One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Hydroxychloroquine temporal arteritis Treatment of cerebral malaria chloroquine Chloroquin malaria Whats the dosage that causes plaquenil toxicity Chloroquine retinopathy, is a form of toxic retinopathy caused by the drugs chloroquine or hydroxychloroquine, which are sometimes used in the treatment of autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus. This eye toxicity limits long-term use of the drugs. 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. Risk factors that increase the chance of hydroxychloroquine retinopathy include daily dosage, cumulative dose, renal or liver disease, age, and previous retinal disease 9. A daily dose of 6.5mg/kg ideal body weight places patients at higher risk, but a daily dose below this level did not preclude the patient from developing toxicity after many years of treatment. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Plaquenil retinopathy risk factors Hydroxychloroquine toxicity - EyeWiki, Plaquenil Side Effects on Your Eyes and Vision High cost of hydroxychloroquineWill plaquenil show up on a drug screen Our results show that the prevalence of hydroxychloroquine retinopathy is much higher than previously recognized and depends on risk factors such as daily dose, duration of use, and kidney disease. The results also suggest the need to revise the way that dosage is calculated to minimize risk. The Risk of Toxic Retinopathy in Patients on Long-term.. Hydroxychloroquine Plaquenil Toxicity and.. Plaquenil Risk Calculators. In addition, toxic maculopathy has been reported to be dose dependent, whereby retinal toxicity risk increases with more than 6.5mg/kg of body weight. 6. Other risk factors include advanced age and pre-existing retinal disease. Patients with any of the aforementioned findings are considered “high risk” and should be monitored closely. Jan 01, 2020 For individuals with significant risk factors daily dose of hydroxychloroquine sulfate greater than 5.0 mg/kg base of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease monitoring should include annual examinations which include BCVA, VF and SD-OCT. Melles R, Marmor M. The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. JAMA Ophthalmol. 2014;132121453-60. 6. Michaelides M, Niam H, Stover P, et al. Retinal toxicity associated with hydroxychloroquine and chloroquine risk factors, screening, and progression despite cessation of therapy.