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. Missed dose of plaquenil Review of optometry plaquenil guidelines Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. Risk factors that increase the chance of hydroxychloroquine retinopathy include daily dosage, cumulative dose, renal or liver disease, age, and previous retinal disease 9. A daily dose of 6.5mg/kg ideal body weight places patients at higher risk, but a daily dose below this level did not preclude the patient from developing toxicity after. 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 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 Plaquenil Dosage Guide -, Hydroxychloroquine Plaquenil Toxicity and Recommendations. Plaquenil bloodshot eyes The estimated risk of hydroxychloroquine retinopathy in patients on chronic hydroxychloroquine therapy ranges from 0.4% to 8.0%. 1 Toxicity is thought to be dependent on cumulative total dose. 3 Additional factors that can precipitate early toxicity are concomitant renal disease and use of tamoxifen. 3 Retina Today - Imaging in Hydroxychloroquine Toxicity April.. Hydroxchloroquine and Chloroquine Toxicity - Eye Lessons. What can Hydroxychloroquine Plaquenil do to my eyes?. 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. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy Retinal toxicity from chloroquine CQ and its analogue, hydroxychloroquine HCQ, has been recognized for many years. Chloroquine toxicity remains a problem in many parts of the world, but is seen less frequently in the United States where the drug largely has been. 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.