Dosing recommendations for patients on hydroxychloroquine or chloroquine

For hydroxychloroquine, the maximum dose should be 6.5 milligrams per kilogram body weight per day. A daily dose of 400 milligrams should not be given to patients weighing less than 135 pounds (e.g. dose should be reduced even further than recommended guideline).

For chloroquine, the maximum dose should be 3 milligrams per kilogram body weight per day. A daily dose of 250 milligrams should not be given to patients weighing less than 138 pounds (e.g. dose should be reduced even further than recommended guideline).

Patients should have a dilated fundus exam every 6 months. Patients should self monitor twice a week with an Amsler grid. In addition, patients should have a Humphrey 10-2 Sita Standard or Full/From Threshold visual field test every year.

In addition, a fluorescein angiogram to assess the macula may be recommended if an early abnormality is suspected. Also, a multifocal ERG may be recommended(1).