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. What is aralen used for Does plaquenil come as an injection The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1. It succinctly makes the case for screening, and Dosage for the patients with possible retinopathy was 363 mgiday; control patients consumed a mean of 354 mgiday. Weight-adjusted dosage ranged from 1.73 to 8.8 mgikglday case mean 5.2 mgikgiday, control mean 5.1 mgikglday. 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. 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. Hydroxychloroquine retinopathy cumulative dose HCQ Retinopathy Update 2019 - Acuity Eye Center, Incidence of hydroxychloroquine retinopathy in 1,207. What is chloroquine used forChloroquine pretreatment degradation toxicityHydroxychloroquine reviews sjogren& 39 Major risk factors for hydroxychloroquine-induced retinopathy include a cumulative dose of more than 1000 g, 3 a daily dose of more than 6.5 mg/kg, 3 duration of treatment longer than five years, 9 development of age-related changes to the eye, 10 pre-existing retinopathy, 7 kidney or liver disease, 4 and concurrent use of tamoxifen. 4 Hydroxychloroquine-induced retinopathy in a 57-year-old woman. Plaquenil Dosage Guide -. Case Report Hydroxychloroquine Retinopathy Optometry and.. Keep chloroquine daily dose at 3 mg/kg/day and cumulative dose at 460 gm to reduce chances of retinopathy ; Keep hydroxychloroquine daily dose at 6.5mg/kg/day and cumulative dose at 1000gm to reduce chances of retinopathy ; Recognize that patients with renal failure are at unusually high risk of retinal toxicity Retinopathy is rare with hydroxychloroquine when used at currently recommended doses 6.5 mg/kg/d, but increases markedly towards 1% after 5–7 years of usage or a cumulative dose of 1000 g of hydroxychloroquine. 257,258 The risk with chloroquine is thought to be significantly greater, with an increased risk at over 460 g chloroquine. In. A cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine was likely the largest risk factor, which was typically achieved after 5-7 years of a typical dosage 8, 10. However, there have been case reports of patients with hydroxychloroquine toxicity as early as 1.9 months after starting treatment 11.