If a patient is overweight, one should use the ideal body weight to assess whether the doaily dose is in the toxic range (/= 6.5 mg/kg/day). This graph shows various formulas that have been proposed for deriving ideal body weight for women, because virtually all cases of hydroxychloroquine toxicity have been female. Distribution of malaria and chloroquine-resistant Plaquenil drug class Chloroquine review By the old standards, obese people, if dosed by their actual weight, could be overmedicated, Dr. Marmor said. If you’re short, the standard prescription of 200 mg of Plaquenil, twice daily, is too much, he said. The recommended dosage is no more than 6.5 mg/kg/day, using the standard known as “ideal weight,” which factors in height. Dr. Although the incidence of macular toxicity is infrequent with Plaquenil use at a dosage of 200mg or 400mg q.d. its visual impact can be devastating. 2,3 The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. For this dosage, any woman with an ideal body weight less than 135 pounds would be in the toxic dose range. The usual hydroxychloroquine dose that is prescribed is 400 mg/day. Plaquenil dosage by weight Plaquenil Oral Uses, Side Effects, Interactions., New Plaquenil Guidelines Chloroquine crystal structureThe mainstay of treatment for malaria is chloroquine Dec 30, 2015 SAN FRANCISCO – Hydroxychloroquine Plaquenil dosing based on actual body weight – instead of ideal weight – is appropriate for patients with systemic lupus erythematosus SLE, according to a review of 686 lupus patients at Johns Hopkins University in Baltimore. Most were dosed by actual weight, 6.5 mg/kg up to a maximum of 400 mg/day. ACR Actual-weight hydroxychloroquine dosing works in SLE, up.. Despite Plaquenil dosing recommendations, retinal toxicity.. Hydroxychloroquine Dosage Guide with Precautions -. Dosage Hydroxychloroquine Plaquenil® is the drug of choice among antimalarials. Chloroquine is not commonly used because of greater toxicity on the eye. The usual dose of Plaquenil is 400mg/day but 600mg/day is sometimes used as part of an induction regimen. It may be prescribed as a single daily dose or in divided doses twice per day. Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg 5 mg/kg base of actual body weight, durations of use greater than five years, subnormal glomerular filtration. Use in an outpatient setting for adult patients taking hydroxychloroquine Plaquenil. The current American Academy of Ophthalmology AAO guidelines, published in 2016, recommend a maximum daily hydroxychloroquine dose of ≤5.0 mg/kg of real weight.