Chloroquine and Hydroxychloroquine: Should you take them for Covid 19 Prevention?
Chloroquine is routinely used in the treatment of malaria. Hydroxychloroquine (HCQ) is used for treating malaria and rheumatological disorders such as rheumatoid arthritis, systemic lupus erythematosus, etc. Recently they have been in news with regards to their proposed role in preventing Covid 19 infection caused by SARS Cov2 virus. Pharmacies have reported frenetic buying of these two drugs by general public as well as healthcare professionals and stocks have been depleting fast.
What is the current evidence regarding their effectiveness in prevention of Covid 19?
Chloroquine and hydroxychloroquine for Covid 19 prophylaxis
Indian Council of Medical Research (ICMR) has approved the use of hydroxychloroquine for prevention of Covid 19 in high-risk individuals. People who can use are:
- Asymptomatic healthcare professionals (doctors, nurses, etc) involved in taking care of Covid 19 patients.
- Asymptomatic household contacts of laboratory confirmed Covid 19 cases.
For healthcare professionals: 400 mg twice on day 1, then, 400 mg once weekly for next 7 weeks, to be taken with meals
For household contacts: 400 mg twice on day 1 followed by 400 mg once weekly for next 3 weeks, to be taken with meals
The details of the ICMR advisory can be found at the following link: https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloroquinasprophylaxisforSARSCoV2infection.pdf
General public should avoid indiscriminately taking HCQ for preventing Covid 19, as there could be serious adverse effects with it. HCQ should be avoided in patients with heart disease with QT prolongation, myasthenia gravis, retinal diseases, epilepsy and porphyria.
There is no evidence with regards to efficacy of chloroquine in Covid 19 prevention. So, chloroquine should not be used for Covid 19 prophylaxis.
Dr Sudhir Kumar MD DM
Apollo Hospitals, Hyderabad