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. Does hydroxychloroquine make you gain weight Plaquenil drug class Last February I discontinued taking plaquenil after 22 years of being on 400mg a day 200mg 2x day. When I had my annual eye exam the dr told me I had reached the max plaquenil toxicity level which could cause retina cell to die. The good news is that the eye exam did not have any evidence of this problem. A cumulative dose that increases the risk of retinal toxicity • 1000g total Hydroxychloroquine HCQ • 460 g total Chloroquine CQ Cumulative dose of 1000g HCQ is reached in 7 years with the daily dose of 400mg19 Cumulative dose of 460g CQ is reached in 5 years with the typical daily dose of 250mg19 Doses ≥ 5 mg/kg/day real weight of hydroxychloroquine 2.3 mg/kg/day of chloroquine are associated with higher risk of toxicity. Doses lower than 5 mg/kg/day have low risk 1% for the first 5 years, and below 2% between 5-10 years of use. The longer you use. 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 cumulative dose toxicity Chloroquine and Hydroxychloroquine Toxicity Practice., Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy Plaquenil maculopathy treatmentPlaquenil autoimmunePlaquenil and turmericSam-e hydroxychloroquineHydroxychloroquine toxicity eye exam Let's dive in. Melton & Thomas describe the typical safe Plaquenil dosage this way The usual dosage is two 200mg tablets per day. This is generally a "safe" dose for patients having a lean body weight of at least 135 lbs. The generally-regarded safe dosage is 6.5mg/kg/qd, thus the 135 lb. safety threshold. Daily Plaquenil Dosage - Crunching Numbers —. Hydroxychloroquine And Chloroquine Screening 2016 AAO.. New Guidelines on Hydroxychloroquine Dosage - Where Are We.. Jan 03, 2020 Adults 800 mg 620 mg base followed by 400 mg 310 mg base at 6 hours, 24 hours and 48 hours after the initial dose total 2000 mg hydroxychloroquine sulfate or 1550 mg base. Presentation. The risk of toxicity is low for individuals without complicating conditions during the first 5 years of treatment using less than 6.5 mg/kg/day of hydroxychloroquine or 3 mg/kg/day of chloroquine, and/or cumulative doses of less than 1000 gram and 460 gram total dose, respectively. The risk of plaquenil-induced toxic maculopathy is associated with a cumulative dose level of 1,000 grams and it usually takes 5-7 years for patients on the standard dose of 250-400 milligrams per day to reach that level.