Most importantly, you help support continued development of this site. The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine (Plaquenil). This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day (200 bid). Is there a generic form of plaquenil Chloroquine base lethal dose Hydroxychloroquine macular toxicity In addition to dosage, long duration of HCQ usage can put patients at higher risk for developing retinal toxicity. Other risk factors, such as underlying maculopathy, renal disease and use of. Factors that increase the risk of developing hydroxychloroquine associated retinal toxicity include daily dose, cumulative dose, renal or liver impairment, older age, and prior retinal disease. 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. Daily hydroxychloroquine base doses 5 mg/kg actual body weight were associated with an ~10% risk of retinal toxicity within 10 years of treatment and an almost 40% risk after 20 years of therapy. Risk is most accurately assessed on the basis of duration of use relative to daily dose/body weight Marmor AAO 2016; Melles 2014. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. Hydroxychloroquine retinal toxicity risk factors Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine, Retinal Screening for Hydroxychloroquine Plaquenil Toxicity Can you take berberine with plaquenilHydrocodone and plaquenil Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. Therefore, disturbed renal or hepatic function might reduce HCQ clearance and increase the propensity for toxicity. Older age may also be associated with increased risk of macular toxicity, possibly due to the pre-existence. Retinal Physician - Hydroxychloroquine Maculopathy An.. Hydroxychloroquine Professional Patient Advice -. Recommendations on Screening for Chloroquine and.. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. 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 many years of treatment. Retinal toxicity from hydroxychloroquine use cannot be completely prevented, but effective screening should recognize retinal toxicity before symptoms or significant risk of central vision loss appear ie, before the appearance of bull’s eye maculopathy.