If a patient is overweight, one should use the ideal body weight to assess whether the doaily dose is in the toxic range (/= 6.5 mg/kg/day). This graph shows various formulas that have been proposed for deriving ideal body weight for women, because virtually all cases of hydroxychloroquine toxicity have been female. Pharmacokinetics chloroquine mice Chloroquine is used for what SAN FRANCISCO – Hydroxychloroquine Plaquenil dosing based on actual body weight – instead of ideal weight – is appropriate for patients with systemic lupus erythematosus SLE, according to a review of 686 lupus patients at Johns Hopkins University in Baltimore. Most were dosed by actual weight, 6.5 mg/kg up to a maximum of 400 mg/day. Initial dose 400 mg 310 mg base orally 1 to 2 times a day; this dose may be continued for several weeks or months, depending on patient response. Maintenance dose 200 to 400 mg 155 to 310 mg base orally daily. Comments -Each dose should be taken with a meal or a glass of milk. Again, calculating "safe" daily plaquenil dosage for this weight 66.02 kg * 6.5 mg/kg/qd = 429 mg. As expected, it indicates a higher "safe" dosage 429 vs 356mg than the calculation using ideal body weight for this height. For the last time, let's graph this relationship to get a look at the big picture For this dosage, any woman with an ideal body weight less than 135 pounds would be in the toxic dose range. The usual hydroxychloroquine dose that is prescribed is 400 mg/day. Plaquenil dosing ideal body weight Rx Side Effects New Plaquenil Guidelines and More., Hydroxychloroquine Dosage Guide with Precautions - Hydroxychloroquine sulfate davisDoes plaquenil contain sulfate This patient clearly was not of ideal body weight, and, in my opinion, she was probably overdosed in relation to her ideal body weight. In 1983, Mackenzie 4 suggested that overdosage can be prevented if patients are prescribed a dosage that is based not on actual body weight, but on ideal lean body weight. Dosage of hydroxychloroquine should be based on ideal body.. Daily Plaquenil Dosage - Crunching Numbers —. New Guidelines on Hydroxychloroquine Dosage - Where Are We.. Since Plaquenil distributes in lean tissues and not fat, theoretically I would think they'd be at lower risk of toxicity, and I wonder if it may be better to use ideal body weight IBW instead for them. Per ideal body weight calculations, a man who weighs 135# or more and who is not obese should be on 400 mg a day. Typical dose of antimalarial drugs may be too high since these drugs don’t accumulate in fat and bone1,13,14,19 Dosing for overweight and/or short individuals should be based on the basis of height, by finding an estimation of "ideal body weight" and not actual weight1,19 How to define if someone is overweight? The median weight was 160 pounds 72.7 kg, IQR 133, 185 pounds, range 90, 330 pounds. Twenty-nine percent of women were less than or equal to 63 inches tall 160 cm, a threshold height for potentially toxic dosing based on consumption of 400 mg hydroxychloroquine per day and a commonly used IBW algorithm.