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. How does plaquenil affect your eyes Plaquenil cause hair loss reddit Chloroquine malaria resistance Chloroquine 500 mg dosing Initial dose 400 mg 310 mg base orally 1 to 2 times a day; this dose may be continued for several weeks or months, depending on patient response Maintenance dose 200 to 400 mg 155 to 310 mg base orally daily Reported risk factors for toxicity include daily dose 400 mg, or 6.5 mg/kg ideal/lean body weight for short individuals; cumulative dose 1000 g; duration of use 5 years; renal or hepatic dysfunction; obesity; age 60 years; and pre-existing retinal disease or maculopathy. The most critical risk factor for the development of HCQ toxicity is excessive daily dose by weight. 2 Dosage 5.0 mg/kg dramatically increases both population risk and annual incremental risk, and extreme doses can be exceedingly dangerous. 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 Retinal Physician - Hydroxychloroquine Maculopathy An Update., Hydroxychloroquine-related retinal toxicity Rheumatology. Can plaquenil raise blood pressurePlaquenil 100mg tabletsHydroxy chloroquine rheumatoid arthritis pregnancy The prevalence of retinal toxicity was 36.2% among patients who used ≤200 mg HCQ per day and 8.3% among those who used 200 mg HCQ per day, and there was no significant association between daily HCQ dose and retinal toxicity P = 0.062. Retinal Toxicity in Patients Treated With Hydroxychloroquine.. Recommendations on Screening for Chloroquine and.. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. 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. Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. Chloroquine Major Avoid coadministration of hydroxychloroquine and chloroquine due to therapeutic duplication as well as increased risk of retinal toxicity, QT prolongation, and torsade de pointes TdP. Hydroxychloroquine prolongs the QT interval.