DoseCheckerPlus

DoseCheckerPlus is intended for use by physicians and other health care providers who prescribe hydroxychloroquine (HC) to their patients or who monitor the ocular effects of this medication on their patients. It elegantly and simply solves the HC (Plaquenil) dosing dilemma: Which methodology should you use (Ideal Body Weight or Actual Body Weight) to minimize the risk of hydroxychloroquine retinopathy (HCR)?

The app uses 2 new approaches to toxicity dose calculations:

1. Instead of selecting one or the other method, the app uses both methods. It calculates the toxic dose using both methods, and then preferentially selects the method that recommends the lower dose. The premise here is that—to avoid toxicity—the lowest dose is the safest dose.

2. The app uses an adjustable weekly dosing schedule. Instead of placing the patient on either 400 mg per day or 200 mg per day (the drug comes only as a 200 mg tablet), the app suggests a weekly dosing regimen using a combination of 400 mg and 200 mg daily doses. This dosing regimen will yield the highest therapeutic dose attainable without exceeding the toxic limit, which is defined as the lower dose of the two methodologies.

DoseCheckerPlus is simple to use. The clinician just enters the patient’s height in inches or centimeters and weight in pounds or kilograms and touches the calculate button. The recommended weekly dosing appears immediately. In addition, the dosing recommendations always fall within the approved drug labeling (which also obviates the need for FDA mobile medical app registration). Thus, all physicians can use the app to rapidly and efficiently determine the safest dose of HC--the most important step in preventing irreversible vision loss from HCR.

A description of the methods used in the app and its validation can be found in the following article:`

Perlman EM, Greenberg PE, Browning D, Friday RP, Miller JW. Solving the hydroxychloroquine dosing dilemma with a smartphone app. JAMA Ophthalmol. 2018;136(2):218-219.

How to use DoseCheckerPlus:

1. Download from the Google Play Store and install in your android smartphone.

2. IF FONT SIZE SEEMS TOO SMALL OR LARGE, YOU CAN ADJUST IT IN Settings..Display...Font Size.

2. If you want to use the metric system for patient data entry, tap the Disclaimer/Change to Metric button. Then tap Metric button. Phone will stay in metric mode unless the power is turned off.

3. Blinking cursor is in the middle of Height entry text box. Enter the patient’s height in inches or cm. Tap “NEXT” or ">".

4. Blinking cursor is in the middle of Weight entry text box. Enter the patient’s weight in pounds or kg. Tap “NEXT” or ">".

5. Blinking cursor is to the right of the default entry for patient’s current Dose (400 mg). If this correct, just tap “DONE” or green check mark. The only time you would change the entry is if the patient was on 200 mg daily; then you would replace the 400 with 200 and tap “DONE” or green check mark.

6. Once you have entered the data in the textboxes, you can go back as needed if there are errors. Once you are satisfied the entries are correct, tap the CALCULATE button.

7. Tap “RESET” to do another patient.