Clinical Rheumatology

, Volume 26, Issue 11, pp 1809–1810 | Cite as

Chloroquine ototoxicity

  • Rodrigo Bortoli
  • Mittermayer SantiagoEmail author
Review Article


Chloroquine (CQ), a 4-aminoquinoline drug, has been largely used for the treatment of rheumatoid arthritis and other connective tissue diseases. Besides the well-known retinal toxicity, its use has been suspected of be associated to ototoxicity. Some reports have described mainly sensorineural hearing loss, tinnitus, sense of imbalance, and cochleovestibular manifestations. Differently from what occurs in retinopathy, in which there is a predominance of CQ toxicity, there are reports of alterations in hearing related to either CQ or hydroxychloroquine. Brain-evoked response audiometry seems to be the most sensitive test in detecting early manifestations of cochlear injury caused by CQ when still in a reversible stage. The reversibility of CQ ototoxicity has been debatable, but there is suggestion that such complication can be corrected if the medication is stopped and appropriate therapy, with steroids and plasma expanders, is instituted.


Chloroquine Ototoxicity 


  1. 1.
    Page F (1951) Treatment of lupus erythematosus with mepacrine. Lancet 2:755–758PubMedCrossRefGoogle Scholar
  2. 2.
    Johansen PB, Gran JT (1998) Otoxicity due to hydroxychloroquine: report of two cases. Clin Exp Rheumatol 16:472–474PubMedGoogle Scholar
  3. 3.
    Hart EW, Naunton RE (1964) The ototoxicity of chloroquine phosphate. Arch Otolaryngol 80:407–412PubMedGoogle Scholar
  4. 4.
    Rynes NI (1997) Antimalarial drugs in the treatment of rheumatological disease. Br J Rheumatol 36:799–805PubMedCrossRefGoogle Scholar
  5. 5.
    Scherbel AL, Harrison JW, Atojian M (1958) Further observations on use of a 4-amino-quinolone compounds in patients with rheumatoid arthritis or related diseases. Clinical Quarterly 25:95–111Google Scholar
  6. 6.
    Hadi U, Nuwayhtd N, Hasbini AS (1996) Chloroquine ototoxicity: an idiosyncratic phenomenon. Otolaryngol Head Neck Surg 114:491–493PubMedCrossRefGoogle Scholar
  7. 7.
    Matz GJ, Naunton RF (1968) Ototoxicity of chloroquine. Arch Otolaryngol 88:370–372PubMedGoogle Scholar
  8. 8.
    Seckin U, Ozoran K, Ikinciogullari A et al (2000) Hydroxychloroquine ototoxicity in a patient with rheumatoid arthritis. Rheumatol Int 19(5):203–204PubMedCrossRefGoogle Scholar
  9. 9.
    Mukherjee DK, Mukherjee K (1978) Ototoxicity of commonly used pharmaceutical preparations. Niger Med J 3:20–24Google Scholar
  10. 10.
    Mukherjee DK (1979) Chloroquine ototoxicity—a reversible phenomenon? J Laryngol Otol 93:809–815PubMedGoogle Scholar
  11. 11.
    Roverano S, Cassano G, Paira S et al (2006) Asymptomatic sensorineural hearing loss in patients with systemic lupus erythematosus. J Clin Rheumatol 12:217–220PubMedCrossRefGoogle Scholar
  12. 12.
    Bernard P (1985) Alterations of auditory evoked potentials during the course of chloroquine treatment. Acta Oto-laryngol 99:387–392Google Scholar

Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  1. 1.Serviço de Reumatologia do Hospital Santa Izabel (HSI)SalvadorBrazil
  2. 2.Escola Bahiana de Medicina e Saúde PúblicaBahiaBrazil

Personalised recommendations