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. Plaquenil tremors Plaquenil and edema Hydroxychloroquine vs methotrexate Plaquenil ringing in ears My Take on New Ocular Screening Guidelines for Plaquenil By Sergio Schwartzman, MD 12 October 2016 A recent article published by the American Academy of Ophthalmology AAO presented new recommendations for screening of patients being managed with hydroxychloroquine HCQ. Plaquenil and eye exams allie_bf posted For the last few years, my rheumagologist and opthamologist have disagreed on the frequency for eye exams my opthamologist says every year is sufficient, but my rheumatologist still insists every 6 months is what should be done. However in 2016, the price dramatically increased from ~ $0.16 to $6 per pill. Cost of biologic is ~$4000 for 40mg Humira for a 2 week dose Retinal toxicity is fairly rare. how rare is a big question Rheumatologists LOVE Plaquenil. SO MUCH LOVE. The most common side effects are nausea and diarrhea, which 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 guidelines for eye monitoring 2016 Wrong Hydroxychloroquine Dose Is Common, Putting Eyes at., Plaquenil and eye exams" Lupus Community - Support Group Can plaquenil cause ankle swelling To date, there are no data demonstrating that monitoring blood levels of HCQ is useful in dosing 34 HCQ to prevent retinal toxicity. 35 36 In addition to dose and duration of therapy, other factors must be considered when prescribing 37 HCQ and making recommendations about monitoring. AMERICAN COLLEGE OF RHEUMATOLOGY. PowerPoint. Update on Plaquenil Testing. How to Succeed in Plaquenil Screenings. Taking Plaquenil long-term or at high doses may cause irreversible damage to the retina of your eye. Stop taking Plaquenil and call your doctor at once if you have trouble focusing, if you see light streaks or flashes in your vision, or if you notice any swelling or color changes in your eyes. Call your doctor at once if you have PLAQUENIL is indicated for the treatment of chronic discoid lupus erythematosus and systemic lupus erythematosus in adults. Rheumatoid Arthritis. PLAQUENIL is indicated for the treatment of acute and chronic rheumatoid arthritis in adults. CONTRAINDICATIONS. Use of PLAQUENIL is contraindicated in patients with known hypersensitivity to 4 One PLAQUENIL tablet contains 200 mg of hydroxychloroquine sulfate, which is equivalent to 155 mg base. Take PLAQUENIL with a meal or a glass of milk.