Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Hydroxychloroquine

DMARD / antimalarial

Brand names: Plaquenil

Oral health effects

  • Mucosal pigmentation / lichenoid reaction

    Can cause blue-gray pigmentation of the hard palate/mucosa and oral lichenoid reactions.

    Clinical management: Reassure and document pigmentation; biopsy uncertain lichenoid lesions.

  • Low blood sugar (hypoglycemia)

    The label warns that hydroxychloroquine can cause severe, potentially life-threatening hypoglycemia, with or without antidiabetic medication.

    Clinical management: Especially in patients who also take insulin or sulfonylureas, ask about recent meals, keep a fast-acting glucose source available, and recognise signs (sweating, shakiness, confusion) during longer appointments.

Sources

  1. A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
  2. Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.
  3. Hydroxychloroquine prescribing information (FDA label) Cardinal Health 107, LLC / DailyMed, 2026.