What is Hydroxychloroquine? Malaria drug and coronavirus treatment

Anti-malaria drug hydroxychloroquine is back in the news after US President Donald Trump on Tuesday hinted at retaliation if India does not export the drug that is believed to be helpful in treating the Coronavirus.

The prospect of using hydroxychloroquine to treat Covid-19 amid the novel coronavirus pandemic has sparked rancor and disagreement among politicians and scientists.

There have been indications that the drug is effective in treating or preventing Covid-19, but the tests haven’t endured the due diligence of extensive clinical trials.

Still, many — including President Donald Trump — are calling for doctors to prescribe hydroxychloroquine to Covid-19 patients.

What is hydroxychloroquine?

Hydroxychloroquine is used to treat malaria. The drug was invented during World War II. It is also prescribed for rheumatoid arthritis. According to the Johns Hopkins University Lupus Center, the anti-malarial medication has been shown to improve symptoms such as muscle and joint pain, skin rashes, inflammation of the heart and lung linings, fatigue, and fever. Hydroxychloroquine is sold under the brand name Plaquenil and is available as generics.

What brand names are available for hydroxychloroquine (Plaquenil)?

Plaquenil

Is hydroxychloroquine (Plaquenil) available as a generic drug?

Yes

Do I need a prescription for hydroxychloroquine (Plaquenil)?

Yes

How is Hydroxychloroquine being used?

The drug can help tame an overactive immune system. It’s been used since the 1940s to prevent and treat malaria and to treat rheumatoid arthritis and lupus. It’s sold in generic form and under the brand name Plaquenil in the United States. Doctors also can prescribe it “off label” for other purposes, as many are doing now for COVID-19.

What’s the evidence?

Some small and very preliminary studies give conflicting results. One lab study suggested it curbed the virus’ ability to enter cells. Another report on 11 people found it did not improve how fast patients cleared the virus or their symptoms. A report from China claimed the drug helped more than 100 patients at 10 hospitals, but they had various degrees of illness and were treated with various doses for different lengths of time, and might have recovered without the drug — there was no group that didn’t get the drug for comparison.

Other researchers in China reported that cough, pneumonia and fever seemed to improve sooner among 31 patients given Hydroxychloroquine compared to 31 others who did not get the drug, although fewer people in the comparison group had cough or fevers to start with. Four people developed severe illness and all were in the group that did not get the drug. These results were posted online and have not been reviewed by other scientists or published in a journal.

Finally, the small study from France that President Donald Trump touted as evidence of the drug’s benefit is now in question. The head of the journal that published it has put out an “ expression of concern ” about its methods.

Larger, more rigorous studies are underway now.

Can hydroxychloroquine be used to treat Coronavirus?

In France, 40 coronavirus patients were given hydroxychloroquine and more than half of them experienced the clearing of their airways within three to six days. The study suggested that the anti-malarial drug can slow infections from Sars-CoV-2 —  the virus behind Covid-19 — by blocking it from entering cells in the body.

What’s the risk?

The drug can cause heart rhythm problems, severely low blood pressure and muscle or nerve damage. Taking it outside of a scientific experiment adds the risk of not having tracking in place to watch for any of these side effects or problems and quickly address them if they do occur.

According to the European Medicines Agency, hydroxychloroquine should not be taken by coronavirus patients except for clinical trials or emergency use programs.