Hydroxychloroquine is typically available in tablet form at a dosage of 200mg. Dosage amounts depend on patient height, weight, and the condition being treated. Recommended dosage guidelines for hydroxychloroquine include:

Malaria Prevention

Hydroxychloroquine is indicated for malaria prophylaxis in geographic areas where there is no report of chloroquine resistance. Weight-based dosing is 6.5 mg/kg (5 mg/kg base) once per week, not exceeding 400 mg (310 mg base). Start two weeks before exposure and continue for four weeks after leaving a malaria-prone area.

For acute treatment of uncomplicated malaria due to P falciparum, P malariae, P ovale, and P vivax dosage recommendation is 800 mg (620 mg base), then 400 mg (310 mg base) 6 hours, 24 hours, and 48 hours following the first administered dose. Weight-based dosing is 13 mg/kg (10 mg/kg base), not exceeding 800 mg (620 mg base), followed by a dose of 6.5 mg/kg (5 mg/kg base) not exceeding 400 mg (310 mg base) at 6 hours, 24 hours, and 48 hours after the initial dose.  

Malaria Use Limitations

Hydroxychloroquine is not recommended to treat complicated malaria and is not effective against chloroquine or hydroxychloroquine-resistant strains of the Plasmodium species. Therefore, hydroxychloroquine is not recommended to treat malaria acquired in geographic areas when the Plasmodium species has not been identified or where chloroquine resistance occurs. In addition, it is not recommended for malaria prevention in geographic in areas prone to chloroquine resistance.

Rheumatoid Arthritis

Hydroxychloroquine is recommended to treat acute and chronic rheumatoid arthritis at 400-600 mg/day (310-465 mg base/day). Following an adequate response, reduce dosage by 50% and continue with a maintenance dose of 200-400 mg/day. Do not exceed 6.5 mg/kg (5 mg/kg base) or 600 mg per day due to the incidence of retinopathy when this maintenance dose is exceeded.

Systemic Lupus Erythematosus

Hydroxychloroquine is recommended for discoid lupus erythematosus and systemic lupus erythematosus treatment at 200-400 mg/day (155-310 mg base/day) as a single daily dose or divided into two doses. Do not exceed 400 mg/day. 

Coronavirus Disease 2019 (COVID-19) (Off-label)

Note: The FDA revoked the emergency use authorization (EUA) for hydroxychloroquine on June 15, 2020. However, numerous studies have found the drug to be effective in treating COVID-19, including:

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial

An open-label, non-randomized clinical trial of hydroxychloroquine that suggests hydroxychloroquine treatment is significantly associated with a reduction of viral loads and virus disappearance in COVID-19 patients. Further, azithromycin was shown to reinforce this effect. 

COVID-19 Pandemic – A Narrative Review of the Potential Roles of Chloroquine and Hydroxychloroquine

A narrative review demonstrating the potential roles of hydroxychloroquine and chloroquine, showing positive results in preliminary scientific research for treating the severe acute respiratory syndrome coronavirus (SARS-CoV-2).

Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection

A review published in The American Journal of Medicine by Peter A. McCullough et al. outlining early COVID-19 treatment options, including hydroxychloroquine. Principles of COVID-19 outpatient treatment include: 1) reinoculation reduction, 2) combination antiviral therapy, 3) immunomodulation, 4) antithrombotic/antiplatelet therapy, 5) oxygen administration, monitoring, and telemedicine.