Falciparum Discontinue in 6 months if improvement is inadequate Use in patients with psoriasis may precipitate a severe attack of psoriasis; use with caution Postmarketing cases of life-threatening and fatal cardiomyopathy reported with use of hydroxychloroquine as well as of chloroquine Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg (5 mg/kg base) of actual body weight, durations of use greater than five years, subnormal glomerular filtration, use of some concomitant drug products such as tamoxifen citrate and concurrent macular disease Ocular examination is recommended within first year of therapy; baseline exam should include: best corrected distance visual acuity (BCVA), an automated threshold visual field (VF) of the central 10 degrees (with retesting if an abnormality is noted), and spectral domain ocular coherence tomography (SD-OCT) For individuals with significant risk factors (daily dose of hydroxychloroquine sulfate 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; for individuals without significant risk factors, annual exams can usually be deferred until five years of treatment In individuals of Asian descent, retinal toxicity may first be noticed outside macula; in patients of Asian descent, it is recommended that visual field testing be performed in central 24 degrees instead of central 10 degrees Hydroxychloroquine should be discontinued if ocular toxicity is suspected and patient should be closely observed given that retinal changes (and visual disturbances) may progress even after cessation of therapy Hepatic disease or alcoholism Glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with hemolysis and renal impairment; use with caution Dermatologic reactions to hydroxychloroquine may occur Patients are prone to dermatitis outbreaks Signs or symptoms of cardiac compromise have appeared during acute and chronic treatment; clinical monitoring for signs and symptoms of cardiomyopathy is advised, including use of appropriate diagnostic tools such as ECG to monitor patients for cardiomyopathy during therapy; if cardiotoxicity is suspected, prompt discontinuation may prevent life-threatening complications Not for administration with other drugs that have potential to prolong QT interval; hydroxychloroquine prolongs QT interval; ventricular arrhythmias and torsades de pointes reported in patients taking hydroxychloroquine Skeletal muscle myopathy or neuropathy leading to progressive weakness and atrophy of proximal muscle groups, depressed tendon reflexes, and abnormal nerve conduction, reported; muscle and nerve biopsies have been associated with curvilinear bodies and muscle fiber atrophy with vacuolar changes; assess muscle strength and deep tendon reflexes periodically in patients on long-term therapy Suicidal behavior rarely reported in patients treated with hydroxychloroquine Hematologic reactions (including aplastic anemia) and agranulocytosis may occur May exacerbate heart failure Shown to cause severe hypoglycemia including loss of consciousness that could be life threatening in patients treated with or without antidiabetic medications; warn patients about risk of hypoglycemia and associated clinical signs and symptoms; patients presenting with clinical symptoms suggestive of hypoglycemia during treatment should have their blood glucose checked and treatment reviewed as necessary A reduction in dosage may be necessary in patients with hepatic or renal disease, as well as in those taking medicines known to affect these organs Use with caution in patients with hepatic disease or alcoholism or in conjunction with known hepatotoxic drugs Consider discontinuing therapy if any severe blood disorder such as aplastic anemia, agranulocytosis, leukopenia, or thrombocytopenia, which is not attributable to the disease under treatment appears; perform periodic blood cell counts if patients are given prolonged therapy Pregnancy category: C Lactation: Drug is concentrated in breast milk (American Academy of Pediatrics committee states that it is compatible with nursing) A: Generally acceptable. Contact the applicable plan provider for the most current information. Controlled studies in pregnant women show no evidence of fetal risk. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. Animal studies show risk and human studies not available or neither animal nor human studies done. Can plaquenil cause a rash Plaquenil eye testing Hydroxychloroquine and dormancy Chloroquine cellular toxicity The recommended Plaquenil dosage for malaria prevention is 400 mg once weekly, starting two weeks before the anticipated exposure. The usual starting dosage for treating lupus is 400 mg once or twice a day, and the recommended starting dose for the treatment of rheumatoid arthritis is 400 to 600 mg daily. However, dose is usually not more than 800 mg for the first dose and not more than 400 mg for the next doses. Children—Dose is based on body weight and must be determined by your doctor. At first, 13 mg per kg of body weight taken as a single dose. Then, 6.5 mg per kg of body weight taken 6 hours, 24 hours, and 48 hours after the first dose. The drug clears slowly from the blood, so basing dosage on weight puts obese patients at risk. The typical daily dosage for most indications is 200 mg to 400 mg per day. Daily dosage is recommended not to exceed 400 mg. Risk for Toxicity Unknown; may impair complement-dependent antigen-antibody reactions; inhibits locomotion of neutrophils and chemotaxis of eosinophils Increases p H and interferes with lysosomal degradation of hemoglobin, which in turn interferes with digestive vacuole function Bioavailability: Rapid and complete absorption Onset: May take 4-6 months to show response; peak response takes several months (rheumatic disease) Duration: Unknown Peak plasma time: 1-3 hr Protein bound: 55% Metabolites: Desethylhydroxychloroquine, desethylchloroquine Half-life: 32-50 days Excretion: Urine (60%) The above information is provided for general informational and educational purposes only. D: Use in LIFE-THREATENING emergencies when no safer drug available. Typical plaquenil dosage Plaquenil Dosage Guide -, Hydroxychloroquine Oral Route Proper Use - Mayo Clinic The trade name of chloroquine isCost of plaquenil at costcoOct testing in plaquenil macular toxicity Hydroxychloroquine Prices, Coupons and Patient Assistance Programs. Hydroxychloroquine is a member of the antimalarial quinolines drug class and is commonly used for Dermatomyositis, Lyme Disease - Arthritis, Malaria, and others. Brand names for hydroxychloroquine include Plaquenil. Hydroxychloroquine Prices Hydroxychloroquine Prices, Coupons & Patient Assistance.. Hydroxychloroquine-Induced Retinal Toxicity - American.. SARCOIDOSIS TREATMENT GUIDELINES. An average dose of 200 mg/day PO led to a longer time to renal damage HR 0.12, 95% CI, 0.02 to 0.97, p = 0.0464, which was defined as at least 1 of the following that lasted for at least 6 months estimated or measured glomerular filtration rate less than 50%, 24-hour proteinuria of 3.5 g or more, and end-stage renal disease regardless of. Aug 30, 2011 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. However, there have been case reports of patients with hydroxychloroquine toxicity as early as 1.9 months after starting treatment 11. Nov 25, 2019 Detailed Hydroxychloroquine dosage information for adults and children. Includes dosages for Rheumatoid Arthritis, Systemic Lupus Erythematosus, Malaria Prophylaxis and more; plus renal, liver and dialysis adjustments.