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 toxicity heart Small bowel obstruction bowel obstruction take hydroxychloroquine Is plaquenil safe Drug cost for plaquenil There was a dose response, such that those receiving doses greater that 5 mg / kg had the greatest risk of retinal toxicity. Risk factors for retinopathy included higher doses and longer durations of use. Other major factors are concomitant renal disease, use of tamoxifen and prior retinal or macular disease. 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. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. 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). Chloroquine dosage ophthalmology guidelines New Guidelines on Hydroxychloroquine Dosage - Where Are We., Despite Plaquenil dosing recommendations, retinal toxicity. Plaquenil rash sunHydroxychloroquine withdrawalPlaquenil treatment for crestChloroquine dose per kgEyewiki plaquenil The dose of chloroquine is often expressed or calculated as the base each 500 mg tablet of chloroquine phosphate is equivalent to 300 mg chloroquine base. -The pediatric dose should never exceed the adult dose. Chloroquine Dosage Guide with Precautions -. Recommendations on Screening for Chloroquine and.. Medicines for the Prevention of Malaria While Traveling.. 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. Find patient medical information for Chloroquine Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. For women, start with 100 pounds, and add 5 pounds for every inch over 5 feet. For men, start with 106 pounds, and add 6 pounds for every inch over 5 feet. The maximum dose of Plaquenil is 6.5 mg/kg of ideal body weight per day, regardless of whether a person is overweight, underweight, or normal weight.