone can prolong the QT interval, and hydroxychloroquine adds to this effect, increasing the chance of torsades de pointes. Risk is higher with renal impairment, which raises paliperidone exposure, and with electrolyte abnormalities.

How serious is the interaction between Hydroxychloroquine and Paliperidone?

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 if an alternative exists; otherwise obtain a baseline ECG, correct electrolytes and adjust the paliperidone dose to renal function.

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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