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). Plaquenil free though outreach program Buy aralen side Hydroxychloroquine mfg by mylan There is an increased risk of HCQ retinopathy with increase in the cumulative dose. Per the prior 2011 AAO guidelines the recommended maximum dose to minimize HCQ retinal toxicity was 6.5 mg /kg based on ideal body weight 2. The advantage of the real body weight formula is that it distributes the risk evenly on a broad range of body habitus. Based on these risks, the American Academy of Ophthalmology AAO recommends not exceeding a daily hydroxychloroquine dosage of 5 mg/kg using actual body weight in most patients. Previous recommendations to use ideal body weight are no longer advised; very thin patients in particular were at increased risk for retinal toxicity using this practice. We consider this supportive of dosing based on actual body weight 6.5 mg per kg with a cap at 400 mg per day. From a practical perspective, this means the daily dose should be reduced, from 400 mg per day, for those weighing less than 61 kg 134lbs. Hydroxychloroquine Blood Levels and Adherence 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 weight based dosing 5 mg kg ideal bo Hydroxychloroquine Blood Levels in SLE Clarifying dosing controversies., Hydroxychloroquine Professional Patient Advice - Teva-chloroquine effets secondairesPlaquenil erosive arthritisCan plaquenil cause a positive nicotine urine test400 mg hydroxychloroquineChloroquine off target effects Hydroxychloroquine Plaquenil is used to treat malaria, lupus, and rheumatoid arthritis. Learn about side effects, warnings, dosage, and more. The dosage is based on body weight. 6.5 mg/kg. Hydroxychloroquine Side Effects, Dosage, Uses, and More. The Role of Hydroxychloroquine Blood Levels in SLE RheumNow.. Dosage of hydroxychloroquine should be based on ideal body.. However, since Mackenzie’s time, there have now been multiple reported cases of hydroxychloroquine retinopathy in patients who developed retinopathy despite taking less than 6.5 mg/kg/d based on IBW, not ABW.4,27,30,31,33 Therefore, 6.5 mg/kg/d based on IBW has been transformed from the threshold for safe dosing to the threshold for toxic dosing. On the basis of a recent study of 2,361 long-term HCQ users, 3 the Academy now recommends that all patients using HCQ keep daily dosage less than 5.0 mg/kg actual body weight—not ideal body weight,” said Dr. Marmor. “Older recommendations once advised calculating dosage as 6.5 mg/kg ideal body weight, but that conclusion was based on. The authors collected data for daily doses for all patients who were prescribed hydroxychloroquine. The maximal safe daily dose was calculated based on 6.5 mg/kg of ideal body weight for each patient.