Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Medicine used for malaria hydroxychloroquine Stopping plaquenil effects The side effect that is of greatest concern is retinal toxicity. Retinal toxicity of Plaquenil may manifest itself with subtle disturbances of the retinal pigment epithelium which may eventually lead to complete destruction of the macula in the form of bull’s-eye maculopathy. Hydroxychloroquine is also an antirheumatic medicine and is used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus. Important information. Taking hydroxychloroquine long-term or at high doses may cause irreversible damage to the retina of your eye. 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. Risk of Toxicity: The risk of toxicity is dependent on daily dose and duration of use. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Hydroxychloroquine retinal Hydroxychloroquine retinopathy Eye, Hydroxychloroquine Uses, Dosage & Side Effects - Plaquenil anxiety depression Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. New Plaquenil Guidelines. Retina Today - Imaging in Hydroxychloroquine Toxicity.. This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. Hydroxychloroquine is associated with long-recognized retinal toxicity. 2,3,4 The retinopathy is hallmarked by parafoveal changes within the retina. Early toxicity may be asymptomatic, detected. New information shows that hydroxychloroquine retinal toxicity occurs 7.5 percent of the time, which is not that rare. 3. In those patients who are affected, their daily dose and duration of use varied widely.