She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Hydroxychloroquine 200 mg acetaminophen 400 mg Plaquenil and fevers Apr 10, 2019 Plaquenil is sometimes given only once per week. Choose the same day each week to take this medicine if you are on a weekly dosing schedule. Take Plaquenil with a meal or a glass of milk. To prevent malaria Start taking Plaquenil 2 weeks before entering an area where malaria is common. Continue taking the medicine regularly during your stay. According to revised Plaquenil screening protocol by American Academy of Ophthalmology, spectral domain OCT is the must have test to enable early detection. Spectral domain OCT scan is the only test that is sensitive enough to catch early changes much before other tests can detect. Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Plaquenil testing protocol Plaquenil Dosage Guide -, Plaquenil Use and & Eye Exam EyePlace Chloroquine breast cancer clinical trialWhat if hydroxychloroquine doesn t workPlaquenil makes me sleepySulfasalazine and hydroxychloroquine side effectsContraindications of methotrexate and plaquenil Jan 05, 2020 Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity to various parts of the eye such as the cornea, ciliary body, and retina. Chloroquine can also induce cataract formation; however, no reports of hydroxychloroquine and cataract have been reported. This article focuses upon hydroxychloroquine retinopathy. Disease Hydroxychloroquine toxicity - EyeWiki. How to Succeed in Plaquenil Screenings. Hydroxychloroquine Plaquenil MPKB. In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. 4 Baseline fundus photography was considered as an optional test. For women, start with 100 pounds, and add 5 pounds for every inch over 5 feet. For men, start with 106 pounds, and add 6 pounds for every inch over 5 feet. The maximum dose of Plaquenil is 6.5 mg/kg of ideal body weight per day, regardless of whether a person is overweight, underweight, or normal weight. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been replaced by HCQ.