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 stomach upset Retinal toxicity associated with hydroxychloroquine and chloroquine Hydroxychloroquine mechanism of action in sle Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage. While today it is used to treat autoimmune conditions, such as rheumatoid arthritis and lupus, it was originally used as an anti-malaria drug. As a treatment for sarcoidosis, the antimalarial drug hydroxychloroquine Plaquenil® is most likely to be effective in patients with dermatologic involve-ment, joint manifestations and hypercalcemia. Due to poten-tial macular toxicity, it is recommended that patients on hydroxychloroquine have an eye examination every 6-12 months. Methotrexate. 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. 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 New Guidelines on Hydroxychloroquine Dosage - Where Are We., SARCOIDOSIS TREATMENT GUIDELINES Plaquenil missed periodHydroxychloroquine metabolism cypReactions to plaquenilPlaquenil side effects nausea Aug 30, 2011 Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. It is now considered for new disease applications in diabetes, heart disease and adjunct cancer therapies 2. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Plaquenil Dosage Guide -. Plaquenil and eye exams" Lupus Community - Support Group. 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 The new guidelines recommend 10-2 automated perimetry, plus at least one of SD-OCT, FAF, or mfERG if they are available. These tests should be performed at baseline and at each subsequent evaluation. Other tests may be considered as well, but are generally insufficiently sensitive to detect early evidence of hydroxychloroquine toxicity. Hydroxychloroquine Plaquenil is considered a disease-modifying anti-rheumatic drug DMARD. It can decrease the pain and swelling of arthritis. It may prevent joint damage and reduce the risk of long-term disability. Hydroxychloroquine is in a class of medications that was first used to prevent and treat malaria.