Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Will plaquenill make you stutter Plaquenil loss of appetite Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. Plaquenil toxicity isn’t even in the top 10, or the top 100” if you’re looking at incidence, he said. “It’s a pretty rare thing.” Nevertheless, he urged doctors to master the Academy’s new guidelines, because the effects from chloroquine and hydroxychloroquine, when they do occur, are severe and often irreversible. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Incidence of retinal toxicity from plaquenil Plaquenil Side Effects on Your Eyes and Vision, Rx Side Effects New Plaquenil Guidelines and More - American. Plaquenil sun reactionPlaquenil 200mg qdOrder aralen prescribingPlaquenil retinopathy screening guidelines The Journal of Rheumatology Volume 44, no. 11 Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine Jung-Yoon Choe Ji-Won Kim, Yoon Young Kim, Hwajeong Lee, Sung-Hoon Park, Seong-Kyu Kim and Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. Hydroxychloroquine Plaquenil Toxicity and.. The risk of retinal damages is small with daily doses of up to 6.5 mg/kg ideal lean body weight. Exceeding the recommended daily dose sharply increases the risk of retinal toxicity. Significant risk factors for toxic retinopathy reported during long-term ≥5 years treatment with hydroxychloroquine include daily doses greater than 6.5 This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. Rates and Predictors of Hydroxychloroquine Retinal Toxicity in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus FREDERICK WOLFE1 AND MICHAEL F. MARMOR2 Objective. Hydroxychloroquine HCQ retinopathy is of concern because of the potential seriousness of visual loss and the medicolegal consequences of failure to detect toxicity.