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ARVO: Hydroxychloroquine Daily Dosing Recs Often Exceeded

Seventy percent of patients had daily dosages above recommended 6.5 mg/kg of ideal body weight

TUESDAY, May 5, 2015 (HealthDay News) -- Many patients prescribed hydroxychloroquine exceed the safety guidelines for daily dosing, according to a study presented at the annual meeting of the Association for Research in Vision and Ophthalmology, held from May 3 to 7 in Denver.

Jing Grace Wang, D.O., Ph.D., and Jonathan Levine, M.D., from the Bronx-Lebanon Hospital Center in New York, examined hospital adherence to the American Academy of Ophthalmology guidelines for monitoring the ocular toxicity from hydroxychloroquine at an inner-city hospital. The authors collected data for daily doses for all patients who were prescribed hydroxychloroquine. The maximal safe daily dose was calculated based on 6.5 mg/kg of ideal body weight for each patient. To determine the safe dosing, the actual daily dose was compared to the maximal safe daily dose. Data were included for 643 patients (86 percent female; 62 percent Hispanic; average age, 52 years).

The researchers found that in 86 percent of patients the daily dosage of hydroxychloroquine was 400 mg. Overall, 70 percent of patients had daily doses that exceeded the recommended 6.5 mg/kg of ideal body weight.

"More effective communication may be required between the Department of Ophthalmology and prescribing physicians regarding retinopathy status and detection of potentially toxic dosing," the authors write. "However, the dosing decision for each patient ultimately depends on the judgment of the prescribing physician, and requires weighing all the risks and benefits of different dosing levels."

Abstract No. 1793-A0226
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