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. Plaquenil toxicity vf Chloroquine hydrochloride Is plaquenil a steroid Plaquenil and codeine In this patient, the cumulative dose is 2,190,000 milligrams of plaquenil. This equals 2,190 grams of plaquenil and is above the 1,000 gram threshold for developing toxic maculopathy. The first patient may be screened every few years for toxic maculopathy while the second patient should be examined every six to twelve months. Feb 19, 2020 Plaquenil Hydroxychloroquine may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. Drugs A-Z Pill Identifier Supplements Symptom Checker Diseases Dictionary Media Let's dive in. Melton & Thomas describe the typical safe Plaquenil dosage this way The usual dosage is two 200mg tablets per day. This is generally a "safe" dose for patients having a lean body weight of at least 135 lbs. The generally-regarded safe dosage is 6.5mg/kg/qd, thus the 135 lb. safety threshold. 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 Hydroxychloroquine Plaquenil Dosing Calculator - MDCalc, Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects. Hydroxychloroquine for sjogren's syndromeEffects of hydroxychloroquine on tasteSigns of plaquenil retinopathy 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. Hydroxychloroquine Dosage Guide with Precautions -. Daily Plaquenil Dosage - Crunching Numbers —. Evaluation of Maculopathy in Patients Using Hydroxychloroquine. Plaquenil-induced maculopathy is a form of retinal toxicity that is associated with long-term use of of the anti-inflammatory medication plaquenil. The drug-induced maculopathy is associated with the following risk factors Cumulative dose level of 1,000 grams of plaquenil; Patients with existing retinal or macular disease; Patients over the. The patient reported being diagnosed with systemic lupus erythematosus SLE two years prior and secondary kidney and liver dysfunction. She said she was treated with 200mg to 400mg of Plaquenil hydroxychloroquine sulfate, Sanofi-Synthelabo per day for her lupus 4.4mg/kg to 8.8 mg/kg per day for two years with a cumulative dose of 276g. The patient said she was also prescribed prednisone for her lupus; the dose had been tapered from 5mg/day to 1mg/day. 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.