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 of treatment, “We are significantly below the standard of care for appropriately dosing and screening” patients treated with hydroxychloroquine (Plaquenil), concluded Dr. Koppikar, an internal medicine physician at Queens University in Kingston, Ont. Humira and plaquenil Plaquenil screening guidelines ophthalmology Ophthalmoscopy is not a recommended screening tool because photoreceptor damage can be detected by the above techniques before being clinically visible. Critical Actions If a patient is on a dose that exceeds 5 mg/kg/day of real body weight, the prescribing physician should be contacted to ensure that the dose can be adjusted and medical risks. Hydroxychloroquine comes in an oral tablet. Adult dosing ranges from 200 mg or 400 mg per day 6.5mg/kg. In some cases, higher doses can be used. It is recommended one tablet twice daily if taking more than one tablet. It is recommended to be taken with food. Children—Dose is based on body weight and must be determined by your doctor. At first, 13 mg per 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. However, dose is usually not more than 800 mg for the first dose and not more than 400 mg for the next doses. Although his study did not examine reasons for the compliance shortfall, Dr. HCQ comes only as 200-mg tablets, and prescribing intermediate dosages can be a challenge (although veteran clinicians know that a safe and easy way to dial down a dosage is to have the patient periodically skip a dose). In a second recently reported study, researchers from the Chicago area documented that roughly half of the 554 rheumatology patients on hydroxychloroquine (HCQ) in a regional health system and seen by an ophthalmologist during 2009-2016 received an excessive dosage of the drug (). Recommended dosage of plaquenil Plaquenil - Side Effects, Uses, Dosage, Overdose, Pregnancy., Hydroxychloroquine Plaquenil Chloroquine zika cellChloroquine solubilityAra patient information hydroxychloroquineRheumatoid arthritis guidelines hydroxychloroquine monotherapy This apparently resulted in overdosing of thin patients. Thus, the patient’s real weight is now recommended as the basis for calculating the daily dose per weight in kg. Doses ≥ 5 mg/kg/day real weight of hydroxychloroquine 2.3 mg/kg/day of chloroquine are associated with higher risk of toxicity. Hydroxychloroquine And Chloroquine Screening 2016 AAO Recommendations.. Hydroxychloroquine Oral Route Proper Use - Mayo Clinic. Plaquenil Uses, Dosage & Side Effects -. For treating lupus in adults, the recommended starting Plaquenil dosage is 400 mg once or twice a day. After a while, your healthcare provider may recommend a lower dosage such as 200 mg once daily. The higher the long-term dosage, the more likely that serious Plaquenil side effects especially eye damage may occur. The recommended adult dosage is 200 to 400 mg 155 to 310 mg base daily, administered as a single daily dose or in two divided doses. Doses above 400 mg a day are not recommended. The incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded. 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.