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. Brand name plaquenil cost Chloroquine phosphate doctors foster and smith The maximum dose of Plaquenil is 6.5 mg/kg of ideal body weight per day, regardless of whether a person is overweight, underweight, or normal weight. One kilogram kg equals 2.2 pounds. Women with lupus who are OVER their ideal body weight should go by these dosing rules 5’ 7” or higher - up to 400 mg Plaquenil daily In 2016, a revised version of the guidelines recommended a maximum dose of 5 mg/kg based on actual weight, with an examination at baseline and repeat screening — via optical coherence tomography. The AAO revised the guidelines in 2016 to define excess doses of hydroxychloroquine as greater than 5.0 mg/kg of actual body weight Ophthalmology. 2016;186-94. Based on these new guidelines, the investigators found that 56% of 527 patients who were currently receiving hydroxychloroquine were taking excess doses, and 43% of the 527 patients were still receiving doses that are more than 50 mg in excess of the calculated target dose that is recommended by the guidelines. 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). Hydroxychloroquine dosing guidelines Rx Side Effects New Plaquenil Guidelines and More., Experts debate hydroxychloroquine dosing guidelines in lupus Chloroquine po 300 mg dailyPanama chloroquine Mg daily, daily maximum dose to be based on ideal body-weight; maximum 6.5 mg/kg per day. HYDROXYCHLOROQUINE SULFATE Drug BNF content published by NICE. Hydroxychloroquine dosing guidelines have little impact in.. Hydroxychloroquine Plaquenil Dosing Calculator - MDCalc. 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. Dose 6.5 mg/kg/day, ideal body weight prior recommendation Dose 5 mg/kg/day, actual body weight latest recommendation Number % Crude OR 95% CI Multivariable a OR 95% CI Number % Crude OR 95% CI Multivariable a OR 95% CI Year of initial prescript 2007–2008 1099 40 1.00 Reference 1.00 Reference 1055 38 1.00 Reference Typical starting dosage 400–600 mg per day, given as a single daily dose or in two 2 divided doses.