While many of these can be grouped by anatomic location or type of toxicity, there are also individual medications with characteristic effects. In this article, we will describe several major categories of pharmacologic retinal toxicity and discuss examples of individual medications. Hydroxychloroquine undifferentiated connective tissue disease Plaquenil sjs Hydroxychloroquine retinopathy symptoms Apr 17, 2017 If signs of early toxicity are detected, your doctor may suggest to your rheumatologist to stop Plaquenil and switch to a different medication for your systemic illness. Sometimes the toxicity is not reversible. Purpose. To define the risk of hydroxychloroquine HCQ-related retinal toxicity in patients with rheumatoid arthritis RA and systemic lupus erythematosus SLE who are receiving recommended dosages of the drug ≤6.5 mg/kg/day. The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin -containing structures in the body. With prolonged usage, metabolites in the drug accumulate in the retina. The drug remains in these parts even if the patients stopped taking the drugs. Both medications have been shown to bind melanin and to concentrate in the iris, ciliary body and retinal pigment epithelium, altering normal physiologic function. Chloroquine (Aralen) and hydroxychloroquine (Plaquenil) are traditional antimalarial agents now used in the treatment of autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Retinal toxicity plaquenil reversible Rx Side Effects New Plaquenil Guidelines and More., The incidence of irreversible retinal toxicity in patients. Plaquenil and 5hr energyMetoprolol and hydroxychloroquineNon generic plaquenilHydroxychloroquine sulfate 200 mg oral tablet verified 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. Protecting your eyesight when taking Plaquenil Lupus.. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. Hydroxychloroquine-Induced Retinal Toxicity - American.. Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as. The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid. The reader's question and comment prompted me to do a little more research on the question of whether plaquenil toxicity was reversible which led me to the results of this study, which was published in JAMA Opthamology Jan 2011-- the same month and year as the Sjogren's Syndrome Foundation article was published. The study authors concluded.