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 and filipin lysosome Side effect of plaquenil on eyes Phototherapy and hydroxychloroquine combination High-risk patients would include those who have taken high doses of Plaquenil for years i.e. 1000 g. for over 7 years. are 60 years or older. are obese. have significant liver or kidney disease. have pre-existing retinal, macular disease, or cataracts. They are often used in people who no longer respond to methotrexate. Tofacitinib comes as a pill taken twice a day, while baricitinib or upadacitinib are taken once a day with or without food. Recent findings suggest that Plaquenil toxicity can develop among patients that are taking the drug at a daily dose lower than the suggested “safe” dose and/or have been on Plaquenil for shorter than five years. 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). How often do you take plaquenil Hydroxychloroquine Plaquenil, DMARDs for Treating Rheumatoid Arthritis Can hydroxychloroquine affect neutrophilsNatural alternatives to plaquenil Are many of you taking plaquenil? Does it do anything for you at all? I've been taking it for about 6 months now, and I can't tell that it's done a thing. Arthritis is a bit better, but I also take enbrel, and have recently added mtx, so that confounds it a bit. Plaquenil -. The Risk of Retinal Toxicity with Plaquenil. Side Effects of Plaquenil Hydroxychloroquine, Warnings, Uses. 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. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. Newer techniques for evaluation of retinal disease have been developed and these techniques can detect retinal toxicity earlier. Research has shown that your risk of developing retinopathy is higher the longer you are taking Plaquenil. In fact, the incidence of retinal toxicity rises sharply in people that have taken it between 5 and 7 years. As a result, baseline testing should occur within the first year of taking the drug and then annually at the five-year mark.