HCQ Dosing
Young woman with newly diagnosed lupus starting HCQ
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Evidence-based calculations Used in clinical settings worldwide Regular monitoring recommended
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🦋 New SLE Diagnosis
Young woman with newly diagnosed lupus starting HCQ
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🦴 Long-term RA (8 years)
Patient on HCQ for 8 years - annual screening due
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👁️ High Retinal Risk
Multiple risk factors for HCQ retinopathy
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⚖️ Overweight Patient
Dose calculation using ideal body weight
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🩺 CKD Stage 3
Lupus patient with chronic kidney disease
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Clinical Scenarios
🦋 New SLE Diagnosis
New StartYoung woman with newly diagnosed lupus starting HCQ
🦴 Long-term RA (8 years)
MonitoringPatient on HCQ for 8 years - annual screening due
👁️ High Retinal Risk
High RiskMultiple risk factors for HCQ retinopathy
⚖️ Overweight Patient
Weight-BasedDose calculation using ideal body weight
🩺 CKD Stage 3
RenalLupus patient with chronic kidney disease
Patient
Dosing
Renal
Retinal Risk
Safety
For informational purposes only — not medical advice. Consult a healthcare professional before acting on results.
🏥 Health Facts
— WHO
— CDC
What is Hydroxychloroquine?
Hydroxychloroquine (Plaquenil) is an antimalarial drug widely used for autoimmune conditions including systemic lupus erythematosus (SLE), rheumatoid arthritis, and Sjögren syndrome. It has immunomodulatory, anti-inflammatory, and antithrombotic properties. The main concern with long-term use is irreversible retinal toxicity.
AAO 2016 Key Recommendations
1. Use ≤5 mg/kg ACTUAL body weight to minimize retinopathy risk
2. Screen annually after 5 years of use
3. Major risk factors: dose >5 mg/kg, duration >5 years, renal disease, tamoxifen use
Benefits
- • Disease-modifying in SLE/RA
- • Reduces flares and organ damage
- • Cardiovascular protection
- • Antithrombotic effects
Retinopathy Risk
- • Dose-dependent (≤5 mg/kg)
- • Duration-dependent (>5 years)
- • Potentially irreversible
- • Bull's eye maculopathy
Monitoring
- • Baseline exam within 1 year
- • Annual after 5 years
- • SD-OCT + Visual fields
- • Fundus autofluorescence
AAO 2016 Screening Guidelines
| Duration/Risk | Screening Recommendation |
|---|---|
| Baseline | Eye exam within first year of starting |
| Years 1-5 (low risk) | No mandatory screening |
| Years 1-5 (high risk*) | Annual screening recommended |
| >5 years (all patients) | Annual screening MANDATORY |
*High risk: >5 mg/kg/day, renal impairment, tamoxifen use, pre-existing maculopathy
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