Moreover, it is used as an adjunct in chemotherapy, and it is being investigated as a treatment for diabetes and heart disease, thanks to its anti-inflammatory, lipid-lowering, and antithrombotic properties. But as ophthalmologists know, excessive HCQ dosages can result in toxic damage to the eye. Does stopping hydroxychloroquine cold turkey Signs of retinal damage from plaquenil Arthritis medicine plaquenil Dosage. The 2002 recommendations considered a daily dose at or below 6.5 mg/kg/day of hydroxychloroquine to be low-risk for subsequent toxicity. Hydroxychloroquine is dispensed in 200 mg tablets, so an “average” 70-kg patient using the common dose of 200 mg bid actually would be receiving a slight overdose according to this threshold. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. Topiramate Topamax is used to treat epilepsy and migraines. The drug also is used off-label for a number of concerns, including weight loss, bipolar disorder and depression. It has been associated with acute angle-closure glaucoma and transient myopia. Statins may be associated with diplopia. Highlights of the 2016 guidelines include the following. “The bottom line is that the daily dose should be 5.0 mg per kg or less, using real body weight,” said Michael F. In an effort to reduce the incidence of HCQ retinopathy, the Academy published screening guidelines in 2002. Here’s an overview of the latest guidelines—and troubling evidence that far too many patients are still receiving too high a dose of HCQ (see “Excessive Dosing Still a Problem,” below). Hydroxychloroquine dose aao Hydroxychloroquine toxicity - EyeWiki, Despite Plaquenil dosing recommendations, retinal toxicity. Does plaquenil affect cgrp inhibitorsVision loss from plaquenilHydroxychloroquine vitamin dHydroxychloroquine 200 mg coupon Daily dose greater than 400 mg or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight or total cumulative dose of more than 1,000 g ; medication use longer than five years ; concomitant renal or liver disease because the drug is cleared by both routes underlying retinal disease or maculopathy ; age greater than 60 years. Hydroxychloroquine-Induced Retinal Toxicity - American.. Rx Side Effects New Plaquenil Guidelines and More - American.. Hydroxychloroquine Dosage Guide with Precautions -. Chloroquine and Hydroxychloroquine. Chloroquine and its derivative, hydroxychloroquine sulfate, which have been useful in treating malaria and in larger doses, collagen-vascular disease, cause a cumulative dose-related pigmentary retinopathy. The most recent 2016 guidelines from the American Academy of Ophthalmology AAO recommend the dose of HCQ ≤5 mg/kg real body weight to minimize toxicity 1. According to these new guidelines, the risk of HCQ retinal toxicity is less than 1 % in the first year of therapy and less than 2 % up to 10 years of therapy. Mar 08, 2017 The ACR 2016 statement goes on to note that other authors have recommended a dosage of 6.5 mg/kg of actual body weight but capped at 400 mg/day and adjusted for renal insufficiency, and the ACR statement stops short of specifying which dosage strategy it recommends. “The AAO recommendations are much more definitive and state more specifically what screening is recommended and what is a safe dosage,” commented Dr. Rosenbaum.