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. Can hydroxychloroquine cause erectile dysfunction 200 mg of plaquenil how long to work Plaquenil diarrhea Plaquenil dosage guidelines However, these findings do not explain the clinical pigmentary changes causing a bull’s-eye maculopathy. Medication Dosage. Several factors have been associated with the risk of developing hydroxychloroquine retinopathy. One of the most important appears to be dosage—with debate over whether daily intake vs. cumulative dosage is most. Major Risk Factors High dose and long duration of use are the most significant risks. Other major factors are concomitant renal disease, or use of tamoxifen. Screening Schedule A baseline fundus examination should be performed to rule out preexisting maculopathy. Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus. 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., Drug induced maculopathy - EyeWiki Plaquenil skin side effects pictures The AAO guidelines defined high-risk patients by any one of the following criteria HCQ treatment 5 years in duration, HCQ dose 6.5 mg/kg/day, significant renal or hepatic disease, preexisting maculopathy due to other etiology, age 60 years, obesity, or cumulative HCQ consumption of 1000 g. Hydroxychloroquine retinopathy A review of imaging. Retinal Physician - Hydroxychloroquine Maculopathy An.. Hydroxychloroquine And Chloroquine Screening 2016 AAO.. 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. There are risk factors which may increase the likelihood of an individual in developing symptoms of Plaquenil toxicity 1. Dosage The amount of drug the patient takes play a big role in increasing the risk for toxicity.