The Brightwork Hydroxychloroquine Dosage Guide

ByPrimary Researcher

Executive Summary

  • This article covers the factors that play into developing a recommended dosage of Hydroxychloroquine and the recommended dose.

Introduction

We get many questions on Hydroxychloroquine dosage. In this article, we will cover the dosage of Hydroxychloroquine.

The Complications Of Arriving at a Hydroxychloroquine Dosage

Complication #1: Wide Variance of Response

Hydroxychloroquine is an effective drug, and however it can provide very different side effects in other people. In reviewing those who have taken hydroxychloroquine, the most significant thing stopping people from taking it is the side effects, which greatly depend upon the individual. What this means is that different individuals have different tolerance for hydroxychloroquine. Even with these known variances in tolerance — MDs continue to recommend 400 MG per day virtually universally. This is illogical and is why our dosage recommendation is based on a lower initial dosage with incremental increases. This issue is explained in the following quotation from Arthritis.org.

Up to half of patients treated with the arthritis drug hydroxychloroquine (Plaquenil) are prescribed more than the recommended maximum amount, according to new research. In separate studies, Canadian and U.S. researchers found that 30% to 50% of patients didn’t receive the dose outlined in treatment guidelines; a smaller percentage didn’t get recommended eye exams. Hydroxychloroquine is generally safe at normal doses, but higher amounts can damage the retina, the light-sensitive tissue at the back of the eye, and could result in partial or complete blindness. Hydroxychloroquine-related eye problems were once considered rare, but better detection methods now show they occur in a greater proportion of patients — more than the 7% originally thought. More recent data show retinal toxicity occurs in more than 10% of patients who have taken hydroxychloroquine for more than 10 years, and in anywhere from 20% to 50% of those who have taken the drug more than 20 years. The risk increases not only with a higher dose and more years taking it but also in African Americans and people who are slender. Yet Canadian researchers found in a study that approximately one-third of 90 arthritis patients at eight different rheumatology clinics were not prescribed appropriate weight-based doses of hydroxychloroquine, and 12% failed to have an eye exam in the first year of treatment. This is “significantly below the standard of care,” says Sahil Koppikar, MD, a rheumatologist at Women’s College Hospital in Toronto, Canada. In a separate study, published in Ophthalmology in early 2017, Rebekah Braslow, MD, and colleagues at NorthShore University HealthSystem in Chicago reviewed the records of more than 550 rheumatology patients seen by NorthShore ophthalmologists between 2009 and 2016. About half had been prescribed too much hydroxychloroquine, and dosing errors continued at the same rate even after the AAO issued revised treatment guidelines in 2016.

Complication #2: The Complication of Generic Effectiveness Combined With HCQ’s Long Lead Time

As with many generic drugs, some generic hydroxychloroquine versions, particularly those manufactured in India, are ineffective or low in effectiveness; however, the problem with this is taking a while for hydroxychloroquine to show its effect. The presentation by the medical establishment that all generics are identical to the brand name version of the drug is false, as bioequivalence is commonly falsified and easy to falsify. The dosage varies depending on whether hydroxychloroquine is taken short or long-term, and this is because the drug has a delayed effect.

Complication #3: The Issue of Macular Degeneration

A longer-term side effect is macular degeneration, which is why periodic eye exams are essential when taking hydroxychloroquine. Due to these and even more factors, hydroxychloroquine is one of the more challenging drugs to dose correctly. The dosage for HCQ is widely known, but it is too high, and medicine has done an abysmal job of adjusting the dosage.