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 is drug chloroquine administered Can plaquenil cause you to gain weight Hydroxychloroquine 200mg equivalent I c hydroxychloroquine hsdd The action of hydroxychloroquine is cumulative and may require weeks to months to achieve the maximum therapeutic effect see CLINICAL PHARMACOLOGY. Initial adult dosage 400 mg to 600 mg 310 to 465 mg base daily, administered as a single daily dose or in two divided doses. In a small percentage of patients, side effects may require. Chloroquine and its derivative, hydroxychloroquine sulfate, which have been useful in treating malaria and in larger doses, collagen-vascular disease, cause a cumulative dose-related pigmentary retinopathy. Mechanism. Inhibition of critical enzymes & interference with the metabolic functions of retinal pigment epithelium RPE & photoreceptors. This apparently resulted in overdosing of thin patients. Thus, the patient’s real weight is now recommended as the basis for calculating the daily dose per weight in kg. Doses ≥ 5 mg/kg/day real weight of hydroxychloroquine 2.3 mg/kg/day of chloroquine are associated with higher risk of toxicity. 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 maculopathy cumulative dose Plaquenil Updates eyeupdate, Drug induced maculopathy - EyeWiki Chloroquine itch mouse behaviorPlaquenil to treat psoriasis Apr 20, 2011 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. New Plaquenil Guidelines. Hydroxychloroquine And Chloroquine Screening 2016 AAO Recommendations.. Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS. Itwas’previously’thoughtthatdaily’dosage’was’more’importantthan’whatwe’think’now.’’ Currently’we’are’more’interested’in’cumulative. Nov 25, 2019 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. 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 ; medication use longer than five years ; concomitant renal or liver disease because the drug is cleared by both routes underlying retinal disease or maculopathy ; age greater than 60 years.