Author Topic: 400 mgs plaquenil is a HIGH dose????  (Read 4293 times)

Yvette

  • Guest
400 mgs plaquenil is a HIGH dose????
« on: September 19, 2013, 03:28:45 PM »
So I went to my first support group here in Houston. While there the leader said that 400 mgs of plaquenil was considered a high dose. I was really surprised by that.
Has anyone else heard this???

Cassi307

  • Hero Member
  • *****
  • Posts: 743
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #1 on: September 19, 2013, 03:34:28 PM »
That's kind of surprising. Most people start out on 200 mg a day and then move up to 400 mg. I would say that it is the average dose that people take and it is not considered high.
Sjogren's, seronegative RA,  ckd, hyperparathyroidism, asthma,  osteoporosis,  Meds:  amlodipine, low dose Prednisone, calcium, sodium bicarbonate. Also, multivitamin and B complex

Sleepy In Seattle

  • Hero Member
  • *****
  • Posts: 1286
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #2 on: September 19, 2013, 04:11:10 PM »
400mg/day is pretty standard for treating autoimmune diseases - though it might vary depending on your weight. I have read that if your lean body weight is under 130lbs it can be reduced to 300mg/day and still be effective.
Sjogren's, Lupus, Raynaud's, APS
Fatigue, Brain Fog, Autoimmune Hearing Loss, joint/muscle pain, dry mouth, clots in retina, etc
GF, "semi-Paleo" diet, Supplements, Plaquenil 400mg/day, Aspirin 325mg/day (for APS), Methotrexate 7mg/2x per week, Prednisone 3.5mg/day

Dee

  • Guest
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #3 on: September 19, 2013, 04:25:30 PM »
don't take me to your leader

ok just trying to be funny

400mg (200mg, 2x day) is the duly noted standard as duly noted by other posters.

Dee

irish

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 13559
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #4 on: September 19, 2013, 05:14:52 PM »
This is the normal therapeutic dose of this drug when used for autoimmune disease.

This is not an immunosuppressant drug. This is an antimalarial drug that was found many years ago to decrease the inflammatory symptoms of many autoimmune diseases. It has been used for many years in the treatment of rheumatoid arthritis and recently has been deemed the first drug of choice in the treatment of Sjogrens syndrome.

The dose used in malaria is much higher and they speak of  over 600 base dose for primary treatment. The base dose is higher than the mgm that we speak of so don't get confused. I have read in other nursing drug books that the dose is in the 80 mgm range.

The bottom line is that many times people will be started on the 200 mgm for a week or two and then increased to the 400 mgm. This is because this drug can be very irritatiing to the stomach. I have been on 400 mgm for well over a year now and sometimes I will have a gut ache. The best thing to do is find out what time of the day works the best for you and take it with a meal.

I can't take it in the evening and have found that after noon meal works the best for me. I would be kind to the gal who misinformed you---she was probably having a bad day. But---I would do more searching online and be prepared to discuss the situation with her. It is not good to have people giving out erroneous information. Irish

eye2dry

  • Hero Member
  • *****
  • Posts: 659
  • Sjogrens, RA, hypothyroid
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #5 on: September 19, 2013, 06:28:25 PM »
I too take 400 mg of Plaquenil a day.

Does everyone else get weighed at every rheumy apt?

Is it b/c your weight reflects how many mgs of Plaquenil you get?


eye2dry
medications: synthroid- Cymbalta- plaquenil- lots of supplements

***Lord help me to be the person my dog thinks I am***

Rezgirl37

  • Newbie
  • *
  • Posts: 5
  • Psalm 20: 1-4 Remaining Hopeful!
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #6 on: September 19, 2013, 06:48:02 PM »
I am taking 400 mg daily and glad for it. Usual dose I'm told by my Rheumy.

I also get weighed at every appt also my height.  I think it has to do with weight gain, but for a multitude of health reasons.
Shere
6/2013 Sjogrens, 2003 Interstial Cystitist, Small Nerve Neuropathy, Fibro.  Medications: Plaquenil, Celebrex, Savella, Baclofen, Wellbutrin, Vit B12 bi-weekly injections, Alive Women's MV

Katybarstool

  • Hero Member
  • *****
  • Posts: 3994
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #7 on: September 20, 2013, 12:25:00 PM »
I am around 140 lbs and have been taking just 200 mgs for the past three years. It has changed my life. However, the tiredness and brain fog is getting worse now, so I'm going to talk to my rheumy about it next month. Hopefully, she will suggest an increase.

From conversations with my previous rheumy, in his clinic they never prescribed more than 200 mgs.

Kathyx

bailey00

  • Guest
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #8 on: September 20, 2013, 12:34:30 PM »
I take 200mg 2x a day of the Plaquenil and with my gastroparesis I'm only 97 pounds. I think I'm at greater risk for the eye toxicity but my rheumy thinks there is such a low possibility that it shouldn't be a problem. So, I really think your leader was having a major fog/cloud of a moment...especially when you look at my weight.

meow

  • Hero Member
  • *****
  • Posts: 558
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #9 on: September 20, 2013, 01:04:11 PM »
I take 200mg, but only once a day. My skin cannot tolerate a higher dose-- I break out into a hot, itchy rash. After a year on this dosage, my rheumy said to try to bring it up to the standard dose, but 2 days later I was on fire, and not in a good way.

I wish I could tolerate a full dose. I am exhausted, depressed and brain-fogged way more than I like, way more than I was a year ago. Work is very stressful, and my personal life is wearing me out, as well. So I am living on supplements and caffeine, hoping for the best.  Exercise makes me hurt more than it's worth, so I am doing yoga to keep from freezing up completely.
Seeing my rheumy in 2 weeks, though. Maybe she has some ideas.
:(
I refuse to tiptoe quietly through life, only to arrive safely at death's door.

Sjogrens, Hashimotos, CFS.  Also, fast approaching CRS Syndrome ;)

irish

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 13559
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #10 on: September 20, 2013, 01:18:26 PM »
People who are having more symptoms generally have an autosuppresssant added to their cocktail of medications. Many people are on Plaquenil and cellcept, imuran, methotrexate, etc.

I am taking the Plaquenil and tried to take the imuran but could not tolerate it. I need to have my left carpal tunnel surgery done the end of October and then immunology wants me to wait 6 weeks before I start to take the cellcept. I can only hope that this will halt some of the autoimmune issues that seem to be worse lately. Maybe a little less stress in my life would help also. Hello, does anyone think that we every get rid of all the stress???? Irish

Katybarstool

  • Hero Member
  • *****
  • Posts: 3994
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #11 on: September 20, 2013, 01:36:39 PM »
Bless you, Irish

I don't think we ever get rid of the stress - it is there to challenge us at every turn. Being a wife and mother is stressful enough, without being a carer for our loved ones, as well as our own challenges.

Wishing you and Mr Irish a peaceful weekend.

Kathyx   

meow

  • Hero Member
  • *****
  • Posts: 558
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #12 on: September 20, 2013, 02:11:49 PM »
I am on methotrexate, also. That has made a substantial difference. Leaving the house at 7 and returning at 5:30-6 just in time to make dinner is wearing me out. I don't dare sit down on the couch until everything is done for the day--I'll be asleep inside of 5 minutes.

My husband gets all annoyed about it, complaining that I am "not even watching" the movie he is playing, etc. I get completely pissed, and holler at him, "What, you think I WANT to come home and fall asleep at 7pm? really?"
I refuse to tiptoe quietly through life, only to arrive safely at death's door.

Sjogrens, Hashimotos, CFS.  Also, fast approaching CRS Syndrome ;)

connie50

  • Guest
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #13 on: September 20, 2013, 02:24:50 PM »
My doctor just reduced my dose to 200 mg. per day, due to my height and weight.  She said that she only keeps her patients on 400 mg. for about 6 months until is has a chance to build in your system and then uses 200 mg. for ongoing maint.

don't feel bad Meow,  I'm the same only I can usually manage to stay awake until 8:30  :P  I've jumped down my husbands throat enough that he doesn't complain anymore that I fall asleep during movies.  Been doing it for YEARS, he should be used to it by now... I sometime wonder if I can tell anymore when I'm fatigued other then when it's really bad.  I don't always feel tired when I sit down but sure enough I fall asleep in no time...

grettajo48

  • Newbie
  • *
  • Posts: 17
Re: 400 mgs plaquenil is a HIGH dose????
« Reply #14 on: September 22, 2013, 07:24:57 AM »
I found out the hard way that your Plaquenil dose should be reduced if you weigh less than 132 lbs (60kg). I weigh 99 lbs and took 400 mg of Plaquenil for 3 years and then developed visual field changes and permanent blind spots. The retina specialist told me that the risk of developing retinal toxicity increases significantly if you are small and take 400 mg of Plaquenil. At the very least, you should have regular visual fields and the Plaquenil should be stopped at the 1st sign of any visual field changes.