I appreciate all the information from folks who have contributed to the hydroxychloroquine discussion among my Facebook friends. This has been a fascinating project for me. It seems there are two camps that are putting forth information. There are experts that do not promote its usage & feel more research needs to be done before giving the okay versus those with real-life clinical experience along with local studies of the drug. I had done some homework previously and indicated to my friends that if I were to become ill with Covid-19, I would consider this medication as a viable option.
There are valid points with both the for and against views in my opinion. I agree that more research should be done but with folks suffering from this illness now, it seems that anecdotal evidence should also be seriously considered. The main difference I can find in reviewing several articles for and against using this drug is when it is administered. It appears that after being sick enough to be in the hospital, it is not the optimum time to use hydroxychloroquine, though there may be exceptions. The most favorable time-frame is when you are first diagnosed with Covid19 and symptoms appear. Catching the virus before you are hospitalized seems to be key to a much better outcome.
At drugs.com, I found the recommended dosages for the four illnesses that hydroxychloroquine is approved to treat. I thought it interesting that the dosage and length of treatment are comparable for malaria and Covid19. The other two diseases listed require a daily dose for an unspecified amount of time. I have included a couple of articles that are against using this drug. These say much the same no matter what publication you are reading when it comes to a negative response.
The positive outcomes are listed as well for a variety of places in the world. After those articles, there are some studies from the American Heart Association and then a paper compiling several studies showing the efficacy of the drug in question. I encourage you to click on the links to read for yourself. I don’t propose that I am an expert nor am I a medical doctor. I have done homework enough to satisfy my decision and I add that it would be made with my physician’s input and prescription.
No matter which side you are on- that of extreme caution or those who feel comfortable with the risk- do what you need to take care of yourself and your family. Know your family’s medical history and the reason you take any prescribed medication. This will help you and your doctor no matter what you get sick from.
Drugs.com ___hydroxychloroquine
Usual Adult Dose for Malaria:
Maximum Dose:
-First dose: 800 mg salt (620 mg base)/dose
-Second, third, and fourth dose: 400 mg salt (310 mg base)/dose
Total of 5 doses = 2400mg
Usual Adult Dose for Systemic Lupus Erythematosus:
200 to 400 mg salt (155 to 310 mg base)/day orally divided in 1 or 2 doses
Total = long term daily use
Usual Adult Dose for Rheumatoid Arthritis:
Initial dose: 400 to 600 mg salt (310 to 465 mg base)/day orally divided in 1 or 2 doses
Maintenance dose: 200 to 400 mg salt (155 to 310 mg base)/day orally divided in 1 or 2 doses
The action of this drug is cumulative and may require weeks to months to achieve the maximum therapeutic effect.
Total = long term daily use
Usual Adult Dose for COVID-19:
At least 50 kg: 800 mg salt (620 mg base) orally on day 1, followed by 400 mg salt (310 mg base) orally once a day
Total duration of therapy: 4 to 7 days, based on clinical evaluation
Total of 5-7 doses = 2400mg-3600mg
Articles that Do Not endorse hydroxychloroquine:
“The new analysis — by Mandeep Mehra, a Harvard Medical School professor and physician at Brigham and Women’s Hospital, and colleagues at other institutions — included patients with a positive laboratory test for covid-19 who were hospitalized between Dec. 20, 2019, and April 14, 2020, at 671 medical centers worldwide.
The Lancet analysis is based on a retrospective analysis of medical records, not a controlled study in which patients are divided randomly into treatment groups — the method considered the gold standard of medicine. But the sheer size of the study was convincing to some scientists.
”For those given hydroxychloroquine, there was a 34 percent increase in the risk of mortality and a 137 percent increased risk of serious heart arrhythmias. For those receiving hydroxychloroquine and an antibiotic — there was a 45 percent increased risk of death and a 411 percent increased risk of serious heart arrhythmias.
Those given chloroquine had a 37 percent increased risk of death and a 256 percent increased risk of serious heart arrhythmias. For those taking chloroquine and an antibiotic, there was a 37 percent increased risk of death and a 301 percent increased risk of serious heart arrhythmias.” ~ Washington Post article
“A former Army doctor who has spent a career helping veterans who believe they were permanently harmed by malaria drugs said two medications being considered to treat the COVID-19 coronavirus could cause brain damage and other long-term health problems in some “susceptible individuals.”
“We are trying to strike a balance between making something with the potential of an effect to the American people available while at the same time doing it under the auspices of a protocol to determine whether it is truly safe and effective,” Fauci said during a press briefing March 20.
He added that, although chloroquine has been used safely as a treatment for malaria, what “we don’t know is when you put it in the context of another disease whether it is safe.”
“Any drug has some toxicities. The decades of experience that we have in this drug indicate that the toxicities are rare and they are in many respects reversible,” Fauci said.” ~military.com
Articles and studies that DO endorse hydroxychloroquine:
London: Oxford University began enrolling U.K. health workers on Thursday in a global trial to see whether anti-malaria drugs can prevent infection by the coronavirus. ~ The Print
France: In the last week of March, for instance, over 10,000 people were prescribed hydroxychloroquine in Marseille alone. . . In France and the U.S., the use of hydroxychloroquine has been fraught between those who think the risks are small enough to warrant widespread use and those who think that more research is required before the widespread prescription. ~ forbes.com
Costa Rica: The medical director of the Caja, Mario Ruiz, as the director of Pharmacoepidemiology, Marjorie Obando Elizondo, the director of the Children’s Hospital, Olga Arguedas and the minister of Health, Daniel Salas, confirmed the use of the drug and the success in mitigating and containing the progression of the virus and also in reducing the number of patients who must be hospitalized in intensive care units. . . We were told that it is key that a mild or moderate patient does not become severe. ~ QCOSTARICA.COM
Texas: “The Texas State Board of Pharmacy issued a new rule that no prescriptions for hydroxychloroquine could be dispensed without a diagnosis, then changed their tune.
On March 20, the Texas State Board of Pharmacy issued a new rule that no prescriptions for hydroxychloroquine or azithromycin could be dispensed without a diagnosis “consistent with evidence for its use.”
“Never before have we had to turn in a diagnosis with a prescription,” Lozano told The Texan. Lozano has seen about five to six patients per week for coronavirus. “They see a dramatic improvement within six to eight hours,” Lozano said.” ~the Texan News
New York: My name is Dr. Zev Zelenko and I practice medicine in Monroe, NY. For the last 16 years, I have cared for approximately 75% of the adult population of Kiryas Joel, which is a very close-knit community of approximately 35,000 people in which the infection spread rapidly and unchecked prior to the imposition of social distancing.
Given the urgency of the situation, I developed the following treatment protocol in the pre-hospital setting and have seen only positive results:
Any patient with shortness of breath regardless of age is treated.
Any patient in the high-risk category even with just mild symptoms is treated.
Young, healthy and low-risk patients even with symptoms are not treated (unless their circumstances change and they fall into category 1 or 2).
My out-patient treatment regimen is as follows:
Hydroxychloroquine 200mg twice a day for 5 days
Azithromycin 500mg once a day for 5 days
Zinc sulfate 220mg once a day for 5 days
AHA Journal: – “Results – Two hundred one patients were treated for COVID-19 with chloroquine/hydroxychloroquine. Ten patients (5.0%) received chloroquine, 191 (95.0%) received hydroxychloroquine and 119 (59.2%) also received azithromycin. The primary outcome of TdP was not observed in the entire population.
Conclusions – In the largest reported cohort of COVID-19 patients to date treated with chloroquine/hydroxychloroquine {plus minus} azithromycin, no instances of TdP or arrhythmogenic death were reported. Although use of these medications resulted in QT prolongation, clinicians seldomly needed to discontinue therapy. Further study of the need for QT interval monitoring is needed before final recommendations can be made.” ~ The American Heart Association Journal
Timeline & 17 Research Papers: Executive Summary Interpretation of the Data In This Report- The HCQ-AZ combination, when started immediately after diagnosis, appears to be a safe and efficient treatment for COVID-19, with a mortality rate of 0.5%, in elderly patients. It avoids worsening and clears virus persistence and contagious infectivity in most cases. ~ Sequential CQ / HCQ Research Papers and Reports:
~Dr. Catherine Denton is a Metaphysician who lives in the foothills of the Great Smoky Mountains. She is the author of her memoir- Metaphysical Girl: How I Recovered My Mental Health. While on her medical journey, she was prescribed more than a dozen psychiatric medications over thirteen years. She knows what it means to “do your homework” when it comes to prescription drug use, though much of it was hindsight during those years. Looking before she leaps is now her motto.
Image by Dimitris Vetsikas from Pixabay