Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Plaquenil p450 enzymes Chloroquine tablet for malaria December 10, 2016. Clinical Disease, Pharmacology. The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1. That recommendation was lowered in March 2016 to 5.0 mg per kg of actual body weight, up to a maximum of 400 mg a day. One PLAQUENIL tablet contains 200 mg of hydroxychloroquine sulfate, which is equivalent to 155 mg base. Take PLAQUENIL with a meal or a glass of milk. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Plaquenil guidelines for eye monitoring 2016 Plaquenil Side Effects on Your Eyes and Vision, Wrong Hydroxychloroquine Dose Is Common, Putting Eyes at. How to pronounce hydroxychloroquineCan you take advil with plaquenilDwarf lionfish and chloroquine As a treatment for sarcoidosis, the antimalarial drug hydroxychloroquine Plaquenil® is most likely to be effective in patients with dermatologic involve-ment, joint manifestations and hypercalcemia. Due to poten-tial macular toxicity, it is recommended that patients on hydroxychloroquine have an eye examination every 6-12 months. Methotrexate. SARCOIDOSIS TREATMENT GUIDELINES. Plaquenil Dosage Guide -. Hydroxychloroquine Plaquenil. Plaquenil and eye exams allie_bf posted For the last few years, my rheumagologist and opthamologist have disagreed on the frequency for eye exams my opthamologist says every year is sufficient, but my rheumatologist still insists every 6 months is what should be done. MONITORING. Baseline CBC, lytes, Cr, BUN, AST, ALT. Baseline major eye exam. Every year, repeat basic labs described above and ensure repeat major eye exam to look for retinopathy due to this medication. CONTRAINDICATIONS. Hypersensitivity to hydroxychloroquine. Caution in patients with previous retinal or visual field changes. Highlights of the 2016 guidelines include the following. Use real body weight. “The bottom line is that the daily dose should be 5.0 mg per kg or less, using real body weight,” said Michael F. Marmor, MD, at Stanford University in Palo Alto, Calif.