Medications
There are hundreds of drugs with potential retinal toxicity—so many Apr 28, 2023 · Plaquenil (Hydroxychloroquine sulfate) is a drug used to treat certain autoimmune diseases
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Here’s an overview of the latest guidelines—and troubling evidence that far too many patients are still receiving too high a dose of HCQ (see
Dr
We discuss updated recommendations concerning hydroxychloroquine daily dosing, retinopathy
200-400 mg PO daily in a single or divided dose (tablets are 200 mg)
In 2016, the AAO issued guidelines for monitoring for HCQ retinal toxicity (2)
After careful review of the existing peer-reviewed literature, we recommend that all patients be
Newer guidelines state that daily dose >5mg/kg of real weight/day can lead to toxicity
PLAQUENIL® (hydroxychloroquine sulfate) is a white or practically white, crystalline powder, freely soluble in water; practically insoluble in alcohol, chloroform, and in ether
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Implementing these updated recommendations will help ensure dermatologists continue using hydroxychloroquine safely and effectively
400 mg/day maximum
4 HYDROXYCHLOROQUINE FOR USE IN RHEUMATOLOGY AND DERMATOLOGY Shared Care Protocol This protocol provides prescribing and monitoring guidance for hydroxychloroquine therapy
Lotery A, Ardern-Jones M, Bishop P et al
The Royal College of Ophthalmologists (RCOphth) published recommendations for monitoring in users of hydroxychloroquine and chloroquine in the United Kingdom in 2018 in order to reduce the risk of irreversible sight loss from toxic retinopathy in this group []
Answer: When billing Plaquenil examinations, or any other high risk medication exams, it is appropriate to bill the systemic disease or any ocular manifestations as the primary diagnosis since many payers may not reimburse for the high-risk medication diagnosis as a stand-alone diagnosis
Malaria:
Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide general guidance for commonly encountered clinical scenarios
Since the drug is cleared by the kidneys, one should also monitor renal function
Thomas is enthusiastic about the updated guidelines, although he worries that the new dosing recommendations have not been widely disseminated to Medication monitoring: Hydroxychloroquine: Guidelines for referral and management of systemic lupus erythematosus in adults