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. Chloroquine functional groups Chloroquine pretreatment degradation toxicity Chloroquine sold where 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. Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some. 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. 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 Retinal toxicity associated with chronic exposure to., Plaquenil Side Effects Common, Severe, Long Term - What drug classification is plaquenilHydroxychloroquine liver function tests Nov 01, 2015 The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. Protecting your eyesight when taking Plaquenil Lupus.. Aug 30, 2011 Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. 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 Nov 01, 2007 If signs of toxicity develop, the internist or rheumatologist should be consulted to determine if the medication can be discontinued. Toxicity may progress even after the medication has been discontinued. 15. Figure 2a. Color photograph OD revealing a classic Bull's eye lesion in a patient on hydroxychloroquine therapy for rheumatoid arthritis.