Is it safe to use quinacrine in SLE patients with a history of hydroxychloroquine-associated retinopathy?

To my knowledge, quinacrine, an anti-malarial, is not FDA-approved for use in the US. It may be obtained from compounding pharmacies but the FDA makes no assertions regarding either its safety or its efficacy. For lupus, it has been used primarily as adjunctive therapy for cutaneous disease, e.g. ad...

I do use quinacrine as an alternative to hydroxychloroquine (HCQ) and chloroquine (CQ) in patients with anti-malarial retinopathy. It has been reported as not causing retinopathy (Mittal et al., PMID 28989103).

Here, I give some tips on using Quinacrine (Thomas).

However, I must add some caveats:

• Not...

Quinacrine given as a single agent has a very low incidence of retinal toxicity and, in my opinion, is effective for both cutaneous and systemic lupus, particularly for patients with constitutional symptoms and fatigue.

That said, studies that have combined quinacrine with hydroxychloroquine in the ...