Plaquenil and its generic option hydroxychloroquine (HCL) are trusted prescription medications. Both are available as oral swallowable tablets containing 200 milligrams of hydroxychloroquine and are equally effective in the treatment of varied symptoms of malaria, lupus, and rheumatoid joint inflammation (rheumatoid arthritis, or RA).

Mechanism of action

Hydroxychloroquine falls into the class of drugs known as antimalarials; however, this medication is also helpful in reducing the symptoms of some autoimmune diseases like RA, lupus, and juvenile idiopathic arthritis. It is still not clear how the drug works to fight malaria, but hydroxychloroquine is assumed to inhibit the process of cell degradation known as autophagy when cells eliminate toxins and re-use damaged components to produce energy.

It is yet to be scientifically explained why hydroxychloroquine works so well for treating autoimmune illnesses. At present, the drug is thought to interfere with the immune system’s cell communication.

Dosage recommendations of Hydroxychloroquine

Patients need to follow their doctor’s instructions regarding the use and dosages of Hydroxychloroquine closely. They cannot rely solely on the information available online, as it may not be suitable for their particular situation.

These are general dosage recommendations on the use of Hydroxychloroquine:

Malaria treatment

Adult dosage

  • Acute phase: adult patients diagnosed with an acute attack of malaria are advised to take 800mg of Hydroxychloroquine at the start and then continue with 400mg of hydroxychloroquine 6, 24, 48 hours after the administration of the first dose.
  • Prophylactic therapy: the recommended dose for preventing malaria in adults is 400mg taken once weekly. The treatment starts a fortnight before the expected exposure to the disease, then continues during such exposure and for another 4 weeks after leaving the malaria-stricken area.

Pediatric dosage

  • Acute phase: the starting dose for a minor patient with an acute malaria attack is calculated individually, taking into account the patient’s weight (usually, it is 13mg/kg, with the maximum amount of drug taken being 800mg). This is followed by 3 additional intakes of the drug at a rate of 6.5mg/kg (not more than 400mg each) 6, 24, and 48 hours after the first intake.
  • Prophylactic therapy: calculated for each patient individually based on their body weight (usually, it is 6.5mg/kg once per week, with the maximum amount of drug taken being 400mg).

Lupus treatment

Adult dosage

  • Maintenance dose: the usual daily maintenance dose for adult patients with lupus ranges between 200mg and 400mg taken once daily or split into two equal servings.
  • Maximum single dose: should not exceed 400mg per day.

Pediatric dosage

The drug’s safety and efficiency for treating lupus in children aged 0-17 years old have not been confirmed, and the correct pediatric dosage is thus unknown.

Rheumatoid arthritis (RA) treatment

Adult dosage

  • Recommended starting dose: to treat RA in adults, doctors recommend taking 400mg or 600mg of hydroxychloroquine per day – in one go or divided into two equal servings.
  • Maintenance dose: the recommended maintenance dose of Plaquenil for adult RA patients is 200-400mg per day administered in one intake or split into two equal servings.

Pediatric dosage

The drug’s safety and efficiency for treating RA in children aged 0-17 years old have not been confirmed, and the correct pediatric dosage is thus unknown.

Precautions and safety recommendations of Hydroxychloroquine

It is very unsafe to mix Hydroxychloroquine with marijuana or alcohol as such a combination can make the person extremely dizzy, lead to reduced alertness and blurry vision. One should always tell their doctor if they are prescribed cannabis for medical purposes.

Plaquenil can increase sensitivity to the sun. It is crucial to avoid exposing the eyes and skin to too much sunlight, natural or artificial. Patients taking these medications should wear proper protection clothes and apply sunscreen when they go out. If they notice any sunburns or blisters after having spent some time in the sun, patients are advised to see their physician.

Plaquenil may affect blood sugar levels in diabetic patients, which is why they need to monitor their BSL regularly and contact their physician promptly if it is too low. The doctor may adjust the current antidiabetic medicine dosage, suggest a different diet, or recommend a new physical exercise program.

This medicine should be used with great caution and only when absolutely necessary by pregnant women and breastfeeding mothers. Pregnant women should avoid visiting countries and regions affected by malaria, as this infectious disease can harm the unborn baby.