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. Hydroxychloroquine annual monitoring Taking melatonin with hydroxychloroquine Shin pain plaquenil Shared care guidelines hydroxychloroquine H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. The most common side effect associated with its use is retinal toxicity, which may be irreversible. Symptoms of Plaquenil toxicity are similar to other macular problems and may include Decreased fine vision or difficulty reading. Changes in Color vision. Missing Spots or shadows near the center of the vision. Ocular manifestations of hydroxychloroquine include corneal verticillata and retinal toxicity. Verticillata are cornea deposits of salts within the corneal epithelium. This condition does not cause symptoms and is reversible with cessation of the medication. 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). Plaquenil macular toxicity Hydroxychloroquine-related retinal toxicity Rheumatology., Plaquenil Toxicity Screening - Retina Group of New York Can you take aleve with plaquenilPlaquenil and ironWikipedia hydroxychloroquine A risk factor for Plaquenil hydroxychloroquine retinotoxicity is a daily dose that exceeds 5.0 mg of drug per kg of body weight. The tool on the right simply calculates this threshold based on a ppatient’s real body weight. It’s important to understand that the daily dose is only one risk factor for plaquenil retinotoxicity. Plaquenil Risk Calculators. Hydroxychloroquine Plaquenil Toxicity and.. Protecting your eyesight when taking Plaquenil Lupus.. This occurs when melanin is able to bind to the “High Risk Medication” Plaquenil within the Retinal Pigment Epithelium RPE as well as direct toxicity to retinal ganglion cells. The drugs ability to bind to these pigmented cells creates a “Bulls Eye” around the macula, giving it this very unique appearance. 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. 2,3 The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is relatively rare, estimated at 1 percent after five years and rising with continued therapy. 3 However.