She reported that the blurriness was in both eyes, and it was slowly progressive over the past few months. She had a medical history of high blood pressure, high cholesterol, and rheumatoid arthritis. Plaquenil manufacturer mylan pharmaceuticals inc assist Plaquenil 100mg tablets Hydroxychloroquine contraindications Methotrexate and hydroxychloroquine Discussion. A risk factor for Plaquenil hydroxychloroquine retinotoxicity is a daily dose that exceeds 5.0 mg of drug per kg of body weight. The tool on the right simply calculates this threshold based on a patient’s real body weight. It’s important to understand that the daily dose is only one risk factor for plaquenil retinotoxicity. Hydroxychloroquine blood levels predict retinopathy risk in lupus HealthDay—Hydroxychloroquine HCQ blood levels are useful in predicting retinopathy among patients with systemic lupus. Nov 01, 2015 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 of age-related macular changes that might not allow for the identification of early signs of toxicity. Her visual acuity with habitual Rx at distance was 20/40 OD and 20/50-OS, while at near was 20/40. She was currently taking 81 mg aspirin, atorvastin (Lipitor, Pfizer), Centrum Silver multivitamin, fish oil, hydroxychloroquine (Plaquenil, Concordia) 200 mg QD, isosorbide mononitrate (Imdur, Hikma), levetiracetam (Keppra, Pfizer), Nitrostat (nitroglycerin, Pfizer), Restasis (cyclosporin, Allergan), Ranexa (ranolazine, Gilead), Trexall (methotrexate, Teva), citalopram (Celexa, Forest Labs), losartan/hydrochlorothiazide (Hyzaar, Merck), sulfamethoxazole/trimethoprim (Bactrim DS and topiramate (Trokendi XR, Ortho-Mc Neil). Hydroxychloroquine retinopathy risk Hydroxychloroquine - Wikipedia, Hydroxychloroquine blood levels predict retinopathy risk. Abatacept sulfasalazine hydroxychloroquine triple therapyThe deneric plaquenil is not as good as non genericDoes hydroxychloroquin protext against malaria 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. Hydroxychloroquine toxicity - EyeWiki. Retinal Physician - Hydroxychloroquine Maculopathy An Update.. Hydroxychloroquine retinopathy Eye. Managing the complications of hydroxychloroquine retinopathy is an evolving process driven by research papers such as this. The risk is increased for patients taking more than 5 mg/kg/day. 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. This is the first study that focuses on assessing retinopathy risk by tracking hydroxychloroquine blood levels. Despite the benefits of treatment, which may also include anti-thrombotic and anti-diabetic effects and complete renal remission when given in combination with mycophenolate mofetil, the risks have been well documented.