Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking hydroxychloroquine: Incidence not known Some side effects of hydroxychloroquine may occur that usually do not need medical attention. Plaquenil surgery healing Plaquenil is os junction Previous reports indicate that toxicity is rare if dosing is less than 6.5 mg/kg/day. 2 To avoid overdosage, especially in obese patients or those of short stature, dose should be based on height, which allows for an estimation of ideal body weight. The drug clears slowly from the blood, so basing dosage on weight puts obese patients at risk. The maximum dose of Plaquenil is 6.5 mg/kg of ideal body weight per day, regardless of whether a person is overweight, underweight, or normal weight. One kilogram kg equals 2.2 pounds. Women with lupus who are OVER their ideal body weight should go by these dosing rules Hydroxychloroquine retinopathy is most influenced by daily dose and duration of use. Risk for toxicity is less with 5.0 mg/kg real weight/day for hydroxychloroquine and 2.3 mg/kg real weight/day for chloroquine. Patients are at low risk during the first 5 years of treatment. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. These side effects may go away during treatment as your body adjusts to the medicine. Plaquenil toxicity ideal body weight Early Plaquenil Toxicity Detected without Bull’s Eye Maculopathy, Protecting your eyesight when taking Plaquenil Lupus. Effects of plaquenil on teeth Retinal damage from Plaquenil is extremely rare when doses do not exceed the maximum recommended which is about 3 mgs per lb/ 6.5 mgs per kilo of IDEAL body weight and when the patient has no liver or kidney problems. Since doses are cumulative the risk increases with time - 10 years is usually quoted. Discontinued Plaquenil.other options?. Hydroxychloroquine toxicity - EyeWiki. Rx Side Effects New Plaquenil Guidelines and More - American.. 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. A cumulative dose of 1000g of hydroxychloroquine or 460g of chloroquine was likely the largest risk factor, which was typically achieved after 5-7 years of a typical dosage 8, 10. Melton & Thomas describe the typical safe Plaquenil dosage this way The usual dosage is two 200mg tablets per day. This is generally a "safe" dose for patients having a lean body weight of at least 135 lbs. The generally-regarded safe dosage is 6.5mg/kg/qd, thus the 135 lb. safety threshold. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight.