Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Chloroquine effective against malaria Plaquenil bradycardia Plaquenil retinopathy visual fields Plaquenil is manufactured in only a 200 mg tablet The typical dosage is either 200 or 400 mg per day 200 mg daily puts anyone under 68 pounds at risk1 400 mg of Plaquenil daily puts anyone under 135 pounds at a higher risk for toxicity Therefore, 200mg of Plaquenil daily is going to be a safe dosage for virtually all adults13 In 2011, guidelines warned about toxicity risk at a cumulative dose of 1000 g or exceeding 6.5 mg/kg body weight/day. For a typical patient, most would reach the cumulative dose at 200 mg bid in 5 years. 2 It is rare for vision changes to occur. Our results show that the prevalence of hydroxychloroquine retinopathy is much higher than previously recognized and depends on risk factors such as daily dose, duration of use, and kidney disease. The results also suggest the need to revise the way that dosage is calculated to minimize risk. Risk of Toxicity: The risk of toxicity is dependent on daily dose and duration of use. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Plaquenil maculopathy risk The risk of toxic retinopathy in patients on long-term., Determine risk for hydroxychloroquine retinal toxicity. Can you take plaquenil with leaky gutRecommended eye for sjogrens plaquenil Feb 19, 2020 SIDE EFFECTS. The following adverse reactions have been identified during post-approval use of PLAQUENIL or other 4-aminoqunoline compounds. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Side Effects of Plaquenil Hydroxychloroquine, Warnings, Uses. The Risk of Toxic Retinopathy in Patients on Long-term.. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. 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 ppatient’s real body weight. It’s important to understand that the daily dose is only one risk factor for plaquenil retinotoxicity. Utterback’s rheumatologist also referred her to neuro-ophthalmologist David Katz, MD, in Bethesda, Md. “We don’t know which patients might develop Plaquenil retinopathy, but the patient often can see it before the doctor can,” he says. Here are some important warning signs Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy.