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. Drinking alcohol while talking plaquenil Pilocarpine hydroxychloroquine 5 mg tablet 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. 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. 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. 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 Hydroxychloroquine Plaquenil, Plaquenil Side Effects on Your Eyes and Vision Plaquenil side effects go awayPlaquenil for pmrChloroquine-primaquine-phosphate tablets Highlights of the 2016 guidelines include the following. Use real body weight. “The bottom line is that the daily dose should be 5.0 mg per kg or less, using real body weight,” said Michael F. Marmor, MD, at Stanford University in Palo Alto, Calif. Plaquenil Guidelines Point Out New Risks, New Presentation.. Plaquenil and eye exams" Lupus Community - Support Group. Despite Plaquenil dosing recommendations, retinal toxicity.. 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. 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. That recommendation was lowered in March 2016 to 5.0 mg per kg of actual body weight, up to a maximum of 400 mg a day.