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 pregnacy Chloroquine injection route Plaquenil lichen planus Plaquenil 200mg price in pakistan Although it is not possible to predict which patients will develop retinal toxicity, high-risk characteristics include the following daily dose greater than 400 mg or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight or total cumulative dose of more than 1,000 g. Everything is dark inside and outside is so bright the it is painful to open my eyes. Plaquenil toxicity is not reversible in most cases and continues to progress even after you stop taking it for several month and sometimes years because of the half life of Plaquenil One should see a retina special before taking Plaquenil in my opinion 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. 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 Early Plaquenil Toxicity Detected without Bull’s Eye., Has anyone experienced plaquenil toxicity with damage to eyes? Chloroquine-medicated saltDry cough hydroxychloroquineHydroxychloroquine sulfate tabsChloroquine suicide survivor The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening. Despite Plaquenil dosing recommendations, retinal toxicity.. Retinal Physician - Hydroxychloroquine Maculopathy An.. Is Damage Still Occurring? - Review of Optometry. The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin -containing structures in the body. With prolonged usage, metabolites in the drug accumulate in the retina. The drug remains in these parts even if the patients stopped taking the drugs. Risk factors for toxicity. Reported risk factors for toxicity include daily dose 400 mg, or 6.5 mg/kg ideal/lean body weight for short individuals; cumulative dose 1000 g; duration of use 5 years; renal or hepatic dysfunction; obesity; age 60 years; and pre-existing retinal disease or maculopathy 31. Chloroquine-induced retinal toxicity was first described in 1959 and the retinal toxic effects of hydroxychloroquine were later described in 1967 3, 4. Hydroxychloroquine has significantly less retinal toxicity and has largely replaced chloroquine as a treatment of inflammatory disease.