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). How does chloroquine work against malaria Are you more like to get sick while take hydroxychloroquine 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. Hydroxychloroquine has a lower risk of ocular toxicity, both corneal and retinal, compared with chloroquine. Smoking possibly reduces the efficacy of hydroxychloroquine, although studies have not usually confirmed this clinical impression. Hydroxychloroquine is considered safer than chloroquine during pregnancy and lactation. Retinal toxicity associated with hydroxychloroquine and chloroquine risk factors, screening, and progression despite cessation of therapy. Arch Ophthalmol. 2-20. In patients in whom the daily dosage of hydroxychloroquine could be estimated 12 of 13, when using actual body weight, 8 were taking 6.5 mg/kg or less and 4 were taking greater. 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 Recommendations on Screening for Chloroquine and., Hydroxychloroquine DermNet NZ Plaquenil medication interactionsIs plaquenil hard on the liverPlaquenil vs hydroxycholorquine sulfateChloroquine suppliedPlaquenil toxicity oct It is recognized, however, that retinal toxicity is occasionally seen in apparently low-risk individuals, inviting the possibility that there may be genetic or other as yet unrecognized risk factors or alternative causes of retinopathy, as these can be hard to distinguish clinically, especially in early stages. Hydroxychloroquine-related retinal toxicity Rheumatology.. Retinal toxicity associated with hydroxychloroquine and.. Determine risk for hydroxychloroquine retinal toxicity.. 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. Importance Hydroxychloroquine sulfate is widely used for the long-term treatment of autoimmune conditions but can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity bull’s eye maculopathy. Other risk factors for Hydroxychloroquine retinal toxicity include kidney or liver disease and obesity. Obesity is a risk factor because the drug does not penetrate fat tissue so there is more of the drug in your lean body mass including your retina and its supporting cells called the retinal pigment epithelium.