Most importantly, you help support continued development of this site. The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine (Plaquenil). This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day (200 bid). Can drink if i using hydroxychloroquine Plaquenil rash pictures Hydroxychloroquine plaquenil oitcome for lupas patients Hydroxychloroquine and chloroquine comparison An audit of 100 patients seen at any of nine Canadian rheumatology clinics during early 2016 showed that 30% of patients were not on appropriate weight-based hydroxychloroquine dosages, and 13% of patients on the drug had not received a baseline retinal assessment during their first year. 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. Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg 5 mg/kg base of actual body weight, durations of use greater than five years, subnormal glomerular filtration. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. Hydroxychloroquine weight based dosing Adherence to Weight-Based Dosing Guidelines in Patients., Wrong Hydroxychloroquine Dose Is Common, Putting Eyes at Risk. Optometrist letter to primary care physician plaquenilMechanism of chloroquine on lysosomePlaquenil dx code Weight-based dosing Dose is based on body weight and must be determined by your doctor. At first, 6.5 mg per kilogram kg of body weight, not to exceed 400 mg, once weekly on the same day of the week starting 2 weeks before traveling to an area where malaria occurs, and continued for 4 weeks after leaving the area. Hydroxychloroquine Oral Route Side Effects - Mayo Clinic. Plaquenil hydroxychloroquine sulfate dosing, indications.. Ideal Body Weight for Calculating Hydroxychloroquine Dosage.. Background/Purpose Hydroxychloroquine HCQ is a widely-used medication in many rheumatologic conditions. The most worrisome toxicity is irreversible damage to retinal pigment epithelium which can lead to blindness. The most recent 2016 guidelines from the American Academy of Ophthalmology AAO recommend the dose of HCQ ≤5 mg/kg real body weight to minimize toxicity1. According to these Dosing is usually much lower in children and infants depending on their body weight, usually 5 mg, calculated as base, per kilogram kg of body weight one 200 mg tablet = 155 mg base. Child dosages should never exceed adult dosages. To treat lupus, one or two tablets are usually taken once or twice a day. The dosage is based on body weight. 6.5 mg/kg maximum dose 400 mg should be given on the same day each week starting 2 weeks before exposure to malaria.