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 cancer stem cell Plaquenil and vaccines Plaquenil side effects dreams 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. The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day 200 bid. 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. 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 Plaquenil Dosage Guide -, Plaquenil Risk Calculators What are symptoms of plaquenil eye problemsHow can you get hydroxychloroquinePlaquenil and pvc 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. Chloroquine Retinopathy - an overview ScienceDirect Topics. Hydroxychloroquine Plaquenil Toxicity and.. New Guidelines on Hydroxychloroquine Dosage - Where Are We.. The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. 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. 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 2011 AAO guidelines stated that a cumulative dose of 1000 g increases the risk of retinopathy equating to 6.85 years of treatment at 400 mg, and 13.7 years of treatment at 200 mg. However, the conclusions drawn on the significance of the cumulative dose are inconsistent.