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. What is plaquenil used for in lyme Chloroquine and breastfeeding 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. For individuals with significant risk factors daily dose of hydroxychloroquine sulfate greater than 5.0 mg/kg base of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease monitoring should include annual examinations which include BCVA, VF and SD-OCT. 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. 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 Hydroxychloroquine Dosage Guide with Precautions -, PLAQUENIL HYDROXYCHLOROQUINE SULFATE TABLETS, USP DESCRIPTION Plaquenil radiation therapyPlaquenil arthritis side effectsHydroxychloroquine wr walter reedPlaquenil kidneys Some people who take Plaquenil have a higher risk of retinal damage than others. They include people taking Plaquenil for 5 or more years. people taking Plaquenil at higher doses than recommended. people who already have retinal disease. people who already have kidney or liver disease. people over 60 years old. Who Is at Risk for Vision Loss with Plaquenil? - American.. Wrong Hydroxychloroquine Dose Is Common, Putting Eyes at Risk. Hydroxychloroquine Plaquenil Dosing Calculator - MDCalc. What is Hydroxychloroquine, and What Does It Do? According to the American College of Rheumatology, hydroxychloroquine Plaquenil, is a “disease-modifying anti-rheumatic drug DMARD,” meaning that it helps reduce the pain and swelling that come with arthritis. It can also reduce the incidence of joint damage, thus lessening the risk of. 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. 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.