Tamoxifen plus Plaquenil anyone? Eye problems?

SummerAngel · July 2015

I've been taking Plaquenil for a couple of years now with no issues. I started taking Tamoxifen about a month ago. I've noticed that my eyes have been bothering me more and more, especially in the last couple of days. I feel like I can't see clearly, like there's something in my eyes all the time. Near the end of the day I've been developing a headache from it. I know both of these meds are tough on the eyes and I plan to talk to my docs about it, but if it comes down to quitting one or the other I'm not sure what to do. The Plaquenil greatly reduces the frequency of flares of my connective tissue disease, which were pretty bad before I started taking it. Everyone here knows what the Tamoxifen does. According to my Oncotype results, my risk of recurrence with Tamoxifen is 6%, so I assume without it's about 12%.

Has anyone else had issue like this with both meds and if so, what did you do?

glennie19 · July 2015

Summerangel: there is a drug interaction between tamoxifen and Plaquenil. Plaquenil reduces the effectiveness of tamoxifen.

Drug to Drug Interactions:Tamoxifen and Hydroxychloroquine

Tamoxifen has its effect reduced by Hydroxychloroquine. (source: Clinical Pharmacology)

Both meds do have side effects assoicated with vision,, but whether they would be additive being on both, I'm not sure.

coraleliz · July 2015

Tamoxifen alone, took the joy out of reading. If you've noticed a decrease in vision since starting on Tamoxifen, that's reason to see an opthamologist. My reading is limited because my eyes feel tired & I just can't stick with it.

I didn't have an eye exam or opthamologist prior to BC. I read that you should have an eye exam prior to starting Tamoxifen. My MO never mentioned it & I was tired of MD appts at that point. I did notice a decrease in vision. Eventually I went to the eye doctor & he found cataracts forming. Don't know if I had them before starting tamox. So now I get my eyes monitored. As for cataracts, both my parents had them. I'm outdoors a ton. I would have gotten them anyway. But maybe at 70 & not 53. I will eventually need surgery.

I was told to call for an appt if I noticed a sudden decrease in vision.

SummerAngel · July 2015

Thanks for the replies! Interesting that my eye issues could just be caused by the Tamoxifen itself. I'm lucky in that I've been seeing an opthamologist every year since starting on Plaquenil, so if I get an exam they'll be able to see changes. I'm going to go ahead and schedule an exam, even though it's only been 6 months since my last one.

Glennie, that's interesting, because my searching has come up with just the opposite: http://clincancerres.aacrjournals.org/content/20/1...

There is now a call for more study to be done with the combination of drugs in order to reverse Tamoxifen resistance.

I was only able to find one study that mentioned eye issues being made more likely by the combination of both meds, and that study was specific to Plaquenil: http://www.ncbi.nlm.nih.gov/pubmed/25275721

"The overall prevalence of hydroxychloroquine retinopathy was 7.5% but varied with daily consumption (odds ratio, 5.67; 95% CI, 4.14-7.79 for >5.0 mg/kg) and with duration of use (odds ratio, 3.22; 95% CI, 2.20-4.70 for >10 years). For daily consumption of 4.0 to 5.0 mg/kg, the prevalence of retinal toxicity remained less than 2% within the first 10 years of use but rose to almost 20% after 20 years of use. Other major risk factors include kidney disease (odds ratio, 2.08; 95% CI, 1.44-3.01) and concurrent tamoxifen citrate therapy (odds ratio, 4.59; 95% CI, 2.05-10.27)."

Tamoxifen plus Plaquenil anyone? Eye problems?

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