A healthy living blog from Marshfield Clinic Health System

3 things to know about hydroxychloroquine and COVID-19

Pharmacist explains hydroxychloroquine to patient

Early research is inconsistent about hydroxychloroquine’s effect on COVID-19.

Editor’s note: This article was published on April 21, 2020. COVID-19 information and recommendations are subject to change. For the most up-to-date information, visit the Centers for Disease Control and Prevention (CDC) website or view our most recent COVID-19 blog posts.

Hydroxychloroquine is in the news and at the top of internet searches of people looking for options to treat novel Coronavirus (COVID-19). Used since the 1950’s, this prescription drug can treat rheumatoid arthritis and lupus to decrease the pain and swelling of arthritis. It also prevents and treats malaria.

Is hydroxychloroquine effective against COVID-19?

Since March 2020, hydroxychloroquine has received significant attention by medical researchers across the globe.

“There have been many poorly designed studies published showing contradictory results leading to significant confusion,” said Logan Whitfield, PharmD, Marshfield Clinic Health System pharmacy antimicrobial stewardship coordinator. “Some studies reported modest benefit, some studies reported no benefit, and some studies even hinted at potential harm.”

Whitfield notes that many of those studies were not peer-reviewed.

“More recently, there have been several peer-reviewed, randomized-controlled trials, the highest grade of evidence, that have shown hydroxychloroquine does not promote viral clearance, prevent hospitalization in those taking it at the onset of symptoms, or improve clinical outcome in patients with COVID-19 of any severity,” Whitfield said. “Some of these studies included the concomitant use of azithromycin, zinc, and vitamin C without any statistically significant benefit.”

Three of the most well respected guidelines for the treatment of COVID-19 published by the World Health Organization, Infectious Diseases Society of America, and National Institutes of Health now recommend against use of hydroxychloroquine for the treatment of COVID-19 outside enrollment in a clinical trial.

Potential for severe side effects

While everyone reacts differently to medications, common side effects with hydroxychloroquine include headache, dizziness, diarrhea, stomach cramps or vomiting. Some of these effects occurred up to 3-5 times more often than placebo in COVID-19 clinical trials. Above all, it also can cause serious side effects like irregular heartbeat.

Unless enrolled in a clinical trial, hydroxychloroquine should be avoided for the prevention or treatment of COVID-19. The available evidence suggests it is not effective, and side effects may include fatal arrhythmias in susceptible populations.

Risk of shortage

Hydroxychloroquine currently is no longer in shortage. This could change rapidly, however; if misinformation propagates continued use of hydroxychloroquine in COVID-19.

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