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. Hydroxychloroquine and tanning Hydroxychloroquine azithromycin Is plaquenil an nsaid Zydus hydroxychloroquine While there have been reported cases of hydroxychloroquine toxicity at cumulative doses similar to our patient’s 1460 g over a 10 year period, these patients had 1 received chloroquine therapy before hydroxychloroquine therapy, 2 were treated with daily doses 400 mg/day, or 3 exceeded a daily dosage of 6.5 mg/kg of body weight/day.2 Our patient’s daily dose never exceeded 400 mg/day or 6.3 mg/kg of body weight/day. Her renal function was normal, thereby making the possibility of. The incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded. Rheumatoid Arthritis. The action of hydroxychloroquine is cumulative and may require weeks to months to achieve the maximum therapeutic effect. Following a single 200 mg oral dose of PLAQUENIL to healthy male volunteers, the mean peak blood. Retinopathy is rare with hydroxychloroquine when used at currently recommended doses 6.5 mg/kg/d, but increases markedly towards 1% after 5–7 years of usage or a cumulative dose of 1000 g of hydroxychloroquine. 257,258 The risk with chloroquine is thought to be significantly greater, with an increased risk at over 460 g chloroquine. In. 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. Hydroxychloroquine retinopathy cumulative dose Recommendations on Screening for Chloroquine and., Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects. Simple synthesis of chloroquine 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. Chloroquine retinopathy - Wikipedia. Chloroquine Retinopathy - an overview ScienceDirect Topics. Plaquenil Risk Calculators. There is an increased risk of HCQ retinopathy with increase in the cumulative dose. Per the prior 2011 AAO guidelines the recommended maximum dose to minimize HCQ retinal toxicity was 6.5 mg /kg based on ideal body weight 2. The advantage of the real body weight formula is that it distributes the risk evenly on a broad range of body habitus. Major risk factors for hydroxychloroquine-induced retinopathy include a cumulative dose of more than 1000 g, 3 a daily dose of more than 6.5 mg/kg, 3 duration of treatment longer than five years, 9 development of age-related changes to the eye, 10 pre-existing retinopathy, 7 kidney or liver disease, 4 and concurrent use of tamoxifen. 4 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.