PLAQUENIL film-coated tablets cannot be divided, therefore they should not be used to treat patients who weigh less than 31 kg. For radical cure of The recommended adult dosage is 200 to 400 mg (155 to 310 mg base) daily, administered as a single daily dose or in two divided doses. The incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded. Aao preferred practice patterns plaquenil What is the drug plaquenil used for Info plaquenil Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity. Plaquenil-induced toxicity usually will not occur before five years of. 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. In a small percentage of patients, side effects may require. The risk of retinal toxicity was initially believed to be less than 1% after long-term or a cumulative dosage of 1,000mg. 3 The toxicity would double by 10 years, resulting in a 20% prevalence after 20 years. 4 However, research now shows toxicity continues even after cessation of the drug. 5 Thus preventing and detecting early effects of retinal toxicity prior to irreversible complications is key. 6 In a small percentage of patients, side effects may require temporary reduction of the initial dosage. 400 mg to 600 mg (310 to 465 mg base) daily, administered as a single daily dose or in two divided doses. Plaquenil cumulative dose toxicity retina Hydroxychloroquine-Induced Retinal Toxicity - American., Plaquenil Dosage Guide - Hydroxychloroquine sclerodermaChloroquine phosphate cryptocaryon 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. New Plaquenil Guidelines. How to Succeed in Plaquenil Screenings. Retinal toxicity associated with chronic exposure to.. While a high daily dose is a risk factor for retinotoxicity, the risk also increases as an individual’s cumulative lifetime dosage increases. The risk of a toxicity sharply increases after 5 years, with majority of cases of retinotoxicity occurring in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine Plaquenil. Conclusion. Hydroxychloroquine and chloroquine has become a mainstay in the DMARD management of inflammatory disease. While very effective, the use of the medication carries the risk of retinotoxicity that is most directly tied to pre-existing retinal disease and cumulative dosage. 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.