Could the anti-malarial drug chloroquine treat COVID-19?
Based upon limited in-vitro and anecdotal data, chloroquine or hydroxychloroquine are currently recommended for treatment of hospitalized COVID patients in several countries. Both chloroquine and hydroxychloroquine have known safety profiles with the main concerns being cardiotoxicity prolonged QT syndrome with prolonged use in patients with hepatic or renal dysfunction and immunosuppression but have been reportedly well-tolerated in COVID patients.
Due to higher in-vitro activity against SARS-CoV-2 and its wider availability in the United States compared with chloroquine, hydroxychloroquine has been administered to hospitalized COVID patients on an uncontrolled basis in multiple countries, including in the United States.
One small study reported that hydroxychloroquine alone or in combination with azithromycin reduced detection of SARS-CoV-2 RNA in upper respiratory tract specimens compared with a non-randomized control group but did not assess clinical benefit [ 7 ]. Hydroxychloroquine and azithromycin are associated with QT prolongation and caution is advised when considering these drugs in patients with chronic medical conditions e. Hydroxychloroquine is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis of SARS-CoV-2 infection, and treatment of patients with mild, moderate, and severe COVID In the United States, several clinical trials of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection are planned or will be enrolling soon.
Lopinavir-ritonavir did not show promise for treatment of hospitalized COVID patients with pneumonia in a recent clinical trial in China [ 8 ]. This trial was underpowered, and lopinavir-ritonavir is under investigation in a World Health Organization study.
Hydroxychloroquine and Chloroquine
Several other drugs are under investigation in clinical trials or are being considered for clinical trials of prophylaxis or treatment of COVID in the United States and worldwide. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation. Minus Related Pages. Remdesivir Remdesivir is an investigational intravenous drug with broad antiviral activity that inhibits viral replication through premature termination of RNA transcription and has in-vitro activity against SARS-CoV-2 and in-vitro and in-vivo activity against related betacoronaviruses [ ].
The manufacturer is currently transitioning the provision of emergency access to remdesivir from individual compassionate use requests to an expanded access program.
Hydroxychloroquine: MedlinePlus Drug Information
For rheumatoid arthritis, one to three tablets are usually taken once a day. Hydroxychloroquine can be taken with a glass of milk or a meal to decrease nausea. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Take hydroxychloroquine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. If you are taking hydroxychloroquine for symptoms of rheumatoid arthritis, your symptoms should improve within 6 months. If your rheumatoid arthritis symptoms do not improve, or if they worsen, stop taking the drug and call your doctor.
Hydroxychloroquine (Plaquenil) and Chloroquine Shortage Caused by COVID-19 Coronavirus Claims
Once you and your doctor are sure the drug works for you, do not stop taking hydroxychloroquine without talking to your doctor. Symptoms of rheumatoid arthritis will return if you stop taking hydroxychloroquine. Hydroxychloroquine is used occasionally to treat porphyria cutanea tarda. Talk to your doctor about the possible risks of using this drug for your condition.
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Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat and moisture not in the bathroom. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program.
It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.
155 comments on “Chloroquine, Past and Present”
Manufacturers recommend regular ophthalmological examination but the evidence of practical value is unsatisfactory see advice of the Royal College of Ophthalmologists. To avoid excessive dosage in obese patients, the dose of hydroxychloroquine should be calculated on the basis of ideal body-weight.
Other drugs classified as disease-modifying anti-rheumatic drugs. Acute porphyrias ; diabetes may lower blood glucose ; elderly ; G6PD deficiency ; may aggravate myasthenia gravis ; may exacerbate psoriasis ; neurological disorders especially in those with a history of epilepsy—may lower seizure threshold ; severe gastro-intestinal disorders Cautions, further information Screening for retinopathy A review group convened by the Royal College of Ophthalmologists has updated guidelines on screening for chloroquine and hydroxychloroquine retinopathy Hydroxychloroquine and Chloroquine Retinopathy: Recommendations on Screening Individual interactants: Hydroxychloroquine.
Common or very common Abdominal pain ; appetite decreased ; diarrhoea ; emotional lability ; headache ; nausea ; skin reactions ; vision disorders ; vomiting. Uncommon Alopecia ; corneal oedema ; dizziness ; eye disorders ; hair colour changes ; nervousness ; neuromuscular dysfunction ; retinopathy ; seizure ; tinnitus ; vertigo.
Frequency not known Acute hepatic failure ; agranulocytosis ; anaemia ; angioedema ; bone marrow disorders ; bronchospasm ; cardiac conduction disorders ; cardiomyopathy ; hearing loss ; hypoglycaemia ; leucopenia ; movement disorders ; muscle weakness ; myopathy ; photosensitivity reaction ; psychosis ; reflexes absent ; severe cutaneous adverse reactions SCARs ; thrombocytopenia ; tremor ; ventricular hypertrophy.
Overdose Hydroxychloroquine is very toxic in overdosage; overdosage is extremely hazardous and difficult to treat.