The recommended Plaquenil dosage for malaria prevention is 400 mg once weekly, starting two weeks before the anticipated exposure. The usual starting dosage for treating lupus is 400 mg once or twice a day, and the recommended starting dose for the treatment of rheumatoid arthritis is 400 to 600 mg daily. For children, Plaquenil dosing is determined by the child's weight.
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The dose of Plaquenil® (hydroxychloroquine sulfate) 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 always the case, 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 Plaquenil 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 Plaquenil 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. Plaquenil 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.