Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Hydroxychloroquine new indications Plaquenil sore more Plaquenil withdrawal severe hunger pains A 55-year-old black female returned to the clinic for a six-month follow-up evaluation. Her ocular history was remarkable for Plaquenil hydroxychloroquine, Sanofi-Aventis macular toxicity. Her systemic history was significant for lupus, which was initially diagnosed 15 years earlier. For the last 14 years, she took 400mg Plaquenil QD. A sharp increase in the prevalence of retinal toxicity is noted following five to seven years of medication use. 6 Newer literature emphasizes the risk of cumulative dosing that occurs over a period of time 1,000g rather than the previous suggestion of 6.5mg/kg of body weight. Thus, annual screening is recommended after five years for non-high risk patients. Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity. Plaquenil-induced toxicity usually will not occur before five years of taking the drug. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Retinal toxicity from plaquenil years after discontinued Plaquenil Toxicity - Symptoms, Treatment, Risk Factors., New Plaquenil Guidelines - Hydroxychloroquine adderall interactionWhat are symptoms of plaquenil eye problemsLupus fog plaquenilScreening criteria for ocular toxicity of plaquenil 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. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. Protecting your eyesight when taking Plaquenil Lupus.. Retinal toxicity secondary to Plaquenil therapy - ScienceDirect. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Plaquenil induced retinal toxicity is reversible if detected early and plaquenil dosage altered or the medication discontinued. Even suspicious early plaquenil toxicity warrants communication with the patient’s treating physician, and meaningful coordination of care would include a report even if the findings are normal. Retinal Damage. According to Drugs.com, Plaquenil given for a long term can cause retinal disorders after a few months or years of daily use--especially if the dose exceeds 400mg per day. The risk of retinal damage increases at doses of 600mg to 700mg.