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Hydroxychloroquine for COVID-19

  • FDA revoked emergency use authorization of hydroxychloroquine for COVID June, 2020.
  • FDA published its review of safety issues with this drug July 1, 2020
  • Cochrane review published March,2021 looking at chloroquine or hydroxychloroquine. They found 14 studies
    • 12 studies for COVID treatment – 8569 adult patients total
    • 2 studies of hydroxychloroquine as prophylaxis after exposure – 3346 patients
    • Conclusions:
      • “Hydroxychloroquine does not reduce deaths from COVID-19, and probably does not reduce the number of people needing mechanical ventilation.”
      • “Hydroxychloroquine caused more unwanted effects than a placebo treatment, though it did not appear to increase the number of serious unwanted effects.”
      • “The authors do not think new studies of hydroxychloroquine should be started for treatment of COVID-19.”
  • National Institute of Health (NIH) published its review of data (Updated July 2021) from published trials of chloroquine, hydroxychloroquine, with and without azithromycin and concluded
    • “The COVID-19 Treatment Guidelines Panel (the Panel) recommends against the use of chloroquine or hydroxychloroquine and/or azithromycin for the treatment of COVID-19 in hospitalized patients (AI) and in nonhospitalized patients (AIIa).”
    • “Chloroquine and hydroxychloroquine are moderate inhibitors of cytochrome P450 2D6, and these drugs are also P-glycoprotein inhibitors. Chloroquine and hydroxychloroquine may decrease the antiviral activity of remdesivir; coadministration of these drugs is not recommended.”
    • “Cardiac adverse events that have been reported in people who received hydroxychloroquine include QTc prolongation, Torsades de Pointes, ventricular arrythmia, and cardiac deaths. … The use of azithromycin has also been associated with QTc prolongation, and using it in combination with hydroxychloroquine has been associated with a higher incidence of QTc prolongation and cardiac adverse events in patients with COVID-19.”
  • The World Health Organization also recommends against its use, updated April, 2021.
    • “WHO does not recommend hydroxychloroquine to prevent COVID-19. This recommendation is based on six trials with more than 6000 participants who did not have COVID-19 and received hydroxychloroquine. Using hydroxychloroquine for prevention had little or no effect on preventing illness, hospitalization or death from COVID-19. Taking hydroxychloroquine to prevent COVID-19 may increase the risk of diarrhea, nausea, abdominal pain, drowsiness and headache. More information can be found here. “
    • “WHO does not recommend hydroxychloroquine as a treatment for COVID-19. This recommendation is based on 30 trials with more than 10 000 COVID-19 patients. Hydroxychloroquine did not reduce mortality, the need for or duration of mechanical ventilation. Taking hydroxychloroquine to treat COVID-19 may increase the risk of heart rhythm problems, blood and lymph disorders, kidney injury, liver problems and failure. More information can be found here. However, hydroxychloroquine and chloroquine are safe for use in patients with autoimmune diseases or malaria (not COVID-19).”
    • “The Solidarity trial, the UK’s Recovery trial, and a Cochrane review of other evidence on hydroxychloroquine conclusively showed that hydroxychloroquine did not reduce deaths among hospitalized COVID-19 patients. Based on this evidence, WHO dropped the hydroxychloroquine arm of the Solidarity Trial in June of 2020. More information can be found here. “

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