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. Plaquenil and prednisone during pregnancy Chloroquine storage Hydroxychloroquine high anion gap ketoacidosis Can chloroquine help rheumatoid arthritis 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 the medication, the higher the risk of toxicity. Usual Adult Dose for Malaria Prophylaxis. Suppression 400 mg 310 mg base orally on the same day every week Comments-Suppressive therapy should begin 2 weeks prior to exposure; however, failing this, an initial dose of 800 mg 620 mg base may be taken in 2 divided doses 6 hours apart. Depending on the patient's condition, the dosage can be tapered at those visits. After 3-6 months, the dose should be tapered to physiolog- ic levels – for example, 10 mg of prednisone per day or less. corticosteroids, one should consider the addition of a steroid-sparing agent, such as methotrexate or azathioprine. 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). Chloroquine dosage ophthalmology guidelines Retinal Physician - New Screening Guidelines for., Hydroxychloroquine Dosage Guide with Precautions - Chloroquine drug indicationPlaquenil and heavy periodsPlaquenil pharmacologyAnyone has uti from taking hydroxychloroquineHydroxychloroquine canada pharmacy The American Academy of Ophthalmology’s recommendations for screening of chloroquine CQ and hydroxychloroquine HCQ retinopathy were published in 2002. Since then, improved screening tools an New guidelines to minimize toxic damage from chloroquine and.. SARCOIDOSIS TREATMENT GUIDELINES. Despite Plaquenil dosing recommendations, retinal toxicity.. Find patient medical information for Chloroquine Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. To reduce the incidence of chloroquine and hydroxychloroquine toxicity, health care providers HCP's that prescribe these medications and those that screen for ocular toxicity have developed clear dosing and screening protocols that have reduced the risk of end-stage disease; bull's eye maculopathy and central vision loss Level I. In 2016, with new scientific data, the American Academy of Ophthalmology revised their screening recommendations for patients on chloroquine for longer than 1 year 5. The two most important risk factors for retinopathy are the duration of chloroquine treatment and a daily dose of chloroquine 2.3 mg/kg of the patient's actual body weight.