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Hello Rachel

Higher doses are often used initially for a speedy effect. The risk of a too high dose for ideal body weight is related to length of use, ten years is the usual figure mentioned. I reckon that 300mgs would be suitable for your body weight in the long term. If that is an issue you could take 2 x 200 mgs one day and 1 x 200mgs the next but I wouldn't worry about a higher than recommended dose short term, for a few months anyway.

I might be asking if this is the best way of using antimalarials.

I have not found any medical reports of how much more effective increasing Plaquenil really is, as compared with adding another drug. Since there is a general concern about over medicating I can only suppose that it is at least worth trying.
However, I suggest asking him about the possibility of adding Mepacrine to the Plaquenil. This drug does not cause eye toxicity and probably would be more effective than simply increasing the Plaquenil because they work together synergistically each enhancing the effects of the other. Mepacrine is particularly good for energising and relieving fatigue.
The combination can be beneficial for non organ threatening lupus, not just lupus skin as many doctors seem to think. It is in fairly common use at St Thomas' either in combination or as an alternative to Plaquenil.
The combination can be steroid sparing and can avoid the need to go onto the DMARDs such as Imuran or Methotrexate.

Good Luck :)
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