This eye toxicity limits long-term use of the drugs. The risk of toxicity is low for individuals without complicating conditions during the first 5 years of treatment using less than 6.5 mg/kg/day of hydroxychloroquine or 3 mg/kg/day of chloroquine, and/or cumulative doses of less than 1000 gram and 460 gram (total dose), respectively. Chloroquine toxicity of retina Lyme biaxin plaquenil Quinolone and chloroquine resistance development What is the drug plaquenil used for Risk for toxicity is least with less than 6.5 mg/kg/day for hydroxychloroquine and 3 mg/kg/day for chloroquine. Patients are at low risk during the first 5 years of treatment. Cumulative use in excess of 250 grams increases the risk for toxic retinopathy. Other risk factors include obesity, kidney or liver disease, older age. Revised Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy. It is important to be aware of risk factors including daily dose, cumulative dose. M. F. Marmor, R. E. Carr, M. Easterbook, et al. American Academy of OphthalmologyRecommendations on screening for chloroquine and hydroxychloroquine retinopathy. Our results show that the prevalence of hydroxychloroquine retinopathy is much higher than previously recognized and depends on risk factors such as daily dose, duration of use, and kidney disease. The results also suggest the need to revise the way that dosage is calculated to minimize risk. The earliest signs of toxicity include bilateral paracentral visual field changes (best detected with a red test object) and a subtle granular depigmentation of the paracentral RPE. Some physicians suggest that lean body weight is more accurate when calculating daily dosage. Hydroxychloroquine retinopathy risk factors Chloroquine retinopathy - Wikipedia, Revised Recommendations on Screening for Chloroquine and. Chloroquine metabolismHydroxychloroquine prescribing information pdfHydroxychloroquine and chloroquin sarcoidosisChloroquine and primaquine treatment Over 80 % of patients taking 4-aminoquinolines 4AQs have risk factors for retinopathy. The most important risk factor is the adjusted daily dose. Taking hydroxychloroquine at a dose less than 6.5 mg/kg/d based on the lesser of actual and ideal body weight is typically safe. Risk Factors for Hydroxychloroquine and Chloroquine.. The Risk of Toxic Retinopathy in Patients on Long-term.. Hydroxychloroquine retinopathy screening. Risk factors for retinopathy normal daily doses range 75-300mg toxicity has been reported with doses of 1200 to 2400 mg/day for 1 to 2 years. Mechanism - Inhibition of retinal enzymes and phototoxicity have been suggested as possible causes of the retinal degeneration. Screening frequency can be performed on a five-year basis unless there are heightened risk factors, in which case visual fields should be performed every year. Other useful screening tests are multifocal electroretinogram mfERG and fundus autofluorescence FAF. Marmor MF, Hu J. Effect of disease stage on progression of hydroxychloroquine. Hydroxychloroquine Maculopathy An Update on Screening and Diagnosis A brief guide for imaging SHIRI SHULMAN, MD. H ydroxychloroquine HCQ; Plaquenil, Sanofi, Bridgewater, NJ is an antimalarial agent that is also commonly used as a treatment for a variety of rheumatologic and dermatologic conditions, such as rheumatoid arthritis and systemic lupus erythematosus.