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 dosage for lupus Delayed allergic reaction to plaquenil Chloroquine resistance mechanism Periodic monitoring for early signs of macular toxicity, to lessen the risk of visual loss. Symptoms Over time, Plaquenil can accumulate in the retina and cause permanent irreversible damage to the center of vision. The classic retinal changes appear as a “bull’s eye” area of discoloration of the central part of the retina. 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. 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 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 SARCOIDOSIS TREATMENT GUIDELINES, Plaquenil and eye exams" Lupus Community - Support Group Hydroxychloroquine not workingPlaquenil skin cha ges Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Pattern of Retinopathy Although the locus of toxic damage is parafoveal in many eyes, Asian. Recommendations on Screening for Chloroquine and.. PLAQUENIL HYDROXYCHLOROQUINE SULFATE TABLETS, USP DESCRIPTION. My Take on New Ocular Screening Guidelines for Plaquenil.. We just need to get better at monitoring the eyes and dosing Plaquenil correctly.” New dosing guidelines for Plaquenil, which Lyons worked on, were published in the journal Ophthalmology. Thomas is enthusiastic about the updated guidelines, although he worries that the new dosing recommendations have not been widely disseminated to. Risk of Toxicity. DOSAGE IS SUPPOSED TO BE BASED ON IDEAL WEIGHT WOMEN 100 LBS FOR 5 FT AND 5 LBS FOR EACH EXTRA INCH OF HEIGHT – 5 ‘ 2 ‘’ SHOULD BE 110 LBS. MEN ADD 10 LBS - 5 ‘ 8 ‘’ SHOULD BE 150 LBS. 6.5 MG/KG/DAY. CUMULATIVE DOSE IS THE TRIGGER FOR TOXICITY 1000 GRAMS THE TIPPING POINT. MONITORING. Baseline CBC, lytes, Cr, BUN, AST, ALT. Baseline major eye exam. Every year, repeat basic labs described above and ensure repeat major eye exam to look for retinopathy due to this medication. CONTRAINDICATIONS. Hypersensitivity to hydroxychloroquine. Caution in patients with previous retinal or visual field changes.