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. Can i drink alcohol while taking plaquenil Natural alternatives for plaquenil Chloroquine egfr Stop hair loss plaquenil There is a small risk that hydroxychloroquine can damage your retina part of the eye, and this increases with long-term use and higher dosage. Your doctor will advise you on a safe dose to take according to your weight, and you will need to have regular monitoring of your eyes. A risk factor for Plaquenil hydroxychloroquine retinotoxicity is a daily dose that exceeds 5.0 mg of drug per kg of body weight. The tool on the right simply calculates this threshold based on a patient’s real body weight. 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. 2,3. The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. 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). At risk lifetime dosage of hydroxychloroquine Plaquenil Uses, Dosage & Side Effects -, Plaquenil Risk Calculators Chloroquine thailand malariaChloroquine indiaCan chloroquine treat diarrheaHydroxychloroquine and dormancy The risk increases with a higher dose and longer therapy. Vision risks. Hydroxychloroquine is dosed according to body weight. The American Academy of Ophthalmology AAO currently defines an overdose of hydroxychloroquine as more than 5.0 milligrams mg per kilogram kg of body weight 1 kg equals 2.2 pounds or more than 400 mg a day. Wrong Hydroxychloroquine Dose Is Common, Putting Eyes at Risk. New Plaquenil Guidelines. PLAQUENIL HYDROXYCHLOROQUINE SULFATE TABLETS, USP DESCRIPTION. Daily hydroxychloroquine base doses 5 mg/kg actual body weight were associated with an ~10% risk of retinal toxicity within 10 years of treatment and an almost 40% risk after 20 years of therapy. Risk is most accurately assessed on the basis of duration of use relative to daily dose/body weight Marmor AAO 2016; Melles 2014. Risk factors that increase the chance of hydroxychloroquine retinopathy include daily dosage, cumulative dose, renal or liver disease, age, and previous retinal disease 9. A daily dose of 6.5mg/kg ideal body weight places patients at higher risk, but a daily dose below this level did not preclude the patient from developing toxicity after. Common, nonocular, side effects of chloroquine and hydroxychloroquine include pruritus, headaches, dizziness, and gastrointestinal upset. Less frequent side effects include discoloration of the oral cavity, nails, skin and hair and rash. HCQ myopathy is uncommon and presents with proximal muscle weakness and rarely ventilatory failure.