Plaquenil maculopathy cumulative dose

Discussion in 'Hydroxychloroquine 200 Mg Tablet' started by sarmat1, 20-Mar-2020.

  1. BLIBRAMAT Guest

    Plaquenil maculopathy cumulative dose


    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 the difference between hydroxychloroquine and chloroquine Recommended dosage of plaquenil Chloroquine and proguanil in pregnancy

    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. One kilogram kg equals 2.2 pounds. Women with lupus who are OVER their ideal body weight should go by these dosing rules 5’ 7” or higher - up to 400 mg Plaquenil daily Apr 20, 2011 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. Chloroquine and its derivative, hydroxychloroquine sulfate, which have been useful in treating malaria and in larger doses, collagen-vascular disease, cause a cumulative dose-related pigmentary retinopathy. Mechanism. Inhibition of critical enzymes & interference with the metabolic functions of retinal pigment epithelium RPE & photoreceptors.

    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 maculopathy cumulative dose

    Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS, New Plaquenil Guidelines

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  4. In this patient, the cumulative dose is 2,190,000 milligrams of plaquenil. This equals 2,190 grams of plaquenil and is above the 1,000 gram threshold for developing toxic maculopathy. The first patient may be screened every few years for toxic maculopathy while the second patient should be examined every six to twelve months.

    • H35.381-383 Toxic Maculopathy Of Retina - Decision-Maker PLUS.
    • Drug induced maculopathy - EyeWiki.
    • Hydroxychloroquine-induced bull's eye maculopathy - The..

    Jan 05, 2020 Risk for toxicity is least with less than 6.5 mg/kg/day for hydroxychloroquine and 3 mg/kg/day for chloroquine. Patients are at low risk during the first 5 years of treatment. Cumulative use in excess of 250 grams increases the risk for toxic retinopathy. Other risk factors include obesity, kidney or liver disease, older age. A cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine was likely the largest risk factor, which was typically achieved after 5-7 years of a typical dosage 8, 10. However, there have been case reports of patients with hydroxychloroquine toxicity as early as 1.9 months after starting treatment 11. Cumulative dose of 1000g HCQ is reached in 7 years with the daily dose of 400mg 19  Cumulative dose of 460g CQ is reached in 5 years with the typical daily dose of 250mg 19

     
  5. shushu Moderator

    I have been on the plaquenil 200 mgm for about 4 months now. Drug tapering An option, not a necessity, for patients. Gabapentin Withdrawal A Guide to Safe Methods OBR Prednisone Tapering Schedule to Reduce Withdrawal
     
  6. jungle2 Moderator

    Medications used to treat lupus Lupus Foundation of America Anti-inflammatory medications help to relieve many of the symptoms of lupus by reducing inflammation and pain. Anti-inflammatories are the most common drugs used to treat lupus, particularly symptoms such as fever, arthritis or pleurisy, which generally improve within several days of beginning treatment.

    Plaquenil Hydroxychloroquine - Side Effects, Dosage, Interactions - Drugs
     
  7. tco XenForo Moderator

    Hydroxychloroquine Oral Uses, Side Effects, Interactions, Pictures. Find patient medical information for Hydroxychloroquine Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.

    Hydroxychloroquine information booklet - Versus Arthritis