Most importantly, you help support continued development of this site. 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). What tier is hydroxychloroquine Saltwater fish chloroquine compatible with acrifulvine Biomicroscopy eye exam slip lamp examination. Quinolones can precipitate in the corneal epithelium in a diffuse punctate or whorl-like pattern which sometimes can result in visual haloes. This sign is less common with HCQ than CQ and its effect is reversible when the therapy is stopped. Visual Field examination. Risk for toxicity is least with less than 6.5 mg/kg/day for hydroxychloroquine and 3 mg/kg/day for chloroquine. Patients are at low risk during the first 5 years of treatment. Cumulative use in excess of 250 grams increases the risk for toxic retinopathy. Other risk factors include obesity, kidney or liver disease, older age. Hydroxychloroquine. As a treatment for sarcoidosis, the antimalarial drug hydroxychloroquine Plaquenil® is most likely to be effective in patients with dermatologic involve-ment, joint manifestations and hypercalcemia. Due to poten-tial macular toxicity, it is recommended that patients on hydroxychloroquine have an eye examination every 6-12 months. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. Hydroxychloroquine eye exam frequency Eye screening for patients taking hydroxychloroquine Plaquenil, Hydroxychloroquine toxicity - EyeWiki Chloroquine interfere nucleic acid biosynthesisPlaquenil cost assistanceChloroquin extends contour length of dnaHydroxychloroquine actavis Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. New Plaquenil Guidelines. SARCOIDOSIS TREATMENT GUIDELINES. Eye screening for patients taking hydroxychloroquine.. Good question. Back on nov 5 i think it was i felt there was a really good discussion about hydroxychlorouine & eye tests here. One of us posted detailed info about her experience & the different types of eye test anyone on plaquenil etc would probably be best to have, and the frequency. Conclusions We identified HCQ in toxicity 1.7 % and bull's eye lesions in 0.7%.92.3% of patients are in high or very high-risk categories. Risk categories appeared to be weakly related to observed toxicity. There was no relation between risk categories and screening examination frequency. Dosage for Plaquenil. The adult dose of Plaquenil to suppress malaria is 400 mg on the same day each week. The pediatric weekly suppressive dosage is 5 mg/kg of body weight. The adult dose of Plaquenil to treat an acute attack of malaria is an initial dose of 800 mg followed by 400 mg in six to eight hours and 400 mg for two more days.