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. Chloroquine dosage for lupus Can plaquenil and metoprolol tartrate be taken together Plaquenil nail discoloration The Hydroxychloroquine Dosing Calculator calculates appropriate daily dose of hydroxychloroquine. Calc Function ; Calcs that help predict probability of a disease Diagnosis. Subcategory of 'Diagnosis' designed to be very sensitive Rule Out. Disease is diagnosed prognosticate to guide treatment Prognosis. 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. A cumulative dose of 1000g HCQ is reached in 7 years with a typical daily dose of 400 mg. In the same study, toxicity was not related to age, weight or daily dose but was related to duration of use and increased rapidly after 5 to 7 years; thus, it is important to be aware of the risk factors and use more effective protocols of screening on all the patients who exceed 5 years of exposure. 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 Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS, H35.381-383 Toxic Maculopathy Of Retina - Decision-Maker PLUS Can you get high off hydroxychloroquine sulfatePlaquenil eye effectsHydroxychloroquine sulfate vs hydroxychloroquineWhen is the best time to take plaquenilIs there a difference between hydroxychloroquine and hydroxychloroquine sulfate Cumulative dose of 1000g HCQ is reached in 7 years with the daily dose of 400mg 19 Cumulative dose of 460g CQ is reached in 5 years with the typical daily dose of 250mg 19 Early Plaquenil Toxicity Detected without Bull’s Eye.. Retinal toxicity associated with chronic exposure to.. Daily Plaquenil Dosage - Crunching Numbers —. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Therefore, disturbed renal or hepatic function might reduce HCQ clearance and increase the propensity for toxicity. Nov 01, 2015 This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Therefore, disturbed renal or hepatic function might reduce HCQ clearance and increase the propensity for toxicity. 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.