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. Hydroxychloroquine 200 mg uses in hindi Plaquenil patient assistance application Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg 5 mg/kg base of actual body weight, durations of use greater than five years, subnormal glomerular filtration. Following a single 200 mg oral dose of PLAQUENIL to healthy male volunteers, the mean peak blood concentration of hydroxychloroquine was 129.6 ng/mL, reached in 3.26 hours with a half-life of 537 hours 22.4 days. 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 retinal toxicity dose Hydroxychloroquine Dosage Guide with Precautions -, Plaquenil hydroxychloroquine sulfate dosing, indications. Plaquenil ear ringingHow about taking half of plaquenilGi problems with hydroxychloroquineDoes hydroxychloroquine have renal toxicity One reaches a cumulative dose of 1000 grams 1 kilogram at 7 years when taking the most commonly prescribed dose of 400 mg a day. A new study then focused on those patients that had taken HCQ over 5 years. This study revealed a much higher overall risk of 7.5% retinal toxicity among the 2361 patients studied. Chloroquine And Hydroxychloroquine Toxicity - StatPearls.. Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects.. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Nov 01, 2015 The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. The recommended adult dosage is 200 to 400 mg 155 to 310 mg base daily, administered as a single daily dose or in two divided doses. Doses above 400 mg a day are not recommended. The incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded. The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys.