Is It Normal to Feel Worse Before Improvement on Hydroxychloroquine?
I’m a 37-year-old, standing at 5'2" and weighing 110 lbs. Recently, I started taking hydroxychloroquine for my autoimmune disorder. My diagnosis primarily indicates spondyloarthropathy, but I've noticed that my recent flare-ups have come with a variety of symptoms, including nerve-related issues, dysautonomia, muscle discomfort, and weakness, as well as respiratory problems like coughing and shortness of breath. Moreover, I've experienced soft tissue pain, flu-like symptoms, sporadic fevers, and swollen lymph nodes along with swollen salivary glands. My rheumatologist has decided to give hydroxychloroquine a try for my treatment. While steroids were effective in alleviating my previous flare, since beginning hydroxychloroquine this past week, I've been feeling more unwell and flu-like. I’m worried that I might be on the brink of another flare. Is such a reaction a typical, temporary phase when starting this medication?
Answers (1)
2/13/2026, 7:30:37 PM
OpenHealth AI
It's understandable to feel concerned about your worsening symptoms since starting hydroxychloroquine, especially given your complex health situation. While some patients do experience a temporary increase in symptoms when beginning this medication, it's important to monitor your symptoms closely.
Explanation: Hydroxychloroquine is often used to manage autoimmune conditions like spondyloarthropathy by modulating the immune response. It's not uncommon for patients to have an initial worsening of symptoms due to the adjustment period as your body starts to respond to the medication. However, this can be concerning, especially given your extensive list of symptoms.
Next Steps:
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Monitor Symptoms: Keep a detailed record of your symptoms, especially noting any severe changes or new developments. Track the severity and duration of symptoms like fever, fatigue, or respiratory issues.
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Self-Care Strategies:
- Stay Hydrated: Drink plenty of fluids to help manage flu-like symptoms.
- Rest: Prioritize sleep and break activities into manageable parts to avoid overstressing your body.
- Manage Pain: Over-the-counter pain relievers (like acetaminophen or ibuprofen), if not contraindicated, might help ease muscle discomfort and related symptoms.
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Watch for Red Flags: Pay attention to any significant worsening of symptoms or new symptoms such as severe breathing difficulties, chest pain, or unusually high fevers. These would require immediate attention.
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Communication: Since you’re under the care of a rheumatologist, if your current symptoms do not improve or worsen, it’s essential to reach out to your healthcare provider. They can determine whether adjustments to your treatment plan are necessary.
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Patience and Support: Understand that it can take time for hydroxychloroquine to reach its full therapeutic effect, often several weeks to months. Stay connected with support networks or counseling if feeling anxious or overwhelmed, as this can help during tough times.
If you have any specific symptoms that concern you or if you need more detailed guidance, feel free to ask. You're not alone in this process, and there are pathways to help manage your condition effectively.
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