Hydroxychloroquine--Do You Want It in Your Medicine Chest?

By now hydroxychloroquine, brand name Plaquenil, should be a household word.  While the debate continues to rage on its efficacy in treating COVID in the US (mostly in the media and among doctors and pharmaceutical companies who have a vested interest in promoting their vaccines and killer expensive novel drug treatments), much of the rest of the world recognizes its value in treating common diseases. 

Hydroxychloroquine is commonly prescribed to treat rheumatoid arthritis and lupus and to prevent and treat malaria.  It’s been used in the US since 1955 and is on WHO’s List of Essential Medicines.  While it is even used in pregnancy to treat rheumatic disease, hydroxychloroquine is not without side effects or contraindications.  It must be used with caution in patients with psoriasis, diabetes, and heart disease.  The majority of problems with hydroxychloroquine stem from high dosages and long-term use, neither of which is a concern when using it to treat COVID.

If nothing else, COVID has exposed the overabundance of misinformation, deception, hypocrisy, lies, and abuse of power from political leaders and bureaucracies in this country.  Masks don’t work, and then they do.  Social distancing doesn’t work, and then it does, but “peaceful” protests are exempt from social distancing requirements.  Bars and restaurants can reopen, but churches cannot.  So churches in Las Vegas started renting out closed casinos so that they could hold services.  Without trusted sources to rely on, we have to seek for the truth ourselves. 

Based on what I have read over the last eight or nine months, I believe hydroxychloroquine to be an effective treatment for COVID, especially when treatment begins early.  If I felt that I or a family member was displaying symptoms of COVID, I would seek proper direction from a physician.  At this point, however, I do not trust the tests one iota.  There are just too many shenanigans being reported from all over the country.  False positives, false negatives.  An individual takes the test four times in a single day and has two positives and two negatives.   A nurse brings home four tests, supposedly for her family, opens the tests up, waves them around in the air, and seals them up and returns them to the lab.  Three positives and a negative.  How does that work?  Are the tests contaminated with COVID so as to produce positive results and increase infection rates and hysteria in the country?  I have no idea what’s going on.  Unfortunately, the people I can trust in the matter are few and far between. 

The following information on medication and dosages that appear to be effective in treating COVID is what I have gathered from various sources in the last several months.  You may find something useful.  In no way am I recommending or prescribing the following. I am not a doctor.  Based on the dosages recommended below, I am storing enough hydroxychloroquine, azithromycin, doxycycline, ceftriaxone, and zinc sulfate for my family.  Fortunately, the antibiotics can be used to treat numerous illnesses. 

Numerous sources indicate that zinc is essential to treatment, so I would not omit that. 

Treatment #1

Hydroxychloroquine 200 mg, twice per day, 5 days
Azithromycin 500mg, once per day, 5 days

Zinc sulfate 220 mg, once per day, 5 days

Treatment #2

Hydroxychloroquine 200 mg, twice per day, 5 days
Azithromycin 500mg, once per day, 5 days

Treatment #3

Hydroxychloroquine, 400 mg, twice per day, day 1; then 200 mg twice per day, days 2-5

Ceftriaxone 1 gram (2 grams if more than 100 kg) IV daily for 3 days, plus azithromycin 500 mg IV daily for 3 days, preferred; OR doxycycline 200 mg twice per day, 4 days

Links to related posts:

Zinc

Ceftriaxone

Doxycycline

References:

https://www.doomandbloom.net/the-missing-zinc/

https://drive.google.com/file/d/186Bel9RqfsmEx55FDum4xY_IlWSHnGbj/view

https://www.sciencedirect.com/science/article/pii/S2052297520300329

The following article came from the CDC back in March.  They no longer have this on their website; you can find references to this letter and the information contained therein all over the web.

Hydroxychloroquine and Chloroquine
Hydroxychloroquine and chloroquine are oral prescription drugs that have been used for treatment of malaria and certain inflammatory conditions. Chloroquine has been used for malaria treatment and chemoprophylaxis, and hydroxychloroquine is used for treatment of rheumatoid arthritis, systemic lupus erythematosus and porphyria cutanea tarda. Both drugs have in-vitro activity against SARS-CoV, SARS-CoV-2, and other coronaviruses, with hydroxychloroquine having relatively higher potency against SARS-CoV-2 [1,4,5]. A study in China reported that chloroquine treatment of COVID-19 patients had clinical and virologic benefit versus a comparison group, and chloroquine was added as a recommended antiviral for treatment of COVID-19 in China [6]. Based upon limited in-vitro and anecdotal data, chloroquine or hydroxychloroquine are currently recommended for treatment of hospitalized COVID-19 patients in several countries. Both chloroquine and hydroxychloroquine have known safety profiles with the main concerns being cardiotoxicity (prolonged QT syndrome) with prolonged use in patients with hepatic or renal dysfunction and immunosuppression but have been reportedly well-tolerated in COVID-19 patients.

Due to higher in-vitro activity against SARS-CoV-2 and its wider availability in the United States compared with chloroquine, hydroxychloroquine has been administered to hospitalized COVID-19 patients on an uncontrolled basis in multiple countries, including in the United States. One small study reported that hydroxychloroquine alone or in combination with azithromycin reduced detection of SARS-CoV-2 RNA in upper respiratory tract specimens compared with a non-randomized control group but did not assess clinical benefit [7].

Hydroxychloroquine and azithromycin are associated with QT prolongation and caution is advised when considering these drugs in patients with chronic medical conditions (e.g. renal failure, hepatic disease) or who are receiving medications that might interact to cause arrythmias.

Hydroxychloroquine is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis of SARS-CoV-2 infection, and treatment of patients with mild, moderate, and severe COVID-19. In the United States, several clinical trials of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection are planned or will be enrolling soon. More information on trials can be found at: https://clinicaltrials.gov/external icon.

There are no currently available data from Randomized Clinical Trials (RCTs) to inform clinical guidance on the use, dosing, or duration of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection. Although optimal dosing and duration of hydroxychloroquine for treatment of COVID-19 are unknown, some U.S. clinicians have reported anecdotally different hydroxychloroquine dosing such as: 400mg BID on day one, then daily for 5 days; 400 mg BID on day one, then 200mg BID for 4 days; 600 mg BID on day one, then 400mg daily on days 2-5.

References

1. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, Shi Z, Hu Z, Zhong W, Xiao G. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020 Mar;30(3):269-271.
2. Sheahan TP, Sims AC, Leist SR, Schäfer A, Won J, Brown AJ, Montgomery SA, Hogg A, Babusis D, Clarke MO, Spahn JE, Bauer L, Sellers S, Porter D, Feng JY, Cihlar T, Jordan R, Denison MR, Baric RS. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020 Jan 10;11(1):222.
3. Sheahan TP, Sims AC, Graham RL, Menachery VD, Gralinski LE, Case JB, Leist SR, Pyrc K, Feng JY, Trantcheva I, Bannister R, Park Y, Babusis D, Clarke MO, Mackman RL, Spahn JE, Palmiotti CA, Siegel D, Ray AS, Cihlar T, Jordan R, Denison MR, Baric RS. Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Sci Transl Med. 2017 Jun 28;9(396).
4. Colson P, Rolain JM, Lagier JC, Brouqui P, Raoult D. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents. 2020 Mar 4:105932. doi: 10.1016/j.ijantimicag.2020.105932. [Epub ahead of print]
5. Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, Liu X, Zhao L, Dong E, Song C, Zhan S, Lu R, Li H, Tan W, Liu D. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020 Mar 9. pii: ciaa237. doi: 10.1093/cid/ciaa237. [Epub ahead of print]
6. Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020 Mar 16;14(1):72-73
7. Gautret P, Lagier J, Parola P, Hoang V, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents. In Press.
8. Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, Ruan L, Song B, Cai Y, Wei M, Li X, Xia J, Chen N, Xiang J, Yu T, Bai T, Xie X, Zhang L, Li C, Yuan Y, Chen H, Li H, Huang H, Tu S, Gong F, Liu Y, Wei Y, Dong C, Zhou F, Gu X, Xu J, Liu Z, Zhang Y, Li H, Shang L, Wang K, Li K, Zhou X, Dong X, Qu Z, Lu S, Hu X, Ruan S, Luo S, Wu J, Peng L, Cheng F, Pan L, Zou J, Jia C, Wang J, Liu X, Wang S, Wu X, Ge Q, He J, Zhan H, Qiu F, Guo L, Huang C, Jaki T, Hayden FG, Horby PW, Zhang D, Wang C. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020 Mar 18. doi: 10.1056/NEJMoa2001282. [Epub ahead of print]