NOT USED FOR COVID-19
Hydroxychloroquine, the active drug in Plaquenil, is not recommended for treating COVID-19 (the illness caused by the coronavirus SARS-CoV-2). Do not take any prescription drug, including Plaquenil or hydroxychloroquine, unless your doctor recommends that you do so.
For information on how to prepare, advice on prevention and treatment, and expert recommendations, visit our COVID-19 hub.
Plaquenil (hydroxychloroquine) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to:
- treat certain forms of lupus in adults
- treat rheumatoid arthritis in adults
- treat and help prevent certain types of malaria in adults and children
Plaquenil comes as an oral tablet. It belongs to a drug class called antimalarial and antirheumatic drugs. It’s available in both a brand-name version, Plaquenil, and a generic form, hydroxychloroquine.
For information about the dosing guidelines for Plaquenil, including its strength and how to take the drug, keep reading. For a comprehensive look at Plaquenil, see this article.
This article describes typical dosages for Plaquenil provided by the drug’s manufacturer. When taking Plaquenil, always follow the dosage prescribed by your doctor.
Below are some common dosages for Plaquenil. It’s important that you always take the dose of Plaquenil that your doctor prescribes.
Plaquenil comes as oral tablets.
Plaquenil tablets come in one strength: 200 milligrams (mg).
Your doctor will prescribe the most appropriate dosage of Plaquenil based on your condition. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly prescribed or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosages for lupus
Plaquenil is prescribed to treat two different forms of lupus in adults:
The dosage for both forms of lupus is either 200 mg or 400 mg of Plaquenil once per day. If you take 400 mg per day, your doctor may recommend taking your dose of 400 mg once daily. Or they may recommend splitting your dosage into 200 mg twice daily. Talk with your doctor about the best dosage schedule for you.
Dosages for rheumatoid arthritis
For treating rheumatoid arthritis in adults, you’ll likely begin treatment with a higher dose of Plaquenil. This may be referred to as a loading (starting) dose of the drug. A loading dose allows the medication to start working quickly. Since Plaquenil may take weeks or months to work, your doctor may prescribe a higher dose at the beginning of treatment.
Your doctor will likely recommend a starting dosage of between 400 mg and 600 mg daily of Plaquenil. They may recommend taking your dosage all at once, or taking it in two divided doses. For example, if your dosage is 400 mg per day, your doctor may recommend taking 400 mg once daily or 200 mg twice daily. Talk with your doctor about the best way for you to take your dosage of Plaquenil.
Your doctor may have you take a starting dosage of Plaquenil until the medication begins working for you. Then, they will likely decrease your starting dosage. For example, if your starting dosage was 400 mg per day, your long-term dosage may be 200 mg per day.
Dosage for malaria
Plaquenil can be taken to help prevent malaria or treat certain types of malaria. Since these are different uses, the dosages are different as well.
For the prophylaxis (prevention) of some forms of malaria, the usual Plaquenil dose is 400 mg for adults. You’ll take this once per week. You should take your weekly dose on the same day each week.
You should begin taking Plaquenil 2 weeks before you travel to an area where you may be at risk of malaria. Then, you’ll continue taking your weekly dosage throughout your stay in the area. You should keep taking Plaquenil for 4 weeks after you leave that area.
Plaquenil may also be taken to treat some forms of malaria. If you take Plaquenil to treat malaria, your doctor will likely recommend that you take four doses of medication over 48 hours.
Below is an example of a Plaquenil dosage schedule for treating malaria in adults:
- First dose: 800 mg
- Second dose: 400 mg, 6 hours after your first dose
- Third dose: 400 mg, 24 hours after your first dose
- Fourth dose: 400 mg, 48 hours after your first dose
Plaquenil is approved to both help prevent and treat certain types of malaria in some children. This medication should not be taken by children weighing fewer than 31 kilograms (kg), which is about 68 pounds (lb).* Plaquenil is not approved to treat rheumatoid arthritis or lupus in children.
To help prevent certain types of malaria in children, the typical dosage of Plaquenil is based on body weight in kg. The dosage for children weighing 31 kg (about 68 lb) or more is 6.5 mg per kg of body weight. This dosage should be taken once per week to help prevent malaria. The maximum dosage of Plaquenil to help prevent malaria in children is 400 mg once per week.
For example, if your child weighs 35 kg (about 77 lb), their Plaquenil dosage would be about 227 mg once per week. However, this medication comes only in 200-mg tablets that cannot be split. So your child’s doctor will likely recommend that your child take a 200 mg tablet once per week. Talk with your doctor about the best dosage schedule for your child.
Your child should begin taking Plaquenil 2 weeks before traveling to an area where malaria may be a risk. Be sure to give your child their dose of Plaquenil on the same day each week. Continue to give your child the drug weekly throughout their stay in the area. You should keep giving them Plaquenil for 4 weeks after they leave that area.
* 1 kg is about 2.2 lb.
To help treat certain types of malaria in children, the typical dosage of Plaquenil is based on body weight in kg. Your child will take 4 total doses of Plaquenil to help treat malaria. The dosage for children weighing 31 kg (about 68 lb)* or more is:
- First dose: 13 mg/kg (up to 800 mg)
- Second dose: 6.5 mg/kg (up to 400 mg), 6 hours after your first dose
- Third dose: 6.5 mg/kg (up to 400 mg), 24 hours after your first dose
- Fourth dose: 6.5 mg/kg (up to 400 mg), 48 hours after your first dose
For example, if your child weighs 35 kg (about 77 lb), their first dose of Plaquenil would be about 455 mg. However, this medication comes only in 200-mg tablets that cannot be split. So your child’s doctor will likely recommend that your child take a dose of 400 mg as a starting dose. They will then take 200-mg doses of the drug 6 hours, 24 hours, and 48 hours after their first dose to complete treatment.
If your child needs medication to help prevent or treat malaria, talk with your doctor about what dosage is appropriate.
* 1 kg is about 2.2 lb.
Which condition you take Plaquenil for will determine if you’ll take it long term or short term.
If you’re taking Plaquenil to treat lupus or rheumatoid arthritis, you’ll likely take the drug as a long-term treatment. You and your doctor can determine if Plaquenil is safe and effective for you.
If you’re taking Plaquenil to help prevent malaria, you’ll start taking the drug 2 weeks before you’ll be in an area where you’re at risk of malaria. You’ll continue taking Plaquenil throughout your stay in that area and for 4 weeks after you’ve left the area.
If you are taking Plaquenil for malaria treatment, you will need to take four total doses of medication within 48 hours.
Below are some answers to questions that you may have about Plaquenil dosages.
Can Plaquenil treat Sjogren’s syndrome? If so, what’s the dosage for this condition?
At this time, Plaquenil is not approved to treat Sjogren’s syndrome, so there isn’t a recommended dosage. (Sjogren’s syndrome is a condition where your immune system mistakenly attacks your own body). However, in some cases, Plaquenil may be prescribed off-label for Sjogren’s syndrome. Off-label use is when a drug that’s approved to treat one condition is prescribed to treat a different condition.
Some studies, such as
If you’re interested in taking Plaquenil for Sjogren’s syndrome, talk with your doctor.
Does Plaquenil help treat osteoarthritis or psoriatic arthritis? If so, what are the dosages?
Plaquenil is not approved to treat osteoarthritis or psoriatic arthritis, so there aren’t recommended dosages. The only form of arthritis that Plaquenil is approved to treat is rheumatoid arthritis.
Osteoarthritis is a wearing down of the bone in a joint, which causes joint pain to occur. One study looked at the possible benefits of hydroxychloroquine (the generic form of Plaquenil) in people with osteoarthritis of the hands. The study compared hydroxychloroquine with a placebo (a pill with no active drug in it). This study did not find any benefit in people taking hydroxychloroquine compared with those taking a placebo.
You may also wonder if Plaquenil may be taken to treat psoriatic arthritis. This is an autoimmune condition that occurs in people with psoriasis (a condition causing plaques on the skin). At this time, the American College of Rheumatology states that although hydroxychloroquine may be taken, it can also cause symptoms of psoriasis to worsen. So in many cases, due to this risk, your doctor may recommend a different treatment option for you.
If you have osteoarthritis or psoriatic arthritis and are interested in taking Plaquenil, talk with your doctor.
What’s the Plaquenil dosage for symptoms of Lyme disease?
Plaquenil is not approved to treat symptoms of Lyme disease, so there’s no recommended dosage.
Lyme disease is a condition caused by a bacteria called Borrelia burgdorferi, which may be transmitted through a tick bite. In some cases, symptoms of Lyme disease, such as arthritis or neuropathy (nerve damage), may last for years.
Hydroxychloroquine (the active drug in Plaquenil) was studied to see if it may work to treat long-term symptoms of Lyme disease. In this study, people were first given antibiotics. Then, they were given 12 weeks of either an antibiotic called doxycycline, hydroxychloroquine, and an antibiotic called clarithromycin, or a placebo (a pill with no active drug in it). In this study, people taking doxycycline or hydroxychloroquine did not experience fewer symptoms than people taking a placebo.
If you have Lyme disease, talk with your doctor before taking Plaquenil.
The Plaquenil dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition you’re taking Plaquenil to treat
- your age
Other medical conditions you have can also affect your Plaquenil dosage.
Your doctor may adjust your dosage of Plaquenil if you have certain conditions.
If you have a kidney condition, such as chronic kidney disease, your doctor may recommend a decreased dose of Plaquenil. They may also recommend a decreased dose of the drug if you have a liver condition, such as hepatitis. This is because the drug may affect your kidneys and liver and may make your condition worse. Before you start taking Plaquenil, talk with your doctor about any medical conditions that you have. They can determine what the best dose of Plaquenil is for you.
You should swallow Plaquenil tablets whole. You should not split, crush, or chew them. Be sure to take your dose with food or milk.
Take your dose of Plaquenil as directed by your doctor or pharmacist. In some cases, you may take Plaquenil once or twice per day. In other cases, you may take it once per week. Your doctor or pharmacist can advise you on when you should take your doses of Plaquenil.
If you miss a dose of Plaquenil, talk with your doctor or pharmacist about the best way to continue treatment. They’ll recommend when to take the next dose based on what condition you’re taking Plaquenil to treat.
In some cases, they may recommend taking your missed dose as soon as you remember. Other times, they may recommend skipping your missed dose and taking your next dose of Plaquenil as scheduled.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.
It’s important not to take more Plaquenil than your doctor prescribes. If you take more Plaquenil than your doctor prescribes, you may develop serious side effects.
Symptoms of an overdose
Symptoms of Plaquenil overdose can include:
- irregular heart rhythm, which can be life threatening
- heart attack
- low blood pressure
- severe hypokalemia (low blood potassium levels)
- slowed breathing
If you take more than the recommended amount of Plaquenil
Call your doctor right away if you believe you’ve taken too much of Plaquenil. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Plaquenil for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.
As with any drug, never change your dosage of Plaquenil without your doctor’s recommendation. If you have questions about the dosage of Plaquenil that’s right for you, talk with your doctor.
Besides learning about dosage, you may want other information about Plaquenil. These additional articles might be helpful to you:
- More about Plaquenil. For information about other aspects of Plaquenil, refer to this article.
- Side effects. To learn about side effects of Plaquenil, you can look at this article. You can also look at the Plaquenil prescribing information.
- A look at your condition. For details about some of the conditions Plaquenil is approved to treat, these lists of lupus articles and rheumatology articles may be helpful.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.