There’s been a lot of chatter regarding a drug called hydroxychloroquine sulfate (brand name Plaquenil) lately, so I decided to do a little research to see why this drug was tapped as a possible treatment for COVID-19. As a pharmacist, we regularly dispense hydroxychloroquine to patients with auto-immune conditions, such as rheumatoid arthritis. So how can a drug that is used for an auto-immune disease also be effective against a virus?
Let’s investigate:
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Plaquenil (hydroxychloroquine sulfate) is a derivative of quinine, a substance found in the bark of the countess-Cinchona Tree, and the main ingredient found in tonic water.
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In 1638, quinine was found to help treat symptoms of malaria for the Countess Cinchona (thus the name of the tree)
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Quinine (in tonic water) is also an effective treatment for leg cramps
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Malaria is caused by a life-threatening parasite that is found in tropical regions of the planet. It is transmitted by a mosquito bite and enters the liver where it infects red blood cells.
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Quinine, or rather its derivative chloroquine, was used to treat malarial symptoms for soldiers fighting in the South Pacific during WW-II. The drug was found to have toxic side effects and was later modified to the drug we use today, hydroxychloroquine.
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When doctors began to experiment with its applications for Lupus, an auto-immune disorder, in the 1950s, it was found to cause retinal toxicity (leading to blindness) at higher dosages.
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To this day, we do not know the mechanism of action of the drug. We do not know exactly how it works in the body.
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Today, hydroxychloroquine is most used often prescribed as a combination therapy for patients rheumatoid arthritis.
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There is not enough data showing hydroxychloroquine or chloroquine work for COVID-19. Some studies show some benefits while others show no benefits.
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No studies show that hydroxychloroquine or chloroquine works for the prevention of COVID-19.
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Patients can develop serious side effects with hydroxychloroquine or chloroquine and should, therefore, it should not be considered a therapy that can be used outside of the hospital setting for COVID-19 patients.
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Hydroxychloroquine has a long side effect profile that includes: seizures, toxic epidermal necrolysis, cardiomyopathy, suicidality, hypoglycemia, tinnitus, leukopenia, retinal damage, and more.
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Patients who have been regularly taking hydroxychloroquine are now having to experience difficulty finding the medication in pharmacies. Why? Once a medication is touted as a possible cure for a disease like this, many prescribers will write prescriptions for themselves and their families thus depleting supplies for patients who need it.
The bottom line on hydroxychloroquine? It’s never a good idea to start taking a medication with a panic mentality. These drugs are serious and no one should consider it an acceptable therapy without looking at the potential problems that may surface when its use is widely expanded across the patient base.
Stay Safe. Stay Healthy.