She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Causes for plaquenil to stop working Long term chloroquine prophylaxis Plaquenil for pain control Chloroquin doses Have received a cumulative chloroquine dose of 300 g, or a daily dose greater than 3 mg/kg, 3,4 or a daily dose of hydroxychloroquine greater than 6.5 mg/kg. 6 It must Dose equivalence and conversion. Doses expressed as chloroquine base. Each tablet contains 155 mg of chloroquine base equivalent to 250 mg of chloroquine phosphate. Syrup contains 50 mg/5 mL of chloroquine base equivalent to 80 mg/5 mL of chloroquine phosphate. Usual Adult Dose for Malaria Prophylaxis. Suppression 400 mg 310 mg base orally on the same day every week Comments-Suppressive therapy should begin 2 weeks prior to exposure; however, failing this, an initial dose of 800 mg 620 mg base may be taken in 2 divided doses 6 hours apart. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Chloroquine maculopathy cumulative dose Macular Disorders. Read about Macular Disorders. Patient, CHLOROQUINE Drug BNF content published by NICE Chloroquine pills given to troops in viet nameCan hydroxychloroquine make you tiredI stopped plaquenil and now i have goutBrand name plaquenil cost He had received oral chloroquine 150 mg per day for 6 months duration 27 g cumulative dose 12 years ago. The drug was discontinued at the onset of bull’s eye maculopathy in both the eyes. Despite early cessation of the drug the maculopathy progressed leading to consecutive optic atrophy. Long-term continuation of chloroquine-induced retinal.. Hydroxychloroquine Dosage Guide with Precautions -. Hydroxychloroquine - Wikipedia. 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. 2,3. The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. Nov 01, 2015 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. Therefore, disturbed renal or hepatic function might reduce HCQ clearance and increase the propensity for toxicity. Chloroquine and hydroxychloroquine can cause toxic retinopathy due to their binding of melanin in the retinal pigmented epithelium RPE as well as direct toxicity to retinal ganglion cells. Early findings include mottling of the RPE and blunted foveal reflex. As the retinopathy progresses, a bull's-eye maculopathy develops, as seen in these.