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. Hydroxychloroquine nsaid cream Chloroquine classification Can hydroxychloroquine cause dry eyes The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring 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. One reaches a cumulative dose of 1000 grams 1 kilogram at 7 years when taking the most commonly prescribed dose of 400 mg a day. A new study then focused on those patients that had taken HCQ over 5 years. This study revealed a much higher overall risk of 7.5% retinal toxicity among the 2361 patients studied. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. 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 retinal toxicity dosage Retinal Screening for Hydroxychloroquine Plaquenil Toxicity., Chloroquine And Hydroxychloroquine Toxicity - StatPearls. Does plaquenil cause high blood sugar 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. Hydroxychloroquine-Induced Retinal Toxicity - American.. My Take on New Ocular Screening Guidelines for Plaquenil RheumNow.. Recommendations on Screening for Chloroquine and.. Postmarketing cases of life-threatening and fatal cardiomyopathy reported with use of hydroxychloroquine as well as of chloroquine. Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg 5 mg/kg base of actual body weight, durations of use greater than five years, subnormal glomerular filtration, use of some concomitant drug. The prevalence of retinal toxicity was 36.2% among patients who used ≤200 mg HCQ per day and 8.3% among those who used 200 mg HCQ per day, and there was no significant association between daily HCQ dose and retinal toxicity P = 0.062. Plaquenil side effects Get emergency medical help if you have signs of an allergic reaction to Plaquenil hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Taking Plaquenil long-term or at high doses may cause irreversible damage to the retina of your eye.