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. Heme chloroquine complex Mechanism of action of hydroxychloroquine in rheumatoid arthritis Research has shown that your risk of developing retinopathy is higher the longer you are taking Plaquenil. In fact, the incidence of retinal toxicity rises sharply in people that have taken it between 5 and 7 years. As a result, baseline testing should occur within the first year of taking the drug and then annually at the five-year mark. Diagnosis of Plaquenil Retinopthy or Toxicity. Patients starting on plaquenil should have a baseline exam consisting of a dilated exam to look for other eye problems and to make sure the patient is on the recommended dose. Additional baseline testing include Visual field test. High definition optical coherence tomography OCT, A baseline ocular examination is recommended within the first year of starting PLAQUENIL. The baseline exam should include best corrected distance visual acuity BCVA, an automated threshold visual field VF of the central 10 degrees with retesting if an abnormality is noted, and spectral domain ocular coherence tomography SD-OCT. 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. Baseline reading for plaquenil therapy New Plaquenil Guidelines -, PLAQUENIL MONITORING — Ocean Opthalmology Plaquenil vs methotrexateNatural substitute for plaquenil PLAQUENIL hydroxychloroquine sulfate tablets is indicated for the treatment of rheumatoid. PLAQUENIL is not recommended for use in patients with baseline QTc prolongation e.g. PLAQUENIL should be discontinued and alternative therapy considered. If Plaquenil Hydroxychloroquine Sulfate. PLAQUENIL HYDROXYCHLOROQUINE SULFATE TABLETS, USP DESCRIPTION. Hydroxychloroquine And Chloroquine Screening 2016 AAO.. If there is a favorable response, therapy is tapered to 50mg every 2 weeks for 3 months, then every 3 weeks for 3 months and then finally to a maintenance monthly dose. No response after a total of 1g should be considered a treatment failure. Monthly gold should be continued indefinitely. Baseline Examination All patients should have a baseline ophthalmologic examination within the first year of initiating HCQ or CQ therapy with thorough risk factor assessment and fundus examination of the macula to rule out underlying disease. Baseline visual field and SD OCT are recommended if abnormalities are present e.g. macular lesions, glaucoma, etc that could affect screening tests. Find patient medical information for Plaquenil Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.