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Hydroxychloroquine Update for April 6

blogs.sciencemag.org

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Re: Hydroxychloroquine Update for April 6

#31

Post by tptacek »

m0zg wrote: post #21
tptacek wrote: post #15

Earlier quoted context omitted.

I think we can all intuitively see the distinction in risk tolerance between table salt consumption and HCQ consumption.

Now try to estimate the risk of _not_ consuming HCQ when you have C19 symptoms. Armchair virology and statistical studies are fun right up until the moment you get dry cough and shortness of breath.

You mean, like, that I'll have an infarction because of Q-T disruption, probably won't do anything to ward off C19, and, if I'm dosing it "over the counter" "like candy", might not have even had C19 in the first place? Seems like I can distinguish the risks between that and table salt too.

Re: Hydroxychloroquine Update for April 6

#33

Post by stri8ed »

m0zg wrote: post #3

Counterpoint: http://www.leparisien.fr/societe/sante/chloroquine-ne-perdon... You can do double blind studies until your patients are literally blue in the face, or you can try what works now. That is literally the choice at the moment. According to Peter Navarro, a good percentage of NYC patients are getting HCQ at the onset of symptoms now. Cuomo wants more of it, because it "appears to be working". Oklahoma is giv…

> Kentucky is giving it to patients, too.

Source?

> Italy saw its numbers of deaths stabilize once they started giving it.

It appears the total number of cases also decreased. Which would suggest effect is likely due to social distancing.

> Marseille (where Raoult's hospital is) has the lowest fatality rate in all of France

Source?

Re: Hydroxychloroquine Update for April 6

#34

Post by dionian »

pazimzadeh wrote: post #30

Taking Chloroquine too soon might promote viral infection by inhibiting the anti-viral response. https://sciencedirect.com/science/article/abs/pii/S016635421... CQ is for patients who have uncontrolled inflammation in response to the virus, not to be taken as a prophylactic.

Chloroquine is more toxic than Hydrochloroquine, isn't it?

Re: Hydroxychloroquine Update for April 6

#35

Post by kevingadd »

Mountain_Skies wrote: post #14
kevingadd wrote: post #4

Earlier quoted context omitted.

The fact that you can buy the drug over the counter doesn't mean it's universally safe. The people being hospitalized here are already doing poorly so exposing them to additional risk is not something you should just do on a whim. As the linked post mentions, there are clear signs of potential risks associated with the use of HCQ. I hope for the patients being dosed with it now that it both works and is safe, but it'…

Is it being used as a treatment for those already on a ventilator? My impression is that it is being used as a way to help prevent patients from getting to the point of needing a ventilator.

I should have been more precise - even if you're not already on a ventilator, your respiratory system is under some stress that isn't going to be equivalent to the experience of most people taking HCQ under normal circumstances. There are also various reports of COVID stressing the heart which is another potentially scary thing that could change the safety of the drug.

As Derek notes in the article, "Many people are saying that perhaps it will work best if taken early in the course of infection" - so at that point your lungs and heart are probably doing great, so the risks aren't quite as severe if we're talking about early intervention... but in the event that it doesn't help and your condition worsens, now you've got HCQ in your system getting up to its side effect business while the virus goes to town on your cells.

Ultimately if a doctor is prescribing this stuff as an early preventative measure or attempting to use it to help patients who are in bad shape, best of luck to them - I hope it works. But it's really depressing to see laymen telling each other that it's safe to just take this drug.

Re: Hydroxychloroquine Update for April 6

#36

Post by xienze »

threeseed wrote: post #26
m0zg wrote: post #9

Earlier quoted context omitted.

> doesn't mean it's universally safe _Table salt_ is not safe. Eat 100 grams of it and you will die. This does, however, mean that it's not as "dangerous" as the mainstream press wants you to believe. It's a 50 year old drug used all over the world. If it was "deadly", we'd know it by now. CDC itself recommends taking it _as a prophylaxis_ when heading to the areas where malaria might be present: https://www.cdc.gov/…

This drug is not administered to everyone though. It's only been tested and verified for people with I believe lupus and malaria. So we don't know the implications of rolling it out to millions of people worldwide. That's why you do clinical trials.

> So we don't know the implications of rolling it out to millions of people worldwide.

It’s 70+ years old. It’s a well-understood drug. It’s an experimental treatment, not an experimental medicine.

It’s also frequently prescribed to grandmas with rheumatoid arthritis.

Re: Hydroxychloroquine Update for April 6

#37

Post by buboard »

kevingadd wrote: post #2

The possible high-mortality interaction with metformin is a terrifying prospect. Diabetes is so common... hopefully it's something that doesn't apply to humans.

In mice. Hcq has been around for a long time, you d think that if it was so lethal in humans someone would have noticed

Re: Hydroxychloroquine Update for April 6

#38

Post by dmh2000 »

ck2 wrote: post #6

While other drugs are looking far more promising, there might be an obvious reason why despite lack of clear proof/results the president is pushing it so hard like everything else that motivates him: https://lawandcrime.com/covid-19-pandemic/major-producer-of-...

that wouldn't explain why Gov Cuomo is also a fan

Re: Hydroxychloroquine Update for April 6

#39

Post by threeseed »

Mountain_Skies wrote: post #16
ck2 wrote: post #6

While other drugs are looking far more promising, there might be an obvious reason why despite lack of clear proof/results the president is pushing it so hard like everything else that motivates him: https://lawandcrime.com/covid-19-pandemic/major-producer-of-...

Is it possible to corner the market on a generic drug that is produced across the world?

Who says you need to corner the market ?

It's much easier to ramp up production than start an entirely new process with a new drug. And given we are talking about timeframes of weeks and months and not years all of the existing manufacturers will have a significant lead.

Re: Hydroxychloroquine Update for April 6

#40

Post by kevingadd »

dionian wrote: post #34
pazimzadeh wrote: post #30

Taking Chloroquine too soon might promote viral infection by inhibiting the anti-viral response. https://sciencedirect.com/science/article/abs/pii/S016635421... CQ is for patients who have uncontrolled inflammation in response to the virus, not to be taken as a prophylactic.

Chloroquine is more toxic than Hydrochloroquine, isn't it?

IIRC the addition of the hydroxy to the drug means it's going to be more water-soluble so it would be easier to excrete in urine and flush it out of the system, which would count as "less toxic" if you squint when reading the paper

I haven't seen any detailed discussions of the differences in toxicity, but one physician made a comment to that effect.

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