What is the hydroxychloroquine (British National Formulary for Children (BNFC)) dose for a 13-year-old girl weighing 52 kg?

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Hydroxychloroquine Dosing for a 13-Year-Old Girl Weighing 52 kg

For a 13-year-old girl weighing 52 kg, hydroxychloroquine should be dosed at 260 mg daily (calculated as 5 mg/kg actual body weight), not to exceed 400 mg daily, to minimize retinal toxicity risk while maintaining therapeutic efficacy. 1

Dosing Calculation and Rationale

  • The American Academy of Ophthalmology recommends a maximum daily dose of 5.0 mg/kg based on actual body weight for hydroxychloroquine, which should not exceed 400 mg daily regardless of weight 1

  • For this patient: 52 kg × 5.0 mg/kg = 260 mg daily 1

  • This dose is well below the 400 mg maximum ceiling and represents the safest long-term dosing strategy 1

Why Actual Body Weight (Not Ideal Body Weight)

  • Real weight-based dosing is now recommended because hydroxychloroquine stores primarily in melanotic tissue, liver, and kidney—not in fat or muscle 1

  • Previous ideal body weight calculations resulted in systematic overdosing in thin individuals and underdosing in heavier patients 1

  • The American Academy of Ophthalmology guidelines shifted to actual body weight dosing to account for retinopathy risk evenly across different body types 1

Retinopathy Risk at Recommended Doses

  • Patients maintained at 5.0 mg/kg have <1% risk of retinopathy in the first 5 years and <2% risk up to 10 years of therapy 1

  • Risk increases sharply to approximately 20% after 20 years of continuous use, even at recommended doses 1

  • Daily doses exceeding 5 mg/kg significantly increase the incidence of retinopathy, which can be permanent and progress even after drug discontinuation 1, 2

  • A large contemporary cohort study found overall cumulative retinopathy incidence of 8.6% at 15 years, with most cases being mild when proper dosing was followed 3

Critical Monitoring Requirements

  • Baseline ophthalmologic examination is required before starting therapy 1

  • Annual screening should begin after 5 years of continuous use to detect toxicity at the earliest stage 1

  • Closer monitoring should be considered if cumulative dose exceeds 1000 g or if any retinopathy risk factors exist 1

  • No treatment exists for hydroxychloroquine retinopathy once it develops, making prevention through proper dosing and monitoring essential 1

Administration Instructions

  • Administer hydroxychloroquine orally with food or milk to improve gastrointestinal tolerability 2

  • Do not crush or divide the tablets 2

  • Available as 200 mg tablets, so this patient would receive one 200 mg tablet daily (slightly below the calculated 260 mg, but within safe parameters) 2

Common Pitfall to Avoid

  • Do not exceed 5 mg/kg daily dosing even if the calculated dose seems low compared to the 400 mg maximum—the weight-based calculation takes precedence for patients under 80 kg 1, 2

  • The FDA label states that daily doses exceeding 5 mg/kg increase the incidence of retinopathy 2

References

Guideline

Hydroxychloroquine Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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