She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. How effective against malaria is chloroquine Chloroquine phosphate brand name Chloroquine ovarian cancer Hypersensitivity to hydroxychloroquine. Caution in patients with previous retinal or visual field changes. SIDE EFFECTS AND ADVERSE REACTIONS. Hydroxychloroquine is generally considered to be the safest DMARD, and a “go to” drug for pregnancy. Retinal pigment changes and retinal toxicity can occur with prolonged use. Safe use of Plaquenil. In our eye clinic we frequently see patients who need to be screened because they have been prescribed hydroxychloroquine Plaquenil and have concerns, so I wanted to write a short article summarizing the necessity and purpose of proper eye screening in these individuals. It has become fairly common practice for most rheumatologists to recommend that patients being treated with hydroxychloroquine be seen for formal visual field evaluation once or twice a year to monitor for retinal toxicity. The previous AAO guideline recommended screening every 12 months. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Plaquenil toxicity monitored with Hydroxychloroquine retinopathy A review of imaging, Plaquenil hydroxychloroquine and eye screening Jitander Dudee Plaquenil 200 mg tablets side effectsCan i dissolve hydroxychloroquine tablets in waterHydroxychloroquine and chloroquin Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Hydroxychloroquine-Induced Retinal Toxicity - American.. My Take on New Ocular Screening Guidelines for Plaquenil.. Plaquenil Side Effects Common, Severe, Long Term -. In early cases of Plaquenil toxicity, an early indicator of damage is the appearance of a paracentral scotoma seen on automated visual field testing in the absence of fundus changes. 18 Each of the testing strategies can be used to detect early toxicity changes, but the presentation of the visual field effects will vary. Due to the central area. Objective To report the detailed clinical findings of patients with retinal toxicity that developed secondary to the use of hydroxychloroquine sulfate n = 13, chloroquine phosphate n = 2, or a combination of the agents n = 1. Methods Ophthalmologic examination, fundus photography. Clinical monitoring for signs and symptoms of cardiomyopathy is advised, including use of appropriate diagnostic tools eg, ECG to monitor patients for cardiomyopathy during Plaquenil therapy. — Chronic toxicity should be considered when conduction disorders bundle branch block/AV heart block or biventricular hypertrophy are diagnosed.