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. Granulomatous nodules treated with plaquenil Plaquenil suddenly stopping and mania Is plaquenil a thiopurine drug Folic acid and hydroxychloroquine dosing The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. 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. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. 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 dosage maculopathy Hydroxychloroquine Dosage Guide with Precautions -, Drug induced maculopathy - EyeWiki Hydroxychloroquine side effects hair lossHydroxychloroquine annual monitoringWhat is the difference between hydroxychloroquine and chloroquineChloroquine phosphate brand name Hydroxychloroquine is typically prescribed at 200mg/day to 400 mg/day. Dosage should be based on ideal body weight, not actual body weight because the medication is not retained in fatty tissues. 3,4,9 A 200mg tablet is safe for all but the smallest patients. Does Patient with Lupus Have Plaquenil Retinopathy?. The Risk of Retinal Toxicity with Plaquenil. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. What is the dosage for hydroxychloroquine Plaquenil? The usual adult dose for treating malaria is 800 mg initially, followed by 400 mg 6-8 hours later and then 400 mg at 24 hours and 48 hours. The dose for malaria prevention is 400 mg every week starting 1 or 2 weeks before exposure and for 4 weeks after leaving the high risk area. Initially, its manufacturers recommended that hydroxychloroquine dosage be no higher than 6.5 mg/kg of ideal body weight to prevent retinopathy. 1,29,30 However, it has recently been demonstrated that real body weight is a better predictor of risk of retinopathy than ideal body weight when dosing hydroxychloroquine, perhaps because of the increasing variance of real body weight in our patient population. 26 The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid.