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. Hydroxychloroquine sulfate monitoring What is plaquenil diagnosed for Hydroxychloroquine pharmacotherapy There was a dose response, such that those receiving doses greater that 5 mg / kg had the greatest risk of retinal toxicity. Risk factors for retinopathy included higher doses and longer durations of use. Other major factors are concomitant renal disease, use of tamoxifen and prior retinal or macular disease. Usual Adult Dose for Malaria Prophylaxis. Suppression 400 mg 310 mg base orally on the same day every week Comments-Suppressive therapy should begin 2 weeks prior to exposure; however, failing this, an initial dose of 800 mg 620 mg base may be taken in 2 divided doses 6 hours apart. Mar 01, 2011 Hydroxychloroquine is dispensed in 200 mg tablets, so an “average” 70-kg patient using the common dose of 200 mg bid actually would be receiving a slight overdose according to this threshold. Nevertheless, the 200 mg bid dosage is commonly prescribed. 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). Chloroquine dosage ophthalmology guidelines New guidelines to minimize toxic damage from chloroquine and., Hydroxychloroquine Dosage Guide with Precautions - Treatment of hydroxychloroquine retinopathyChloroquine work in the body govSide effects of hydroxychloroquinPlaquenil for inflammatory arthritisPrimaquine chloroquine Occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving. The weekly dosage for adults is 300mg base 500mg salt. Your doctor will have calculated the correct weekly. dose for your child based on the child’s weight. The child’s dose should not exceed the adult dose of 300mg base 500mg salt per week. Medicines for the Prevention of Malaria While Traveling.. Retinal Physician - New Screening Guidelines for.. Hydroxychloroquine And Chloroquine. - Ophthalmology Review. Oct 04, 2019 Based on these risks, the American Academy of Ophthalmology AAO recommends not exceeding a daily chloroquine phosphate dosage of 2.3 mg/kg using actual body weight. Previous recommendations to use ideal body weight are no longer advised; very thin patients in particular were at increased risk for retinal toxicity using this practice. Previous 30 recommendations by the AAO to limit HCQ dosing to 6.5 mg/kg of ideal body weight have been 31 revised to 5 mg/kg of actual body weight 5. Some authors recommend 6.5 mg/kg of actual 32 body weight with a cap at 400 mg per day and further adjustments for renal insufficiency 10. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight.