Hydroxychloroquine in prophylaxis of pulmonary embolism following hip arthroplasty.

Two thousand one hundred and forty four patients received Plaquenil (hydroxychloroquine sulphate) prior to total hip arthroplasty; the drug was continued until the patient was fully mobile. Fatal emboli (confirmed by postmortem) occurred in 0.28% and non-fatal emboli (diagnosed clinically) occurred in 4.15%. This was a statistically significant improvement over the overall results of all previous prophylactic measures used in this unit. The results of Plaquenil are significantly better than the most effective agent previously used in this unit, namely, Dindevan (phenindione). There were no deaths and no serious gastrointestinal or genitourinary bleeding. Allergic rashes occurred in 18 patients (0.8%), temporary blurring of vision in 6 (0.3%), and minor gastrointestinal upsets, including nausea, vomiting and minor bleeding in 12 (0.6%).