Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Drug warnings for plaquenil Skin discoloration plaquenil Methotrexate and hydroxychloroquine for rheumatoid arthritis Hydroxychloroquine sulfate and pregnancy For individuals with significant risk factors daily dose of hydroxychloroquine sulfate 5.0 mg/kg base of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease monitoring should include annual examinations which include BCVA, VF and SD-OCT; for individuals without significant risk. At the 2018 ACR/ARHP Annual Meeting, I had the opportunity to co-moderate this year's Great Debate, which was titled "Guidelines for SLE HCQ Dose Should Be No More Than 5 mg/kg In All Patients." The most recent 2016 guidelines from the American Academy of Ophthalmology AAO recommend the dose of HCQ ≤5 mg/kg real body weight to minimize toxicity 1. According to these new guidelines, the risk of HCQ retinal toxicity is less than 1 % in the first year of therapy and less than 2 % up to 10 years of therapy. Risk of Toxicity: The risk of toxicity is dependent on daily dose and duration of use. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Recommended dosage hydroxychloroquine Hydroxychloroquine And Chloroquine Screening 2016 AAO., The 2018 ACR Great Debate Hydroxychloroquine Dosing for SLE Plaquenil 100mg tabletsPlaquenil sarcoidosis treatmentPlaquenil and metforminAnyone has uti after taking f hydroxychloroquine The action of hydroxychloroquine is cumulative and may require weeks to months to achieve the maximum therapeutic effect see CLINICAL PHARMACOLOGY. Initial adult dosage 400 mg to 600 mg 310 to 465 mg base daily, administered as a single daily dose or in two divided doses. In a small percentage of patients, side effects may require temporary reduction of the initial dosage. Plaquenil Dosage Guide -. New Guidelines on Hydroxychloroquine Dosage - Where Are We.. PLAQUENIL HYDROXYCHLOROQUINE SULFATE TABLETS, USP DESCRIPTION. The recommended adult dose for rheumatoid arthritis is 400-600 mg daily for 4-12 weeks followed by 200-400 mg daily. Systemic lupus erythematosus is treated with 400 mg once or twice daily for several weeks then 200-400 mg daily. Hydroxychloroquine should be taken with food or milk in order to reduce stomach upset. Adults—200 to 400 milligrams mg taken as a single dose or in two divided doses once a day. However, dose is usually not more than 400 mg once a day. Children—Use and dose must be determined by your doctor. Missed Dose. If you miss a dose of this medicine, take it as soon as possible. Hydroxychloroquine is usually taken with food or milk to prevent stomach upset. The dosage and length of treatment are based on your medical condition and response to therapy. In children, dosage.