Chloroquine is now uncommonly used in favor of its derivative hydroxychloroquine. In the United States, hydroxychloroquine is most often used for its anti-inflammatory effects in rheumatology and dermatology. Plaquenil pain relief Chloroquine sleep Autophagy inhibitors hydroxychloroquine Plaquenil and antacids Another speculation, based on the macular localization of the toxicity, is that light absorption or cone metabolism may play a role in its effect. 1 Clearance of the drug from blood and urine can take months to years after discontinuation, and a few patients have shown continued toxicity years after hydroxychloroquine treatment was stopped. 3 A 55-year-old black female returned to the clinic for a six-month follow-up evaluation. Her ocular history was remarkable for Plaquenil hydroxychloroquine, Sanofi-Aventis macular toxicity. Her systemic history was significant for lupus, which was initially diagnosed 15 years earlier. For the last 14 years, she took 400mg Plaquenil QD. PLAQUENIL hydroxychloroquine sulfate tablets is indicated for the treatment of rheumatoid arthritis, and discoid and systemic lupus erythematosus, in patients who have not responded satisfactorily to drugs with less potential for serious side effects. While early toxicity may be asymtomatic, patients with more advanced stage of toxicity may complain of color vision changes or paracentral scotomas. Its toxic effects on the retina are seen in the macula. Retinal toxicity from plaquenil years after discontinued Hydroxychloroquine Sulfate Drug Information, Professional, Is Damage Still Occurring? - Review of Optometry Plaquenil arava After seeing MANY professionals including a neurologist, a retinal specialist, neuro-ophthalmologist, and undergoing MANY different tests, she was diagnosed with Plaquenil toxicity. She does have field of vision loss, mostly on things that are close up. She took Plaquenil for almost five years before having any symptoms. Has anyone experienced plaquenil toxicity with damage to eyes?. Plaquenil Hydroxychloroquine Sulfate - Sanofi. Hydroxychloroquine-Induced Retinal Toxicity - American.. At recommended doses, the risk of toxicity up to 5 years is under 1%, under 2% up to 10 years, and rises to almost 20% after 20 years. Patients who are receiving Plaquenil need to have a yearly ocular examination beginning at least within 5 years of starting therapy, including a dilated retinal examination, central visual field testing, and OCT scanning. The drug is usually discontinued at the earliest sign of macular damage since vision loss is usually permanent and can even progress. A cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine was likely the largest risk factor, which was typically achieved after 5-7 years of a typical dosage 8, 10. However, there have been case reports of patients with hydroxychloroquine toxicity as early as 1.9 months after starting treatment 11. Retinal toxicity is a very rare side effect of the hydroxychloroquine therapy, but when it has occurred, vision loss may be permanent and may progress even years after the cessation of medication. Patients would be examined every 3 months, then annually, until they are stabled.