There are hundreds of drugs with potential retinal toxicity—so many that the National Registry of Drug-Induced Ocular Side Effects doesn’t stratify them by incidence or effect, said Frederick W. “Rick” Fraunfelder, MD, director of the Registry and associate professor of ophthalmology at Oregon Health & Science University in Portland. Plaquenil and thinning outer nuclear layer of retina Difference between methotrexate and plaquenil The AAO 2016 guidance suggested that the rates of HCQ retinopathy were higher than had previously been recognised. 1 The recommended dosage per the AAO 2016 guidelines was calculated for the 2696 patients who provided their body weight, and compared with their actual, current HCQ dose. Twenty-six per cent of the patients were on doses exceeding. Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg 5 mg/kg base of actual body weight, durations of use greater than five years, subnormal glomerular filtration. The drug clears slowly from the blood, so basing dosage on weight puts obese patients at risk. The typical daily dosage for most indications is 200 mg to 400 mg per day. Daily dosage is recommended not to exceed 400 mg. “It’s a pretty rare thing.” Nevertheless, he urged doctors to master the Academy’s new guidelines, because the effects from chloroquine and hydroxychloroquine, when they do occur, are severe and often irreversible. “Plaquenil toxicity isn’t even in the top 10, or the top 100” if you’re looking at incidence, he said. Hydroxychloroquine dosage aao Recommendations on Screening for Chloroquine and., Plaquenil hydroxychloroquine sulfate dosing, indications. Can finger joints heal lupus long term usage plaquenil 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 unwanted effects. Plaquenil Side Effects Common, Severe, Long Term -. Hydroxychloroquine-Induced Retinal Toxicity - American.. Plaquenil Guidelines Point Out New Risks, New Presentation.. Because the most commonly prescribed dose of hydroxychloroquine is 400 mg/day, women are on average overdosed much more often than men are based on IBW or RBW, and HR is almost exclusively a problem of women. In this article, we present evidence that the 20 AAO guidelines warnings are valid. Based on the 2011 recommendations from the AAO and ACR, 17% of the patients were receiving an HCQ overdose that was more than 10% above the recommended dosage, and another 13% received a smaller overdose. If the 2016 dosage guidelines were applied, the extent of overdosing might be even greater, Dr. Koppikar said. Doses ≥ 5 mg/kg/day real weight of hydroxychloroquine 2.3 mg/kg/day of chloroquine are associated with higher risk of toxicity. Doses lower than 5 mg/kg/day have low risk 1% for the first 5 years, and below 2% between 5-10 years of use. The longer you use.