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  • Can I take more than 1,000 grams of Plaquenil if it’s been five years since I’ve used it?


    Question:

    I read an American Academy of Ophthalmology publication that says the guideline for maximum Plaquenil dosage, relative to retinal toxicity, is a cumulative dosage of 1,000 grams. Is that a “lifetime” total, or does a minimum time period (e.g., 5 years) between periods of Plaquenil use reset this time period?


    Answer:

    While there is some older research that talks about the increased risk of Plaquenil-induced retinal toxicity associated with a lifetime cumulative dosage of greater than 1,000 grams, current research has found that the most critical risk factor is the daily dosage (greater than 5.0 mg per kg of body weight) and the duration of use for more than 5 years. In fact, the most recent Academy recommendations (revised in March, 2016) states "Earlier literature had suggested that 'cumulative dose' (which combines daily dose and duration) might be a simpler indicator of risk, but this does not hold up well."


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