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. Why is hydroxychloroquine so expensive Baseline eye exam plaquenil Chloroquine cells Sep 13, 2019 Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some. 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. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. 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 retinal toxicity dose Hydroxychloroquine Plaquenil Toxicity and Recommendations., New Plaquenil Guidelines Replacement for hydroxychloroquineAralen phosphate costHydroxychloroquine natural killer cellsHydroxychloroquine dosing lyme Initial dose 400 mg 310 mg base orally 1 to 2 times a day; this dose may be continued for several weeks or months, depending on patient response Maintenance dose 200 to 400 mg 155 to 310 mg base orally daily Hydroxychloroquine Dosage Guide with Precautions -. The Risk of Retinal Toxicity with Plaquenil - Sjogren's. Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy. Chloroquine Major Avoid coadministration of hydroxychloroquine and chloroquine due to therapeutic duplication as well as increased risk of retinal toxicity, QT prolongation, and torsade de pointes TdP. Hydroxychloroquine prolongs the QT interval. Plaquenil toxicity and lowering dosage Posted on August 28, 2015 by Luke — No Comments ↓ Plaquenil generic name hydroxychloroquine is one of the few medications that is regularly prescribed for Sjogren’s Syndrome, despite the fact that it has not been approved for SS by the FDA, so any use is off-label. Hydroxychloroquine sulfate HCQ, Plaquenil is an analogue of chloroquine CQ, an antimalarial agent, used for the treatment of systemic lupus erythematosus, rheumatoid arthritis and other autoimmune disorders. Its use has been associated with severe retinal toxicity, requiring a discontinuation of therapy.