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. Chloroquine diphospahe bbguy Plaquenil for lupus mechanism Adults 800 mg 620 mg base followed by 400 mg 310 mg base at 6 hours, 24 hours and 48 hours after the initial dose total 2000 mg hydroxychloroquine sulfate or 1550 mg base. Daily Plaquenil Dosage - Crunching Numbers. NOTE. In fact, the cumulative dosage is thought to be a more significant risk factor, to the point where the incidence of HCQ retinotoxicity is less than 1% within the first 5 years of medication use. 1 Michaelides, M. et al. "Retinal Toxicity Associated with Hydroxychloroquine and. 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. 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. Plaquenil toxicity cumulative dose Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects., Daily Plaquenil Dosage - Crunching Numbers — Sierra leone chloroquine Specifically, a daily dose of 6.5mg/kg based on ideal body weight and a cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine are both considered risk factors for retinal toxicity. Therefore, lower daily doses do not necessarily preclude patients from developing toxicity due to the risk from cumulative dosage. Retinal Screening for Hydroxychloroquine Plaquenil Toxicity.. New Plaquenil Guidelines. Hydroxychloroquine toxicity - EyeWiki. 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. The same study revealed that the most important predictor of toxicity was the duration of use cumulative dose and that age, the daily dose, and patient weight did not correlate significantly with HCQ toxicity. One reaches a cumulative dose of 1000 grams 1 kilogram at 7 years when taking the most commonly prescribed dose of 400 mg a day. Doses ≥ 5 mg/kg/day real weight of hydroxychloroquine 2.3 mg/kg/day of chloroquine are associated with higher risk of toxicity. Doses lower than 5 mg/kg/day have low risk 1% for the first 5 years, and below 2% between 5-10 years of use. The longer you use the medication, the higher the risk of toxicity.