Patients will rely on you for the bottom line on whether hydroxychloroquine or chloroquine prevents or treats COVID-19.
These meds are thought to prevent some viruses from multiplying...and to have immunomodulating effects.
But neither is proven effective for COVID-19.
It can feel tempting to “do something” in the face of this crisis. But keep in mind, “first, do no harm.”
Supportive care remains the mainstay of treatment.
For now, don’t use hydroxychloroquine or chloroquine...with or without azithromycin...to prevent OR treat COVID-19 in the community.
Save these meds for COVID-19 patients in a clinical trial...or possibly for hospitalized patients with careful monitoring.
Expect evidence to keep flowing in. Put things in perspective.
For instance, the initial French report...which included 6 patients who “cleared” the virus after 6 days on hydroxychloroquine and azithromycin...is now being questioned.
Explain that to date, observational data are inconclusive...and a few small randomized trials show mixed results.
Plus these reports have MANY flaws...and data so far are only in hospitalized patients for treatment, not prophylaxis.
And there’s no optimal dose or duration for any of these meds.
Be concerned about QT prolongation, even with short-term use...especially if these meds are combined with azithromycin or other QT meds. In fact, FDA is now warning about reports of arrhythmia.See our chart, COVID-19 and Pharmacotherapy, for details about remdesivir, tocilizumab, etc...and access our COVID-19 Resource Hub.
- https://covid19treatmentguidelines.nih.gov/ (4-29-20)
- www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or (4-29-20)
- JAMA Published online Apr 13, 2020; doi:10.1001/jama.2020.6019
- www.ama-assn.org/delivering-care/public-health/joint-statement-ordering-prescribing-or-dispensing-covid-19 (4-29-20)
- www.ashp.org/Pharmacy-Practice/Resource-Centers/Coronavirus (4-29-20)