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. Aralen malaria medication Chloroquine philippines If patients are not screened prior to oral Hydroxychloroquine use they should be examined as soon as possible after starting this medication. Advances in technology, specifically the advent of optical coherence tomography, made screening and monitoring for Hydroxychloroquine toxicity much more easier and reliable meantime. Hydroxychloroquine is generally considered to be the safest DMARD, and a “go to” drug for pregnancy. Retinal pigment changes and retinal toxicity can occur with prolonged use. Early changes tend to be reversible but may progress despite discontinuation if advanced. Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. 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 toxicity monitoring HYDROXYCHLOROQUINE Shared Care Guideline V1, Hydroxychloroquine Plaquenil RheumTutor Calcium autophagy chloroquineNonbiological dmard antimalarial hydroxychloroquine plaquenilPlaquenil appetite lossChloroquine maculopathy guidelineHydroxychloroquine sulfate crush Annual screening may be commenced before 5 years of treatment if additional risk factors for retinal toxicity exist, such as concomitant tamoxifen therapy, impaired renal function eGFR less than 60 mL/minute/1.73 m 2 or high-dose therapy greater than 5 mg/kg/day of hydroxychloroquine sulfate. HYDROXYCHLOROQUINE SULFATE Drug BNF content published by NICE. New Plaquenil Guidelines. Hydroxychloroquine Plaquenil. Monitoring and Preventing Hydroxychloroquine, Plaquenil, Toxicity. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U. S. Federal Government. Ensure baseline monitoring of full blood count, biochemical profile ophthalmological examination and muscle function. Discuss how the patient / carer can be aware of possible signs hydroxychloroquine toxicity or intolerance Provide written instruction to the GP for initiation and escalation of hydroxychloroquine. Monitoring is intended to identify separate ocular disease that would interfere with identifying changes or baseline retinal disease that could increase hydroxychloroquine’s risk, as well as to detect the earliest changes related to hydroxychloroquine.