Hydroxychloroquine has been widely discussed as a potential therapeutic for COVID-19. It is approved by the U.S. Food and Drug Administration to treat malaria, lupus and rheumatoid arthritis. In late March, the agency allowed hospitals to use hydroxychloroquine to treat patients who otherwise don’t qualify for a clinical trial.
Barbara Santevecchi, Pharm.D., is an infectious diseases expert and a clinical assistant professor in the department of pharmacotherapy and translational research at the University of Florida College of Pharmacy, part of UF Health. Here, she elaborates on hydroxychloroquine:
What are chloroquine and hydroxychloroquine and what are they used for?
Chloroquine is an antimicrobial agent that has historically been used for treatment and prevention of malaria. Hydroxychloroquine is a similar drug. Both chloroquine and hydroxychloroquine are converted in the body to the same substance, or metabolite. Hydroxychloroquine is commonly used for treatment of lupus and rheumatoid arthritis.
Some news reports mention that hydroxychloroquine has produced promising results in some COVID-19 patients. Can you elaborate on these results?
Data are emerging quickly related to potential treatment options for COVID-19. The majority of data about potential treatment options come from experiences in other countries and studies of previous coronaviruses that are related to SARS-CoV-2, the virus that causes the disease COVID-19. Illnesses caused by previous related coronaviruses include SARS (first reported in 2003) and MERS (first reported in 2012). Both chloroquine and hydroxychloroquine have been shown in lab studies to have activity against SARS-CoV-2. We still need more information on the use of chloroquine and hydroxychloroquine in patients to evaluate how these drugs may impact the course of the disease and outcomes. Globally, there are many clinical trials going on right now evaluating chloroquine, hydroxychloroquine and several other possible treatment options for COVID-19.
What should people know about this drug and how it relates to the coronavirus?
It is important to know that all potential treatment options for COVID-19 are still under investigation. Chloroquine and hydroxychloroquine appear to have activity against the virus, SARS-CoV-2, but more information is needed from treatment in patients, such as through clinical trials, to come to a firm conclusion about these agents. Fortunately, new data seem to be emerging at a fast pace that is providing more evidence for physicians and health care providers to determine the best treatment for COVID-19.
Is it safe for patients to take? What else should people know about this drug?
Chloroquine has been in use since the 1940s for malaria. Both chloroquine and hydroxychloroquine require a prescription from a physician for use. As with all prescription medications, side effects may exist and the risks and benefits of use need to be evaluated by a physician. Potential side effects include cardiovascular side effects, or those involving the heart, and the potential for hypoglycemia, or low blood sugar. In addition, chloroquine and hydroxychloroquine need to be separated from antacids by at least four hours to avoid potential for decreased effectiveness. Patients should only take chloroquine and hydroxychloroquine under the supervision of a physician.
Barbara Santevecchi, Pharm.D., teaches content related to infectious diseases to students in the UF College of Pharmacy and works at UF Health Shands Hospital as an infectious diseases clinical pharmacy specialist. In the hospital role, she provides care for a variety of patients with infectious diseases. After graduating from pharmacy school, she completed a two-year hospital residency program and acquired additional expertise through a one-year infectious diseases pharmacy residency program.