Most importantly, you help support continued development of this site. The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine (Plaquenil). This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day (200 bid). Does plaquenil reduce pain in osteoarthritis Can plaquenil cause skin pigment to darken Ocular safety of hydroxychloroquine Can you drink alcohol on hydroxychloroquine Weight-based dosing Dose is based on body weight and must be determined by your doctor. At first, 13 milligram mg per kilogram kg of body weight taken as a single dose. Then, 6.5 mg per kg of body weight taken 6 hours, 24 hours, and 48 hours after the first dose. An audit of 100 patients seen at any of nine Canadian rheumatology clinics during early 2016 showed that 30% of patients were not on appropriate weight-based hydroxychloroquine dosages, and 13% of patients on the drug had not received a baseline retinal assessment during their first year. The Hopkins team seems to have found a workable middle ground – weight-based dosing up to a maximum of 400 mg/day, which is considered safe in a lean person of about 136 pounds. Three months after being prescribed hydroxychloroquine, however, just 56% of the patients were at a therapeutic level of 500 ng/mL or more. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. Hydroxychloroquine weight based dosing PLAQUENIL® HYDROXYCHLOROQUINE SULFATE TABLETS, USP, Hydroxychloroquine dosage recommendations often ignored MDedge. Chloroquine induces degradation Regarding the dosing of hydroxychloroquine, we advocate the use of a weight-based dosing regimen with a cap at 400 mg per day, except in the case of renal insufficiency, when the dose should be. RheumNow Hydroxychloroquine Blood Levels in SLE MedPage.. ACR Actual-weight hydroxychloroquine dosing works in SLE.. Hydroxychloroquine Oral Route Side Effects - Mayo Clinic. Adherence to Weight-Based Dosing Guidelines in Patients Receiving Hydroxychloroquine for Rheumatoid Arthritis and Systemic Lupus Erythematosus Tara Skorupa 1 and Robert Shmerling 1, 1 Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA Dosing Hydroxychloroquine is generally prescribed at a daily dose of 6.5 milligrams or less per kilogram of body weight. Using this formula, the dosage for a 150-pound person would be 443 mg/day, as one kilogram equals 2.2 pounds. Because HCQ is formulated as a 200 mg tablet, many people taking it for lupus will take two pills per day. Let's dive in. Melton & Thomas describe the typical safe Plaquenil dosage this way The usual dosage is two 200mg tablets per day. This is generally a "safe" dose for patients having a lean body weight of at least 135 lbs. The generally-regarded safe dosage is 6.5mg/kg/qd, thus the 135 lb. safety threshold.