PAD - Prescribing Advisory Database
PLEASE NOTE : This is a development system.

For Surrey PAD, please go to https://surreyccg.res-systems.net/PAD.

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PAD Profile : Hydroxychloroquine sulfate - Rheumatology indications

Keywords :
Inflammatory disorders, RA, SLE, Systemic lupus erythematosus, Rheumatoid Arthritis, retinopathy eye screening, shared care
Brand Names Include :
Plaquenil

Traffic Light Status

Status 1 of 1.

Status :
Amber
Formulations :
  • Tablets
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
Comments :
No comments returned.
Documents :

Guidelines

No guidelines returned.

Other Drugs

Other Indications

Additional Documents

Committee Recommendations

Date
Committee Name
Narrative
06 November 2024
Surrey Heartlands Integrated Care System Area Prescribing Committee (APC)

The Royal College of Ophthalmologists issued monitoring guidelines in 2020 that recommend annual retinopathy monitoring to begin after 1 year of drug therapy for patients with additional risk factors for retinal toxicity: 

  • Concomitant tamoxifen use
  • Impaired renal function (eGFR <60ml/min/1.73m2)
  • Dose of hydroxychloroquine greater than 5mg per kg per day
  • Chloroquine use

For all other patients, monitoring begins after 5 years of drug therapy.

The current arrangements for opthalmology monitoring are:

East Surrey Place: see narrative below from Feb 2020

Guildford & Waverley Place: A retinopathy screening service is provided by Frimley Health NHS Foundation Trust. A self-populating referral form is available on EMIS.

North West Surrey Place: A retinopathy screening service is provided by Frimley Health NHS Foundation Trust. A self-populating referral form is available on EMIS.

Guidelines from the Royal College of Ophthalmologists: Hydroxychloroquine-and-Chloroquine-Retinopathy-Monitoring-Guideline.pdf (rcophth.ac.uk)

06 September 2023
Surrey Heartlands Integrated Care System Area Prescribing Committee (APC)

The Surrey Heartlands Integrated Care System Area Prescribing Committee have agreed a change in traffic light status for hydroxychloroquine for patients within adult services from BLUE to AMBER.

21 February 2020
East Surrey CCG Medicines Programme Board

ESCCG and SASH LOCAL ARRANGEMENTS:

The Royal College of Ophthalmologists issued guidelines which recommend that all patients planning to take hydroxychloroquine long term i.e. over five years have a baseline examination in a hospital eye department ideally within six months, but definitely within 12 months. Patients should be referred for annual screening after five years of therapy and be reviewed annually thereafter whilst on therapy.

A retinopathy screening service is available at SASH NHS Trust and three referral letters have been developed for use - see template letters below

Associated BNF Codes

10. Musculoskeletal and Joint Diseases
10.01.03. Rheumatic disease suppressant drugs
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