The recommended hydroxychloroquine dosage for treating rheumatoid arthritis is 400 to 600 mg daily. For the treatment of lupus, the suggested dose is 400 mg once or twice daily. To prevent malaria in adults traveling to an area of high risk, the recommended dosage is 400 mg once weekly, starting two weeks before anticipated exposure. Hydroxychloroquine dosing for children is determined by the child's weight.
The dose of hydroxychloroquine sulfate (Plaquenil®) that your healthcare provider recommends will vary, depending on a number of factors, including:
- The medical condition being treated (or prevented)
- Your age and weight
- Other medical conditions you may have
- Other medications you may currently be taking.
As is the case with any medicine, do not adjust your dosage unless your healthcare provider specifically instructs you to do so.
To prevent malaria in adults traveling to an area of high risk, the recommended dose of hydroxychloroquine is 400 mg once a week (on the exact same day each week), starting two weeks before the anticipated exposure. The prescribing information recommends that hydroxychloroquine be taken until eight weeks after return from the high-risk area, but the Centers for Disease Control (CDC) recommends only four weeks after the return. If you cannot start the medication in time (two weeks before your travel), it is recommended to start with a "loading dose" of 400 mg plus another 400 mg six hours apart.
For children and infants, the dose is based on weight. Usually, 5 mg per kg of body weight (about 2.3 mg per pound) once weekly is recommended, not to exceed the normal adult dosage. Hydroxychloroquine comes only in adult-strength tablets, which taste extremely bitter when crushed or chewed. Your healthcare provider and pharmacist can work together to find a way for your child to receive the appropriate dose in a form that can be taken by a child. For instance, a pharmacist may crush the tablet, accurately measure the appropriate dose, and place the dose within a capsule. The capsule can then be opened and the contents mixed with something sweet such as applesauce, chocolate syrup, or jelly for each dose. Be sure to allow for plenty of time to find a pharmacy that can do this for you (and time for the pharmacy to prepare the medication) before you must travel.