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. Chloroquine half life Plaquenil 200mg Hydroxychloroquine how do you take it 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. Plaquenil-induced maculopathy is a form of retinal toxicity that is associated with long-term use of of the anti-inflammatory medication plaquenil. The drug-induced maculopathy is associated with the following risk factors Cumulative dose level of 1,000 grams of plaquenil. Patients with existing retinal or macular disease. Hydroxychloroquine retinopathy. It is known that some people who take. hydroxychloroquine for more than five years and/or in high doses are at increased risk of. damage to their retina, the light sensitive layer of cells at the back of the eye. This is known as. retinal toxicity or retinopathy. 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 Plaquenil Risk Calculators, Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS How is plaquenil excretedRestarting plaquenil The risk may be much higher because retinopathy can be detected earlier when using more sensitive screening techniques. OBJECTIVES To reassess the prevalence of and risk factors for hydroxychloroquine retinal toxicity and to determine dosage levels that facilitate safe use of the drug. The risk of toxic retinopathy in patients on long-term.. Eye screening for patients taking hydroxychloroquine.. Recommendations on Screening for Chloroquine and.. Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily. Abstract Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Although it is not possible to predict which patients will develop retinal toxicity, high-risk characteristics include the following daily dose greater than 400 mg or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight or total cumulative dose of more than 1,000 g.