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. Chloroquine and breast cancer Chloroquine mechanism of action cancer An appropriate dose is required to minimize the risk of hydroxychloroquine related retinopathy and to permit long-term use in most patients. The overall risk of developing hydroxychloroquine retinopathy in patients on long-term therapy is 7.5% with the risk increasing with higher doses and long-term use. The 2016 American Academy of Ophthalmology AAO Recommendations for Screening for Hydroxychloroquine and Chloroquine Retinopathy recommended a maximum daily HCQ use of 5.0 mg/kg real weight. The AAO also recommends a baseline fundus examination and annual screening after 5 years for patients without major risk factors. 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 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). Hydroxychloroquine dosing guidelines Plaquenil Dosage Guide -, The Great Debate at ACR 2018 Hydroxychloroquine Dosing. Plaquenil not working anymore for lupusPlasmodium falciparum chloroquine resistance transporterBrand name for hydroxychloroquineHydroxychloroquine used for hair loss The recommended dosage is no more than 6.5 mg/kg/day, using the standard known as “ideal weight,” which factors in height. Rx Side Effects New Plaquenil Guidelines and More.. Protecting your eyesight when taking Plaquenil Lupus.. Hydroxychloroquine prescription trends and predictors for.. 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. Both adults and children should take one dose of hydroxychloroquine per week starting at least 1 week. before traveling to the area where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving. The weekly dosage for adults is 310mg base 400mg salt. The guidelines were never intended to restrict the use of HCQ by rheumatologists, but rather to facilitate the prescription of HCQ by rheumatologists. He described the essentials of the guidelines, which recommend the maximum dose of HCQ should be ≤5.0 mg/kg of actual weight.