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HCQ Maximum Dose Weight-Based — ESENeph MCQ

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EasyChronic Kidney DiseaseHCQ Maximum Dose Weight-BasedESENeph

A 42-year-old woman with CKD G3a and SLE on Hydroxychloroquine asks about the maximum safe daily dose of HCQ to minimise retinal toxicity risk. What is the recommended maximum?

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Correct answer: C≤5 mg/kg actual body weight per day

The RCOphth 2020 guideline and AAO 2016 recommend a maximum HCQ dose of ≤5 mg/kg actual body weight per day to minimise retinal toxicity risk. Higher doses (previously commonly prescribed at 400 mg/day regardless of weight) significantly increase risk. In CKD, HCQ clearance is reduced, effectively increasing drug exposure even at standard doses. Therefore, dose-per-weight calculation is particularly important in CKD patients. For a 60 kg woman, the maximum would be 300 mg/day, not the commonly prescribed 200 mg BD (400 mg/day).

Reference: https://guidelines.ukkidney.org