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. Aralen retail price Macular thinning and plaquenil Daily dose greater than 400 mg or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight or total cumulative dose of more than 1,000 g ; medication use longer than five years ; concomitant renal or liver disease because the drug is cleared by both routes underlying retinal disease or maculopathy ; age greater than 60 years. The action of hydroxychloroquine is cumulative and may require weeks to months to achieve the maximum therapeutic effect see CLINICAL PHARMACOLOGY. Initial adult dosage 400 mg to 600 mg 310 to 465 mg base daily, administered as a single daily dose or in two divided doses. Hydroxychloroquine Plaquenil is a commonly used medication in the management of various rheumatic diseases. Standard doses used by rheumatologists are 200mg to 400mg per day. Although serious toxicity with hydroxychloroquine is very unusual, the most important is retinal toxicity. 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. Hydroxychloroquine retinopathy cumulative dose Chloroquine retinopathy - Wikipedia, Plaquenil Dosage Guide - Minocycline plaquenil lyme The action of hydroxychloroquine is cumulative and may require weeks to months to achieve the maximum therapeutic effect see CLINICAL PHARMACOLOGY. Initial adult dosage. 400 mg to 600 mg 310 to 465 mg base daily, administered as a single daily dose or in two divided doses. Hydroxychloroquine Tablets - FDA prescribing information.. Wayney's BlogPlace Hydroxychloroquine Retinopathy.. Hydroxychloroquine toxicity - EyeWiki. Keep chloroquine daily dose at 3 mg/kg/day and cumulative dose at 460 gm to reduce chances of retinopathy ; Keep hydroxychloroquine daily dose at 6.5mg/kg/day and cumulative dose at 1000gm to reduce chances of retinopathy ; Recognize that patients with renal failure are at unusually high risk of retinal toxicity The incidence of retinal toxicity is associated with the cumulative dose of the drug, increasing significantly beyond 1,000 g of HCQ. This cumulative dose is created when the common dose of 400 mg/day is used for 6.8 years. Hydroxychloroquine is metabolized and secreted by both the liver and the kidneys. The 2011 AAO guidelines stated that a cumulative dose of 1000 g increases the risk of retinopathy equating to 6.85 years of treatment at 400 mg, and 13.7 years of treatment at 200 mg. However, the conclusions drawn on the significance of the cumulative dose are inconsistent.