Retinal toxicity from plaquenil years after discontinued

Discussion in 'Canadian Drug' started by kapik, 18-Mar-2020.

  1. Stalker33 Moderator

    Retinal toxicity from plaquenil years after discontinued


    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.

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    Hydroxychloroquine is excreted very slowly; may persist in urine for months or years after medication is discontinued {21} {31} {63}. Also excreted in bile {55}. Hemodialysis does not remove appreciable amounts of hydroxychloroquine from blood {68}. 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. Retinal toxicity from chloroquine is now rare in the U. S. as the medication has been largely replaced by hydroxychloroquine. These photographs show the toxic effects of chloroqine after taking a dose of 500mg daily for 5 years. There is central macular atrophy and arteriolar attenuation in both eyes.

    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

    Plaquenil Toxicity - Symptoms, Treatment, Risk Factors., Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS

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  6. A 55-year-old black female returned to the clinic for a six-month follow-up evaluation. Her ocular history was remarkable for Plaquenil hydroxychloroquine, Sanofi-Aventis macular toxicity. Her systemic history was significant for lupus, which was initially diagnosed 15 years earlier. For the last 14 years, she took 400mg Plaquenil QD.

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    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. 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. Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity. Plaquenil-induced toxicity usually will not occur before five years of taking the drug.

     
  7. Sommet Well-Known Member

    500 mg chloroquine phosphate (300 mg base) orally on the same day each week Comments: -If possible, suppressive therapy should start 2 weeks prior to exposure; if unable to start 2 weeks before exposure, an initial loading dose of 1 g chloroquine phosphate (600 mg base) may be taken orally in 2 divided doses, 6 hours apart. Autophagy - Selleckchem Chloroquine Oral Uses, Side Effects, Interactions. FAQs - Autophagy and LC3 - Novus Biologicals
     
  8. fabik Guest

    Please make sure that Javascript and cookies are enabled on your browser and that you are not blocking them from loading. PACKAGE LEAFLET INFORMATION FOR THE USER Avloclor 250 mg. Chloroquine Professional Patient Advice - Chloroquine - Wikipedia
     
  9. Ksena User

    Hydroxychloroquine toxicity - EyeWiki Jan 05, 2020 Advanced hydroxychloroquine toxicity presents as a bullseye maculopathy. Since retinal toxicity is usually irreversible, early detection of retinal toxicity and cessation of the offending agent is the best treatment 2 3.

    Hydroxychloroquine Plaquenil Toxicity and Recommendations.