Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Can plaquenil help with small fiber neuropathy Silver and chloroquine Icd 10 code for plaquenil use Hydroxy chloroquine side effects Chloroquine and hydroxychloroquine both belong to the quinolone family and share similar clinical indications and side effects, including retinal toxicity. Chloroquine-induced retinal toxicity was first described in 1959 and the retinal toxic effects of hydroxychloroquine were later described in 1967 3, 4. HCQ has a long half-life about one month and takes about half a year to achieve full elimination from the body; this is significant when managing minor side effects such as itching and corneal deposits and major ones such as retinal toxicity and explains continued maculopathy even after discontinuation of the medication. For a typical patient, most would reach the cumulative dose at 200 mg bid in 5 years. 2 It is rare for vision changes to occur. Related More than a yellow lesion? Is there really a scarcity in cases, though? New information shows that hydroxychloroquine retinal toxicity occurs 7.5 percent of the time, which is not that rare. 3 Risk of Toxicity: The risk of toxicity is dependent on daily dose and duration of use. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Retinal toxicity dosage hydroxychloroquine Toxic Retinopathy With Hydroxychloroquine Therapy, Chloroquine And Hydroxychloroquine Toxicity - StatPearls. Hydroxychloroquine and mood swings 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 both considered risk factors for retinal toxicity. Retinal Screening for Hydroxychloroquine Plaquenil Toxicity Retina.. Determine risk for hydroxychloroquine retinal toxicity Optometry Times. New Guidelines on Hydroxychloroquine Dosage - Where Are We.. The toxic dosage for chloroquine was derived from hydroxychloroquine retinal toxicity studies, although no definitive data have shown pharmacologic equivalence. 1 The first reports of retinal toxicity attributed to chloroquine appeared during the late 1950s. 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. An audit of 100 patients seen at any of nine Canadian rheumatology clinics during early 2016 showed that 30% of patients were not on appropriate weight-based hydroxychloroquine dosages, and 13% of patients on the drug had not received a baseline retinal assessment during their first year.