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. Chloroquine injection route Where can i buy chloroquine Risk of Toxicity. DOSAGE IS SUPPOSED TO BE BASED ON IDEAL WEIGHT WOMEN 100 LBS FOR 5 FT AND 5 LBS FOR EACH EXTRA INCH OF HEIGHT – 5 ‘ 2 ‘’ SHOULD BE 110 LBS. MEN ADD 10 LBS - 5 ‘ 8 ‘’ SHOULD BE 150 LBS. 6.5 MG/KG/DAY. CUMULATIVE DOSE IS THE TRIGGER FOR TOXICITY 1000 GRAMS THE TIPPING POINT. One PLAQUENIL tablet contains 200 mg of hydroxychloroquine sulfate, which is equivalent to 155 mg base. Take PLAQUENIL with a meal or a glass of milk. 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. Pattern of Retinopathy Although the locus of toxic damage is parafoveal in many eyes, Asian. 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 guidelines for eye monitoring 2016 AMERICAN COLLEGE OF RHEUMATOLOGY, Plaquenil Dosage Guide - Plaquenil manufacturer change side effectsTaking methotrexate and plaquenilSide affects hydroxychloroquinePlaquenil overdose symptomsHydroxychloroquine sulphate overdose MONITORING. Baseline CBC, lytes, Cr, BUN, AST, ALT. Baseline major eye exam. Every year, repeat basic labs described above and ensure repeat major eye exam to look for retinopathy due to this medication. CONTRAINDICATIONS. Hypersensitivity to hydroxychloroquine. Caution in patients with previous retinal or visual field changes. Hydroxychloroquine Plaquenil RheumTutor. Recommendations on Screening for Chloroquine and.. New Plaquenil Guidelines -. What is Plaquenil or hydroxychloroquine? Hydroxychoroquine is an oral medication used for the treatment of rheumatologic conditions like lupus systemic lupus erythematosus – SLE, rheumatoid arthritis and other inflammatory conditions. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. It is now considered for new disease applications in diabetes, heart disease and adjunct cancer therapies 2. Highlights of the 2016 guidelines include the following. Use real body weight. “The bottom line is that the daily dose should be 5.0 mg per kg or less, using real body weight,” said Michael F. Marmor, MD, at Stanford University in Palo Alto, Calif.