Macular Degeneration: What Medications to Avoid

Studies suggest that certain drugs may increase your risk of age-related macular degeneration (AMD) or make AMD worse if you already have it. Examples include hydroxychloroquine and tamoxifen.

Research suggests that some medications may increase the likelihood or severity of AMD. The macula is a part of your eye’s retina, which helps produce central vision.

However, more studies are needed to confirm how these medications affect eye health and AMD, and what your overall risks may be. Talk with a doctor if you have any questions about a medication or AMD prevention, treatment, and outlook.

It may not be necessary to avoid or stop taking specific medications, especially if a doctor has recommended them for another health condition.

Experts are still trying

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National Eye Institute
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to find out the exact cause of AMD. However, they don’t currently believe it is caused by medications.

Still, some research suggests that specific medications could increase your risk

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International Journal of Obesity
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of experiencing retinal or macular damage. These medications include:

• hydroxychloroquine (Plaquenil, Quineprox, Sovuna), a medication for autoimmune and inflammatory conditions like arthritis
• tamoxifen (Nolvadex, Tamofen, Soltamox), a medication used to help treat breast cancer

Limited evidence also suggests that other medications

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could potentially raise the risk of or worsen AMD, such as:

• ocular antihypertensive eye drops
• antihypertensive medications, which help treat high blood pressure
• anticoagulant medications, which help prevent blood clots
• nonsteroidal anti-inflammatory drugs (NSAIDs)

However, doctors may not recommend avoiding medications like antihypertensives and anticoagulants, as more research is needed to confirm how they affect AMD and eye health. They can also offer significant health benefits, so it may not be beneficial to your overall health to stop them.

Many other factors can also increase your risk of AMD apart from medications, so it’s possible that a mix of factors are responsible for AMD developing in one person.

Hydroxychloroquine can cause retinal toxicity, a type of damage to your retina caused by medications.

A 2014 study

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JAMA
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reported that around 7.5% of people who took hydroxychloroquine continuously over 5 years developed retinal toxicity. Around 20% of people who took hydroxychloroquine regularly for 20 years developed retinal toxicity.

However, a small 2023 trial got people with AMD to take 400 milligrams (mg) of hydroxychloroquine daily for 12 months alongside their usual AMD treatment. Overall, people with AMD who took the hydroxychloroquine had less visual deterioration and drusen buildup, suggesting the medication helped protect against worse AMD. Still, more research is needed to confirm any benefits of hydroxychloroquine for AMD.

In some cases, tamoxifen may damage your retina.

Researchers from a 2024 review of studies suggest that around 12% of people who took 20 mg of tamoxifen daily for at least two years developed retinal damage, which led to vision impairments for some people.

Doctors may recommend stopping tamoxifen as cancer improves to reduce the risk of retinal damage. However, experts note that stopping tamoxifen cannot reverse visual damage from the medication once it has already happened.

Ocular antihypertensive eye drops contain medications to help reduce eye pressure. Doctors may prescribe them to treat conditions like glaucoma.

A 2022 study reported that people using certain ocular antihypertensive medications known as alpha-agonists had a higher chance of AMD developing or worsening. The study used health insurance claims data from 2006 to 2016.

Some researchers have noticed that taking medications for high blood pressure seems to link to a higher risk of AMD. However, evidence is mixed.

A 2022 study

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Wiley
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suggests that using second-generation calcium channel blockers could raise the risk of wet AMD.

Still, more research is needed to confirm whether the medications are responsible for increasing AMD risks, rather than another factor, such as having high blood pressure.

For example, a 2019 study focusing on females who took diuretics for high blood pressure had a higher risk of AMD than females who took stronger antihypertensive medications. This suggests that under-treated high blood pressure may be partly responsible for higher AMD risks, rather than the medications.

Other studies have also reported links between high blood pressure medications and AMD. A 2014 study suggested that taking vasodilator medications linked to a 72% higher risk of developing early AMD, while using oral beta blockers linked to a 71% higher risk of wet AMD.

Talk with a doctor if you take medications for high blood pressure and have questions about your health.

Anticoagulant or “blood-thinning” medications can increase your risk of bleeding, including in your eye’s macula. As a result, anticoagulant medications could contribute to worse AMD, as bleeding in your macula can cause further eye damage.

A 2024 study suggests that the anticoagulant warfarin (Coumadin, Jantoven) may have a higher risk of causing bleeding complications than direct oral anticoagulants. In the study, people who had dry AMD and took warfarin were more likely to later need care for macular bleeding.

Also, doctors often advise people with AMD to eat plenty of leafy green vegetables, as they may lower the risk of vision loss from AMD. However, leafy green vegetables are rich in vitamin K, which can lower warfarin’s effectiveness.

NSAIDs are medications used to reduce inflammation. Examples include:

• aspirin
• ibuprofen
• naproxen
• celcoxib
• etoricoxib
• diclofenac
• indomethacin

NSAIDs can increase your risk of bleeding, especially when taken along with anticoagulant medications. Bleeding in your retina can worsen AMD.

However, some research suggests that NSAIDs could reduce the risk of AMD in people who haven’t developed the condition yet.

A 2018 study

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surveying participants from the California Men’s Health Study suggested that longer-term use of any NSAID linked to a small decrease in the chances of wet AMD. The study also concluded that new users of any NSAID had a slightly lower chance of dry AMD.

More studies are needed before experts can confirm whether NSAIDs improve or protect against AMD.

Certain steps may help lower your risk

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National Eye Institute
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of AMD or improve the outlook of AMD if you already have it. These steps include:

• avoiding smoking or using other tobacco products
• getting regular physical activity
• working with a doctor to treat high blood pressure and high cholesterol
• using medications as prescribed, and talking with a doctor if you have any concerns or persistent symptoms
• eating a balanced diet, including omega-3 fatty acids and leafy green vegetables
• following your treatment plan for AMD if you already have a diagnosis for the condition
• getting regular comprehensive eye exams

Talk with a doctor if you have concerns about your risk of eye conditions or questions about managing AMD.

Some research

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suggests drinking alcohol in moderate to high amounts may lead to a higher chance of early age-related macular degeneration (AMD).

It may also help to limit drinks that are high in sugar. A high sugar intake can lead to high blood sugar levels, raising your risk of diabetes. Diabetes may make AMD more likely and more severe

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Centers for Disease Control and Prevention (CDC)
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.

Many factors can worsen AMD, including smoking, exposure to UV light, and dietary habits

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Wiley
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like eating too much highly processed food and red meat.

Certain health conditions can also affect your eye health and AMD, such as high blood pressure, high blood sugar, and high cholesterol levels.

If you have AMD, doctors may recommend taking AREDS or AREDS-2 supplements, which are often available over the counter.

However, always talk with a doctor before taking AREDS, AREDS-2, or any other remedies or medications for AMD.

Research suggests that some medications could potentially worsen AMD or increase your likelihood of developing it.

However, do not stop taking a prescribed medication without talking with your medical team first. Avoiding prescribed medications may have other negative impacts on your health.

Also contact a doctor if you have any questions about AMD or your medications.