Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking hydroxychloroquine: Incidence not known Some side effects of hydroxychloroquine may occur that usually do not need medical attention. Is plaquenil used to Plaquenil cumulative dose toxicity Retinal photograph showing classic “bull’s eye” retinopathy of hydroxychloroquine toxicity, which represents atrophy of the retinal pigment epithelium. This is a relatively late change, and good screening can detect toxicity before any bull’s eye is visible. click for large version Figure 2 Automated visual field. Hydroxychloroquine is associated with long-recognized retinal toxicity. 2, 3, 4 The retinopathy is hallmarked by parafoveal changes within the retina. Early toxicity may be asymptomatic. Chloroquine and hydroxychloroquine bind to melanin in the retinal pigment epithelium RPE and cause damage to the macular cones outside of the fovea. The drugs inhibit RPE lysosome activity, reduce phagocytosis of shed photoreceptor outer segments causing an accumulation of outer receptor segments. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. These side effects may go away during treatment as your body adjusts to the medicine. Hydroxychloroquine retinal toxicity Recommendations on Screening for Chloroquine and., New Guidelines for Hydroxychloroquine Visual Screening Hydroxychloroquine and sun sensitivityPlaquenil retinopathy pathogenesisPlaquenil patient assistance formsChloroquine autophagy inhibition Nov 01, 2015 H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. The most common side effect associated with its use is retinal toxicity, which may be irreversible. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Chloroquine And Hydroxychloroquine Toxicity - StatPearls.. Hydroxychloroquine-related retinal toxicity Rheumatology.. Aug 29, 2014 The Risk of Retinal Toxicity with Plaquenil. Plaquenil, hydroxychloroquine HCQ, is an anti-malarial medication that has been proven to be useful in the treatment of patients with rheumatoid arthritis RA, systemic lupus erythematosus SLE and other inflammatory and autoimmune diseases. Several studies have reported risk factors for hydroxychloroquine HCQ retinal toxicity, but data are limited for patients of Asian ancestry. The aim of this study was to investigate the rate of and factors for HCQ retinal toxicity in the Korean population. The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid.