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. Otis pregnancy hydroxychloroquine Can plaquenil cause inflammation in my respiratory system Side effects hydroxychloroquine plaquenil Chloroquine action In a recent case–control study, it was found that patients who used hydroxychloroquine were at increased risk of dementia OR 1.91 1.39–2.64 for exposure ≥305 days on comparison with no exposure.3 However, a significant risk increase was also evidenced in people using methotrexate or sulfasalazine. The effect of hydroxychloroquine on progression of dementia in early Alzheimer's. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. INTRODUCTION Hydroxychloroquine HCQ is an alkalinizing lysosomatropic drug that accumulates in lysosomes where it inhibits some important functions by increasing the pH. HCQ has proved to be effective in a number of autoimmune diseases including systemic lupus erythematosus SLE. 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). At risk lifetime dosage of hydroxychloroquine Chloroquine And Hydroxychloroquine Toxicity - StatPearls., Hydroxychloroquine-Induced Retinal Toxicity - American. Does hydroxychloroquine affect bone graft healingChloroquine injection dosage for adultsPlaquenil vaginalPlaquenil and osteoporosisHydroxychloroquine manufacturer not work For individuals with significant risk factors daily dose of hydroxychloroquine sulfate 5.0 mg/kg base of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease monitoring should include annual examinations which include BCVA, VF and SD-OCT; for individuals without significant risk factors. Plaquenil hydroxychloroquine sulfate dosing, indications.. Hydroxychloroquine in systemic lupus erythematosus SLE.. Plaquenil Risk Calculators. 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 temporary reduction of the initial dosage. The risk increases with a higher dose and longer therapy. Vision risks. Hydroxychloroquine is dosed according to body weight. The American Academy of Ophthalmology AAO currently defines an overdose of hydroxychloroquine as more than 5.0 milligrams mg per kilogram kg of body weight 1 kg equals 2.2 pounds or more than 400 mg a day. 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.