Plaquenil (Hydroxychloroquine) Toxicity


PLAQUENIL is indicated for the treatment of acute attacks and suppression of malaria.


PLAQUENIL is useful in patients who had systemic lupus erythematosus and acute or chronic rheumatoid artheritis.


After prolonged use, usually at least 5 years, pateints may rarely develop retinal toxicity from plaquenil.  The patient pictured on the right had been taking plaquenil for 15 years before developing the bull's eye macular lesions. 


Because of the possibility of retinal toxicity, patients taking plaquenil are usually followed by an ophthalologist periodically.  An examination testing visual acuity, color vision, amsler grid, visual field, and when necessary, fundus photography and fluorescein angiography will usually detect plaquenil toxicity before visual symptoms occur.  Patients with visual symptoms may notice vision loss or blind spots near the central vision.  Discontinuation of the drug usually stops the retinopathy and macular changes can reverse.