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. Chloroquine nursing implications Plaquenil and early menopause Chloroquine methemoglobin Nsaid and plaquenil together Retinal toxicity from Plaquenil is of serious concern because even after cessation of the drug there is little if any visual recovery, and sometimes a progression of visual loss over several years after the drug has been stopped. Fortunately, retinal toxicity from plaquinil is quite rare relative to the number of individuals taking the medication. Plaquenil induced retinal toxicity is reversible if detected early and plaquenil dosage altered or the medication discontinued. Even suspicious early plaquenil toxicity warrants communication with the patient’s treating physician, and meaningful coordination of care would include a report even if the findings are normal. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is relatively rare, estimated at 1 percent after five years and rising with continued therapy. 3 However. 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 toxicity - EyeWiki, Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS Plaquenil help dry eyesAnother medication that can be taken with plaquenilWhat are the side effects of hydroxychloroquine sulfate Hi there, I normally post on the arthritis board, and due to toxicity of the Plaquenil after 2 years, I have had to discontinue it, since I failed the visual field testing. Although I take Enbrel, and MTX, neither one work as well as the Plaquenil and the fatigue and joint pain have returned full force. Discontinued Plaquenil.other options?. Multimodal Imaging in Plaquenil Toxicity. Is Damage Still Occurring? - Review of Optometry. The risk rises to nearly 20% after 20 years of use, but a patient who screens as normal after 20 years has only a 4% risk for converting to toxicity in the subsequent year. An example of advanced toxicity is presented here. A 68-year-old female with rheumatoid arthritis was treated with hydroxychloroquine 200 mg PO bid for almost five years. She complained of bilateral visual disturbances and discontinued the medication. She reported progressive symptoms for over one year following discontinuation. 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.