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Thread: Hydroxychloroquine dosage

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    Default Hydroxychloroquine dosage

    Hi all,
    Question for people who have tried hydroxychloroquine for flushing/neurogenic rosacea. I was just prescribed 200 mg/day - I'm wondering if this is a large enough dosage? Seems like most people are on 400 mg/day. I see that it depends on weight but I am 128 lbs which would put me at about 370 mg/day if I'm doing the math right.
    The rheumatologist that prescribed this to me barely listened to me and told me "maybe you should try wearing makeup". My flushing has been incredibly debilitating so this was like a slap in the face. I'm so angry I could punch a hole in the wall! Anyway, just venting now but I am curious if folks think the 200 mg/day would even be enough to make a difference.

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    Quote Originally Posted by Jamoverton View Post
    Hi all,
    Question for people who have tried hydroxychloroquine for flushing/neurogenic rosacea. I was just prescribed 200 mg/day - I'm wondering if this is a large enough dosage? Seems like most people are on 400 mg/day. I see that it depends on weight but I am 128 lbs which would put me at about 370 mg/day if I'm doing the math right.
    The rheumatologist that prescribed this to me barely listened to me and told me "maybe you should try wearing makeup". My flushing has been incredibly debilitating so this was like a slap in the face. I'm so angry I could punch a hole in the wall! Anyway, just venting now but I am curious if folks think the 200 mg/day would even be enough to make a difference.
    The dosage is by weight as far as I know. when I was ~115 pounds, I was rx'ed 200 mg x2 / day M-F, and 200 mg 1x / day Sat, Sun. = 2400 mg / wk. I was weighed at the appt it was rx'ed. I am maybe 10 pounds more now but still take the same dose (it never helped my face, i continue to take it for other reasons)

    I have wanted to punch a lot of walls. I scream in the car on the freeway sometimes after appts. What I find helpful is to emphasize the sensations of the flushing. Burning, stinging, disabling heat, pins/needles. How it restricts your life. Instead of "flush" I say "flare" or "flush and burn". In the end though this doctor probably can't help you, better to move on to the next. Hang in there
    Last edited by laser_cat; 18th January 2020 at 01:24 AM.

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    I'm sorry to hear that. It's horrible when doctors don't listen. I've been through a few in the past year which were so dismissive that I wish I could've thrown my chair at them in the appointment.

    I second what laser cat said. The best way is to talk about the pain and how debilitating it's been. I also found it useful to photograph all my flares as they tend to happen at night and at their worst and then show them the images in the appointment. That seemed to work. I've had the most luck from a neurologist as they tend to focus on pain and invisible symptoms. I found most of the other derms just didn't acknowledge the pain aspect at all. Too busy hunting for marks on my skin.

    With the hydroxychloroquine I've been prescribed 200mg a day as well. I am 100 pounds. The dermatologist that prescribed it to me thought that was enough for my weight initially. Hope it works for you!

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    Quote Originally Posted by Jamoverton View Post
    Hi all,
    Question for people who have tried hydroxychloroquine for flushing/neurogenic rosacea. I was just prescribed 200 mg/day - I'm wondering if this is a large enough dosage? Seems like most people are on 400 mg/day. I see that it depends on weight but I am 128 lbs which would put me at about 370 mg/day if I'm doing the math right.
    The rheumatologist that prescribed this to me barely listened to me and told me "maybe you should try wearing makeup". My flushing has been incredibly debilitating so this was like a slap in the face. I'm so angry I could punch a hole in the wall! Anyway, just venting now but I am curious if folks think the 200 mg/day would even be enough to make a difference.
    If you tolerate hydroxychloroquine well on 200mg per day, I suspect you will find it easier to persuade your current rheumatologist or another doctor to give you 400mg per day. Some doctors actually like to start with 400mg per day and then taper down to 200mg per day over time. From my experience, 200mg should makes a difference but may not be sufficient - but it should be enough to tell you if it's helping. Hydroxychloroquine has a good anti-inflammatory effect, but works particularly well with blood pressure medications like clonidine or moxonodine and also nerve-related medications like mirtazapine or gabapentin. If it's a difficult case of flushing, treating with two or three of these classes of medications can really help blunt it.

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    Thanks so much to everyone who responded and for the great advice. I agree when I describe my symptoms as just "flushing" to doctors they probably think superficial redness = cosmetic concern.
    Sounds like the 200mg/week could be a good start for me. I'm going to try that for now and reach out to the doctor again about possibly upping the dosage if I'm tolerating that ok.

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    Quote Originally Posted by Jamoverton View Post
    Thanks so much to everyone who responded and for the great advice. I agree when I describe my symptoms as just "flushing" to doctors they probably think superficial redness = cosmetic concern.
    Sounds like the 200mg/week could be a good start for me. I'm going to try that for now and reach out to the doctor again about possibly upping the dosage if I'm tolerating that ok.
    I am interested in trying plaquenil too but Iím going to see a pain management doctor soon so Iíll update you all on that. I too have found dermatologists ( the so called experts) utterly useless in treating stinging and burning. One dermatologist said it was ďoutside his area of expertiseĒ. Seriously- they consider themselves skin experts and yet donít know how to treat the irritated nerves of the skin. The people on this forum know far more!!

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    Quote Originally Posted by Momof View Post
    I am interested in trying plaquenil too but Iím going to see a pain management doctor soon so Iíll update you all on that. I too have found dermatologists ( the so called experts) utterly useless in treating stinging and burning. One dermatologist said it was ďoutside his area of expertiseĒ. Seriously- they consider themselves skin experts and yet donít know how to treat the irritated nerves of the skin. The people on this forum know far more!!
    I appreciate the problem of burning and stinging you describe - I've found controlling demodex mites takes this problem away even better than the redness. Zhongzhou cream and treating the scalp for mites should help this a lot. Plaquenil (hydroxychloroquine) is an anti-parasitic drug and I suspect may well help in managing the mites numbers, although Zhongzhou cream is the most obvious treatment for this.

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    Quote Originally Posted by antwantsclear View Post
    I appreciate the problem of burning and stinging you describe - I've found controlling demodex mites takes this problem away even better than the redness. Zhongzhou cream and treating the scalp for mites should help this a lot. Plaquenil (hydroxychloroquine) is an anti-parasitic drug and I suspect may well help in managing the mites numbers, although Zhongzhou cream is the most obvious treatment for this.
    I would be quite happy to try the zz cream but I donít have mites, just hyper irritated facial nerves from vbeam treatment. Would the zz cream calm down the nerves?

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    Quote Originally Posted by Momof View Post
    I would be quite happy to try the zz cream but I donít have mites, just hyper irritated facial nerves from vbeam treatment. Would the zz cream calm down the nerves?
    Scientific studies show 95% of the adult population have demodex mites - you might not like them, but you probably have them by the laws of probability! The issue in rosacea is that these mites that nearly everyone has cause some damage and irritation. Yes they do cause your facial nerves to feel irritated with their creeping around the face, particularly when you get hot or something activates them.

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