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 side effects rash Plaquenil 200 mg indications Effects of plaquenil on eyes Aao plaquenil guidelines Annual screening may be commenced before 5 years of treatment if additional risk factors for retinal toxicity exist, such as concomitant tamoxifen therapy, impaired renal function eGFR less than 60 mL/minute/1.73 m 2 or high-dose therapy greater than 5 mg/kg/day of hydroxychloroquine sulfate. HCQ Hydroxychloroquine is an antimalarial drug used to treat or prevent malaria. It is highly effective against erythrocytic forms of Plasmodium, but not effective against exoerythrocytic forms of parasites. Hydroxychloroquine is also used to treat symptoms of acute or chronic rheumatoid arthritis and lupus erythematosus. Hydroxychloroquine is a quinoline medicine used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia. This medicine is not effective against all strains of malaria. 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). Hydroxychloroquine monitoring requirements AMERICAN COLLEGE OF RHEUMATOLOGY, HCQ - Clinical Hydroxychloroquine, Serum Chances of having a lupus flare when stopping plaquenil Hydroxychloroquine Plaquenil is a drug that is classified as an anti-malarial drug. Plaquenil is prescribed for the treatment or prevention of malaria. It is also prescribed for the treatment of rheumatoid arthritis, lupus, and the side effects of lupus such as hair loss, joint pain, and more. Hydroxychloroquine Plaquenil Side Effects & Dosage for.. Hydroxychloroquine Uses, Dosage & Side Effects -. New Plaquenil Guidelines. Hydroxychloroquine. Take monitoring booklet every time the patient sees the GP, has a hospital appointment or visits the pharmacist. Secondary care review During initiation 4 – 6 weekly until controlled Once disease controlled Annual review by consultant Availability 200mg tablet 60 = £5.15 Prices from November 2011 Drug Tariff Annual screening is recommended in all patients who have taken hydroxychloroquine for greater than 5 years; Annual screening may be commenced before 5 years of treatment if additional risk factors for retinal toxicity exist, such as concomitant tamoxifen therapy, impaired renal function eGFR less than 60 mL/minute/1.73 m 2 or high-dose therapy greater than 5 mg/kg/day of hydroxychloroquine sulfate. Hydroxychloroquine monitoring requirements. What monitoring is required for hydroxychloroquine? No routine laboratory monitoring is required for hydroxychloroquine. For people on long-term therapy 5 years or more, an annual eye assessment ideally including optical coherence tomography should be carried out.