Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Plaquenil retina Does plaquenil lower blood pressure Purifying chloroquine phospahte Why chloroquine is given in liver abscess Once thought to be safe at a daily dose of 6.5mg/kg/day 16, newer studies show that many years of hydroxychloroquine treatment at a "safe dose" can still lead to toxicity 6. Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. The recommended adult dosage is 200 to 400 mg 155 to 310 mg base daily, administered as a single daily dose or in two divided doses. Doses above 400 mg a day are not recommended. The incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Plaquenil retinal toxicity dose Hydroxychloroquine-Induced Retinal Toxicity - American., Plaquenil Dosage Guide - Hydroxychloroquine dosage for osteoarthritis Plaquenil toxicity and lowering dosage Posted on August 28, 2015 by Luke — No Comments ↓ Plaquenil generic name hydroxychloroquine is one of the few medications that is regularly prescribed for Sjogren’s Syndrome, despite the fact that it has not been approved for SS by the FDA, so any use is off-label. Plaquenil toxicity and lowering dosage What You Sjo. Despite Plaquenil dosing recommendations, retinal toxicity.. How to Succeed in Plaquenil Screenings. Several recent studies have shown that instead of the classic perifoveal changes typical of hydroxychloroquine toxicity, Asians with retinal toxicity have a more peripheral pattern. The dose risk is calculated by REAL weight. Previous recommendations were based on ideal body weight, which is calculated solely on patient age, height, and sex 5. Sep 13, 2019 Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some. The most critical risk factor for the development of HCQ toxicity is excessive daily dose by weight. 2 Dosage 5.0 mg/kg dramatically increases both population risk and annual incremental risk, and extreme doses can be exceedingly dangerous.