I’m currently on 200mg but wondering if I could move up to 400-600mg instead of having two medications (with Sulfasalazine) but bad side effects of the latter?
Question for my specialist but wondered if 200mg was already a max dose or actually a small one?
We will each take a different dose so no usual dose but one tablet a day (200mg) is low so there may be room for manoeuvre, I think it is one drug that your weight affects how high you can go, if I remember rightly, so one to ask your rheumy about as maybe this is why they didn’t alter your dose and added sulphasalazine. If you haven’t been on it long then any side effects can diminish over time so unless they are too awful ( I assume they’re not as it hasn’t been stopped) it’s worth persevering. 🤞🏻
The highest dose of hydroxychloroquine is 400mg daily, the dose I started on, so 600mg wouldn't be an option for you, or anyone else I'm afraid. Dosage can also depend on your weight. This is from NICE, dosage recommendations for Active rheumatoid arthritis (administered on expert advice)
For Adult: 200–400 mg daily, daily maximum dose to be based on ideal body-weight; maximum 6.5 mg/kg per day bnf.nice.org.uk/drug/hydrox...
You're correct, bad side effects from sulfasalazine is definitely something to discuss with your Rheumy, if they've not eased over time but are becoming less tolerable, you've given them long enough to determine that they're not going to ease I mean. We each respond differently but I eventually had to give in & stop taking SSZ… I went to the other extreme & probably gave it too long, not helped by my Rheumy's absence. It can be the case that early symptoms ease the longer you take a med but obviously if they're really bothersome & you've given it your best then make your Rheumy aware otherwise he'll assume all's well. There are other options, an increase in HCQ if appropriate or leflunomide if methotrexate isn’t suitable. Best to be frank, open up the conversation & then your Rheumy can work with you.
All the best & I hope you both find a solution that works well for you.
I’m on 200/400 alternate days. My nurse said the dose could be calculated on your weight, so it might depend how much you weigh. (I’m 73kg). It is a less potent drug than Sulphasalzine and often doesn’t work on its own. (I’m on Methotrexate 20 and Etanercept as well).
I’m same as you 300 daily. Rather than 400/200 a nurse suggested I get a pill cutter. I took her advice so I take 1.5 tablets each day. They are cheap small contraptions via Amazon. I was told it’s ok to break hydroxychloroquine before swallowing. My understanding is that the hydroxychloroquine helps the methotrexate to work, hence often prescribed together.
As the others have said it depends on your weight how much you take each day. Hydroxychloroquine can have an adverse effect on your eyesight so I’d want to keep my dose as low as I could. When yu are taking hydroxychloroquine you make should sure you have an eye test every year - I have an OCT scan done every year too and also use a thing called an Amsler chart every now and again to check them out at home. You can download an Amsler chart online
Hello!
Yep I wear glasses so have a test yearly anyway and recently introduced the OCT scan too which I had done back around November. 
From my personal bad experience with hydroxychloriquine I would not recommend it, unless your eyesight is closely monitored by a hospital Optometrist. I was diagnosed almost 3 years ago with Toxic Retinitis and I was told that I am going blind as result of taking Hydroxichloroquin. I am not saying that this will happen to you, but I wished that I had known before starting the tablets as I was only told that there was a slight risk of getting Cateracts. What ever you decide have a good discussion with your Consultant and then think about it.
Hi yes, 200 mg is the maximum dose usually , after 15 years I'm down to 200 and 100 alternate days.
Rituxan and hydroxychloroquine 
Hydroxychloroquine and nausea
