Ototoxic effects of hydroxychloroquine

Rev Assoc Med Bras (1992). 2021 Jul 9;67Suppl 1(Suppl 1):108-114. doi: 10.1590/1806-9282.67.Suppl1.20200677. eCollection 2021.


Objective: To present scientific evidence based on a systematic review of the literature (PRISMA), aiming to systematize evidence of the ototoxic effects of hydroxychloroquine (HCQ).

Methods: The studies were selected using a combination based on the Medical Subject Headings (MeSH). The databases searched were MEDLINE (PubMed), LILACS, SciELO, and BIREME, encompassing articles from January 2010 to May 2020, with no restrictions of language and place of publication.

Results: A total of 148 articles with the potential to be included were retrieved. Of these, two answered the research question, which consisted of seeking evidence of the ototoxic effects of hydroxychloroquine. These studies scored 11 in their quality assessment with the modified protocol by Pithon et al.13.

Conclusions: The studies reported possible ototoxicity of HCQ. Audiovestibular changes, such as hearing loss, peripheral vestibular syndrome, and tinnitus were evidenced in patients submitted to HCQ. The improvement in the audiological examinations and the regression in the vestibular syndrome after stopping the treatment with HCQ are strong arguments in favor of the ototoxicity caused by this medication. However, there are still divergences about the relationship between ototoxic effects and the use of HCQ.

Publication types

  • Systematic Review

MeSH terms

  • Hearing Loss*
  • Humans
  • Hydroxychloroquine / toxicity
  • Ototoxicity*


  • Hydroxychloroquine