Retinal toxicity from hydroxychloroquine is uncommon early but rises with dose and duration, and damage can progress after the drug stops.
Keeping the daily dose at or below 5 mg/kg actual body weight, and arranging baseline and then annual retinal screening after five years of use, earlier with risk factors such as kidney disease or tamoxifen, catches it before vision is affected.
- Calculate the dose by actual body weight, at or below 5 mg/kg per day
- Arrange a baseline eye examination when starting hydroxychloroquine
- Start annual retinal screening after five years, or earlier with risk factors
- Review the dose when kidney function falls
Why it matters
Hydroxychloroquine retinopathy is preventable with dosing discipline and is irreversible once established.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for rheumatology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free