Hydroxychloroquine (HCQS) is recommended for virtually all lupus patients by ACR guidelines — not just for symptom control but to reduce flares, organ damage, and mortality over the long term. This complete guide covers the mechanism, the critical weight-based 5mg/kg/day dosing rule, the 3 to 6 month benefit timeline, mandatory retinal monitoring protocol, and a full DMARD comparison table showing how HCQS fits within the broader lupus and RA treatment landscape.