Plaquenil dosage

[dry2010]

Hello,
I have been reading that there has been changes in dosage of Plaquenil according to weight. That being said I am female 129 lbs on 400mg past 8 years regular eye check ups. I did take a break from it thinking it wasn?t doing much well that backfired. What dosage do you take if you are under 130? I started back on 400mg do not have a appt for another month with Rheumatologist.

Thanks,
Dry2010

[nannysbaby]

dry2010,

How long had you been taking the Plaquenil?  I have been taking the generic, hydroxychloroquine, for 11 years.  My weight was higher (over 200 lbs) .
My opthamologist suggested I speak to my rheumie about halving the dosage (400 mg/day).  When I spoke to my dr. he agreed right away.  A little over two years ago I stopped eating meat.  About six months later I cut out dairy.  Last year I also cut out nearly all oils.  As much as possible I only eat whole plant foods and foods with overt fats.  It's harmonious with a vegan diet although I don't call myself vegan for several reasons.  I lost 70 lbs.
and have plateaued and fluctuate 5 lbs.  Anyway, my blood tests have been all good for two years and he believes my primary Sjogren's could be in remission.  So I dropped down to 200 mg/day 2 weeks ago.  I have not noticed anything so far.

I do worry about continuing on that med. and putting my eyes at risk.  I get checkups all the time and supposedly the chances are small, but with time running on and on, I feel I am putting it to the test.  I always took my med.  I think it really helps me.  It made my hair so curly and easy to care for as well. (LOL)  I hope I can rock on from here with no surge in problems.  I will keep you all posted.  He also has me on a mini dose of methotrexate (0.3 ml/1x/week).

[WhatYouSjo]

My rheumatologist and the literature that I've read agree that patients should be on the lowest dose possible to still get benefits. I started at 400mg but quickly dropped to 300mg (alternating 1 and 2 pills). Recently I've been trying 200mg. There have been debates about whether dosing calculations should use 'real weight' or 'ideal weight', though more recent literature seems to be accepting of real weight.

Plaquenil does build up in your body, and the threats to eyesight are tied to lifetime consumption as well as rate of consumption. Risk factors include doses greater than 5mg/kg of real weight, renal disease, macular disease, and duration of use exceeding 5 years, though the risk is still low at that point. The annual risk of toxic retinopathy after 20 years of usage based on a dose of:

• < 4mg/kg (200mg for someone weighing 150 lbs) is between 1 and 2%
• 4-5mg/kg (300mg for someone weighing 150 lbs) is ~4%
• >5mg/kg (400mg for someone weighing 150 lbs) is ~8%

Source

As you can see, the dose plays a significant role in your risk for eye damage over time. At 129 lbs and 400mg, you would be in the high-risk category over time. My advice is to drop your dose by 100mg and see how you feel for a couple of months. If your symptoms increase, you can return to a higher dose. If they remain the same, stay at the lower dose and consider trying another 100mg drop in the future. That said, I am not a medical professional, and you should discuss any medication changes with your doctor.

[eye2dry]

Hi dry2010.

I was put on 400mg of Plaquenil in 2010 when first diagnosed with RA and sjogrens. Just
2 months ago my rhuemy decreased it to 200 MG daily. I had regular eye exams....no problems
At all. He just did it d/t new Guidelines.

I feel more fatigue and joint discomfort on the lower dose.

Shelly

[dry2010]

I always get my eyes tested just had macular testing in Jan and all was good. I see my Rheuin couple months I am going to ask about dose drop but have been experimenting with 300mg. Problem is I took a team for a few months so lots of joint issues. I?m trying to get it back in my system I know it takes months and really prefer not to take 400 mg☹️

Dry2010