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. Arthritis medicine hydroxychloroquine Is plaquenil a sulfonamide Is there withdrawal from hydroxychloroquine Hydroxychloroquine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away headache; dizziness; loss of appetite; nausea; diarrhea; stomach pain; vomiting; skin rash; If you experience any of the following symptoms, call your doctor immediately Side Effects Nausea, stomach cramps, loss of appetite, diarrhea, dizziness, or headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember. Taking Hydroxychloroquine develop toxicity2 It’s rare for side effects to occur with Plaquenil if the medication is dosed properly Side effects Blurred vision, bull’s eye maculopathy, scotoma, vortex keratopathy, headache, accommodative dysfunction, whitening of eyelashes, phototoxicity3 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. Symptoms of plaquenil toxicity Retinal Physician - Hydroxychloroquine Maculopathy An Update., Plaquenil Oral Uses, Side Effects, Interactions. Does plaquenil cause fatigueCan plaquenil be taken with naprosynHydroxychloroquine reviews sjogren& 39Plaquenil and pregnancy risk With Plaquenil related toxicity, the pigment in the macula can change and alter vision by producing blurring and distortion of objects. These changes, if they are going to occur, happen slowly over a long period of time. Your eye care provider can examine the macula and detect subtle changes before you begin to notice any symptoms of problems. Conditions Plaquenil-related Eye Problems Eugene Eye Care. Early Plaquenil Toxicity Detected without Bull’s Eye.. Plaquenil Toxicity" Lupus Community - Support Group. Common side effects may include headache, dizziness, ringing in your ears; nausea, vomiting, stomach pain; loss of appetite, weight loss; mood changes, feeling nervous or irritable; skin rash or itching; or. hair loss. Hydroxychloroquine sulfate is an antimalarial agent used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune, inflammatory and dermatologic conditions, with less toxic effects than chloroquine. 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.