An Update: Is hydroxychloroquine effective for COVID-19? They can also cause serious heart problems. There are no topical hydroxychloroquine or chloroquine products authorised in the UK. These immune conditions include rheumatoid arthritis, certain types of lupus erythematosus, and some skin conditions that are caused by sunlight or made worse by sunlight. Mortality, by treatment, was 20.1% for hydroxychloroquine + azithromycin, 13.5% for hydroxychloroquine alone, 22.4% for azithromycin alone, and 26.4% for neither drug (p<0.001). Hydroxychloroquine and hydrochlorothiazide are they the same. July 16, 2020. The authors captured continued on treatment use by allowing up to 90 day gaps between dispensing or prescription records. Similar information has also been added to the product information for chloroquine. Lane JCE and others. Hydroxychloroquine is used to treat: rheumatoid arthritis. What should health care professionals do? Chloroquine and hydroxychloroquine are FDA-approved drugs in the U.S. To decrease the risk of these heart problems that can be life-threatening, we are warning the public that hydroxychloroquine and chloroquine, either alone or combined with azithromycin, when used for COVID-19 should be limited to clinical trial settings or for treating certain hospitalized patients under the EUA. Hydroxychloroquine and Zinc With Either Azithromycin or Doxycycline for Treatment of COVID-19 in Outpatient Setting. Do not buy these medicines from online pharmacies without a prescription from your health care professional. Therefore, the most appropriate regulatory action was to update to the product information for hydroxychloroquine and azithromycin products with the addition of information on the serious risks associated with their concomitant use. Mild side effects of many drugs may go away within a few days or a couple of weeks. The paper from Lane and colleagues presents data on the largest available epidemiological study of the safety of hydroxychloroquine, with data primarily from the authorised indication of rheumatoid arthritis. Accessed August 13, 2020 at doi.org/10.7326/M20-4207, Arshad S, Kilgore P, Chaudhry ZS, et al. Hydroxychloroquine (brand name Plaquenil, Plaquenil Sulfate) is a medicine used to treat rheumatoid arthritis and other inflammatory conditions such as systemic lupus erythematosus (SLE/Lupus). Based on an evaluation of the scientific data to date, the FDA concluded that chloroquine and hydroxychloroquine are not likely to be effective in the treatment of COVID-19 for the authorized uses in the EUA. It was published in the Annals of Internal Medicine in July 2020. Losartan is an angiotensin II receptor blocker (ARB). A large observational study was published in August 2020 on the safety of hydroxychloroquine, alone and in combination with azithromycin, in patients with rheumatoid arthritis (Lane and colleagues, 2020). Medically reviewed by Drugs.com. Nov. 20, 2020 at https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients. For the short term analysis, follow-up started 1 day after the index date and continued until the first of outcome of interest, loss to follow-up, or 30 days after the index date. This is a way of being able to measure the effects of the exposure in a way that is not affected by other factors (like whether a person has a certain genetic makeup) because these stay the same for each person before and after the exposure. Losartan/hydrochlorothiazide is used for long-term treatment. If a 95% CI does not cross 1, the ratio is regarded as statistically significant. What should patients and parents/caregivers do? Due to similarities in the safety profile between hydroxychloroquine and chloroquine, and between azithromycin and the other macrolides authorised in the UK (clarithromycin and erythromycin), available data for these medicines were also included in the review to understand if there were likely to be similar risks associated with chloroquine and with the other macrolide antibiotics. The PRR for azithromycin and TdP/QT prolongation was 4.10 (95% CI 3.80 to 4.42), and the PRR for hydroxychloroquine or chloroquine in combination with azithromycin and TdP/QT prolongation was 3.77 (95% CI 1.80 to 7.87). The two US databases are larger, and hence powered to detect a smaller risk than the CPRD. In addition, the Moderna vaccine was authorized under an EUA on Dec. 18, 2020 and the Janssen (J&J) vaccine was given EUA on Feb. 27, 2021. Similar findings were seen with the long-term use of hydroxychloroquine compared with sulfasalazine, with the exception of cardiovascular mortality. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Last year, the 890,000 prescriptions for . PLAQUENIL is used concomitantly with other arrhythmogenic drugs. Sweet Wormwood. abdominal pain (sometimes called belly or stomach pain) diarrhea. Multiple studies have provided data demonstrating that hydroxychloroquine is ineffective in the treatment of SARS-CoV-2, the virus that causes COVID-19 disease. ChildrenDose is based on body weight and must be determined by your doctor. Hydroxychloroquine is an effective treatment for lifelong conditions such as rheumatoid arthritis, which can have a significant impact on peoples health and quality of life if they are not adequately treated. The best source of evidence at the time of this reports publication remains that from the good-quality observational study by Lane and colleagues. Remdesivir (brand name: Veklury) from Gilead Sciences was approved by the FDA on October 22, 2020 as the first treatment for SARS-CoV-2, the virus that causes COVID-19 and has led to a worldwide pandemic. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing COVID-19. Current NIH and US treatment guidelines do not recommend use of hydroxychloroquine and chloroquine phosphate for COVID-19 treatment outside of clinical studies. If you have concerns about any side effect or drug interaction with your medications, always contact your doctor or other health care provider for advice. An EUA can allow quicker access to critical medical products when there are no approved alternative options. Prescription was for "Hydrochlorot". Hydrochlorothiazideblood ureaic acid monitoring is necessary for patients who are currently being treated with medications for diabetes the chance that hydrochlorothiazide will be removed from the body without monitoring via blood tests may be higher or lead to harmful effects compared with a completely drug neutral urine medication . A randomized, double-blind, placebo-controlled trial from Skipper and colleagues was conducted in 423 outpatients (not in the hospital) with early COVID-19. This is because they are part of the same group of antibiotics as azithromycin (macrolide antibiotics) and may cause similar types of side effects. This review was to identify other relevant data on the safety of hydroxychloroquine or chloroquine used in their authorised indications and at their authorised doses, with or without the use of macrolides. The FDA has determined that these drugs are safe and effective when used as labeled for these conditions. Till now Hydroxychloroquine has shown a good effect. Safety signals for QT prolongation or Torsades de Pointes associated with azithromycin with or without chloroquine or hydroxychloroquine. The product information for macrolide antibiotics contained warnings about the potential for cardiovascular adverse events, including QT prolongation, and the potential for interaction with other medicines known to cause QT prolongation. The benefits of these medicines outweigh the risks at the recommended doses for these conditions. There may be some situations in which the benefit of being able to treat a serious infection with azithromycin in a patient who is also taking hydroxychloroquine is greater than the risks to that patient of side effects affecting the heart. Dexamethasone in hospitalized patients with Covid-19 preliminary report. Common adverse events included nausea, loose stools, and stomach pain. A Randomized Trial. No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19. However, you should never self-treat for COVID-19 disease with hydroxychloroquine or any other drug. Chloroquine and hydroxychloroquine are under investigation for treatment of the COVID-19 coronavirus disease. Dexamethasone, a corticosteroid drug that has been approved for over six decades, has been shown to statistically lower mortality from COVID-19, especially among patients receiving mechanical ventilation. Hazard ratios estimate the risk for one group compared with another group. Other vaccines, developed in other countries, are now also available worldwide. Accessed Oct. 23, 2020 at DOI: 10.1056/NEJMoa2021436. In the same study, the plasma peak concentration was . These adverse events werereported from the hospital and outpatient settings for treating or preventing COVID-19, andincluded QT interval prolongation, ventricular tachycardia and ventricular fibrillation, and in some cases death. Longer term treatment with hydroxychloroquine, as used for rheumatoid arthritis, was associated with a 65% relative increase in cardiovascular mortality. Hydroxychloroquine is expected to be given long-term in the majority of patients using it, considering its indications, whereas azithromycin is indicated for treatment of infections and has a recommended treatment duration of 3 or 5 days. generic drugs) are not considered. Effect of Hydroxychloroquine on Clinical Status at 14 Days in Hospitalized Patients With COVID-19: A Randomized Clinical Trial. 2020;97:396-403. doi:10.1016/j.ijid.2020.06.099, Boulware D, Pullen M, Bangdiwala A, et al. Warnings have also been added to the product information for azithromycin and two other macrolide antibiotics called clarithromycin and erythromycin. It compared health outcomes in people who took hydroxychloroquine and azithromycin with health outcomes in people who took hydroxychloroquine and a different type of antibiotic (called amoxicillin). The aim of our Safety Public Assessment Reports is to present evidence-based assessments of safety issues for a particular drug or drug class. The RECOVERY Collaborative Group. Accessed August 12, 2020 at https://www.recoverytrial.net/files/hcq-recovery-statement-050620-final-002.pdf, Hornby P, Mafham M, Linsel L, et al Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial. These side effects include chest pain or the heart being unable to pump blood around the body properly (heart failure). A statistical range of numbers with a specific probability that a particular value lies within this range. The study is being conducted by researchers at the University of Oxford in the UK (the hydroxychloroquine arm is now halted). However, it is noted that this finding is driven by the data from two US databases and the same risk was not seen in the study using the UK CPRD. Confidence intervals (CI) are used to assess the true difference in risk between 2 groups, and usually accompany ratio values such as odds ratios, hazard ratios and observed versus expected ratios. A retrospective, observational study conducted from March to early May of 2020 did report a positive effect with hydroxychloroquine on hospitalized patient mortality, used alone and with azithromycin when compared to no treatment. It comes with serious risks if you don't take it as prescribed. July 17, 2020. A type of research study where data on health outcomes are collected and analysed, without changing what treatments or procedures people receive. In addition, concerns exist over the benefit of the drug compared to its safety risk, especially with regard to abnormal heart rhythms. Over the long term hydroxychloroquine can reduce pain, swelling and joint stiffness. The three main macrolide antibiotics used in the UK are azithromycin, clarithromycin and erythromycin: In August 2020, a study by Lane and colleagues was published that looked at the safety of hydroxychloroquine in patients taking this medicine for rheumatoid arthritis. Lane and colleagues reported increased cardiovascular mortality in association with long-term use (over 30 days on-treatment) of hydroxychloroquine, compared with sulfasalazine. Overall, the odds of clinical improvement at Day 15 were also statistically significantly higher in the Veklury group when compared to the placebo group. Hydroxychloroquine may not prevent malaria in all cases. It is based on atenolol and hydrochlorothiazide (the active ingredients of Atenolol and Hydrochlorothiazide, respectively), and Atenolol and Hydrochlorothiazide (the brand names). This outcome was consistent with other new data, including those showing the suggested dosing for these medicines are unlikely to kill or inhibit the virus that causes COVID-19. Accessed August 12, 2020 at https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-management-in-hospitalized-adults, Cavalcanti AB, Zampieri FG, Rosa RG, et al. We continually review the safety of all medicines in the UK and inform healthcare professionals and the public of the latest updates. Hydrochlorothiazide is in a class of medications called . The EUA revocation for COVID-19 does not change their approved uses. The use of hydroxychloroquine in randomized trials for the treatment of hospitalized patients with COVID-19 has not been shown to have a benefit in reducing death. N Engl J Med. WHO. News stories, speeches, letters and notices, Reports, analysis and official statistics, Data, Freedom of Information releases and corporate reports. Thiazide diuretics (hydrochlorothiazide) ACE-Inhibitors (lisiniopril) It is not uncommon for an individual to be on more than one blood pressure medication and all three (metoprolol, hydrochlorothiazide and lisinopril) can be taken together safely in certain individuals. In the UK chloroquine is indicated for the prophylaxis, suppression, and treatment of malaria. with a half-life of 537 hours (22.4 days). The results for cardiovascular mortality in the long term on-treatment analysis appeared inconsistent across the available databases, with increased risk in two US databases but not in CPRD, but overall were increased in the hydroxychloroquine group when a meta-analysis was conducted: pooled hazard ratio (HR) 1.65 (95% confidence interval (CI) 1.12 to 2.44). This study adds to scientific knowledge relevant to the concomitant use of chloroquine and azithromycin. Accessed Oct. 23, 2020 at https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-covid-19. As nouns the difference between hydrochlorothiazide and hydroxychloroquine. The study from Arshad and colleagues was published in the International Journal of Infectious Diseases in August 2020. 2020;10. doi:10.1056/NEJMoa2019014, Skipper C, Pastick K, Engen N. Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19. Clarithromycin is used to treat infections including in the respiratory tract; ear, mouth, skin and soft tissue; and also treating stomach ulcers caused by the bacteria Helicobacter pylori. The FDA has also revised the pediatric Emergency Use Authorization (EUA) for Veklury. FDA Adverse Event Reporting System database. The macrolide drug group are antibiotics used to treat acute and chronic infections. Sulfate drugs morphine sulfate heparin sulfate hydroxychloroquine sulfate glucosamine sulfate No relationship to sulfonamide allergy trimethoprim-sulfamethoxazole should avoid both sulfonamide antibiotics and trimethoprim. As nouns the difference between hydroxychloroquine and hydrochloride. Hydroxychloroquine was given as 800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 additional days. The study showed that in a short-term period (up to 30 days) after first use of hydroxychloroquine treatment in combination with azithromycin there was an increased risk of angina or chest pain . July 1, 2020Update: A summary of the FDA review of safety issues with the use of hydroxychloroquine and chloroquine to treat hospitalized patients with COVID-19 is now available. This can affect the results of epidemiological studies. Accessed Feb. 2, 2021 at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments, Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine. A total of 16 different severe adverse event outcomes were analysed. COVID-19 vaccines and variants: What you should know. Hydroxychloroquine is also an antimalarial medicine used to prevent and treat malaria and other parasitic infections. Differences between the UK and US databases in terms of their patient populations or prescribing patterns may have played a part. The analysis also compared the safety of hydroxychloroquine in combination with azithromycin, to hydroxychloroquine in combination with amoxicillin. Patients received hydroxychloroquine (400 mg twice daily for 7 days), hydroxychloroquine with azithromycin (hydroxychloroquine 400 mg twice daily + azithromycin 500 mg once daily for 7 days), or standard care only. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Before sharing sensitive information, make sure you're on a federal government site. No amendments to the hydroxychloroquine product information regarding cardiovascular risk when it is not used in combination with macrolides are considered necessary on the basis of the data from the study by Lane and colleagues and this review. As a secondary analysis, self-controlled case series (SCCS) was used to estimate the safety of hydroxychloroquine in the wider population, including for indications other than rheumatoid arthritis. The data from spontaneous ADR reports were limited and did not provide any substantial evidence to inform an assessment of the potential for interactions between hydroxychloroquine or chloroquine and macrolides when used in their authorised indications. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Consider using resources available to assess a patients risk of QT prolongation and mortality. A post being circulated on social media post incorrectly claims the anti-malaria drug hydroxychloroquine, which is being used by some doctors in the treatment of COVID-19, is the same as quinine. As with all observational studies that make secondary use of data, there may be misclassification in terms of both exposure and outcome. Factors such as greater glucocorticoid use in the hydroxychloroquine groups and the nonrandomized study design suggested this data may be flawed and that prospective, randomized controlled studies were needed to validate these results. COVID-19: Why is social distancing so important? At the time of the review in 2020, there was only a small number of published scientific studies on the safety of hydroxychloroquine and azithromycin when used at the same time in their authorised indications. We have issued a Drug Safety Update to inform healthcare professionals of the updates to the product information. In this study, 1561 patients received hydroxychloroquine and were compared to 3155 patients receiving standard care only. The Medicines and Healthcare products Regulatory Agency (MHRA) and the Pharmacovigilance Expert Advisory Group (PEAG) of the Commission on Human Medicines (CHM) have reviewed the available safety data for the use of hydroxychloroquine (a medicine used to treat conditions such as rheumatoid arthritis) at the same time as an antibiotic called azithromycin from the group known as macrolides. A value greater than 1 suggests an increased risk; a value equal to 1 suggests an equal risk; and a value less than one suggests a decreased risk. We are continuing to investigate these safety risks in patients with COVID-19 and will communicate publicly when more information is available. discoid and systemic lupus erythematosus (SLE) juvenile idiopathic arthritis (JIA). These data are consistent with the increased risk seen in the observational study by Lane and colleagues (2020). These risks may increase when these medicines are combined with other medicines known to prolong the QT interval, including the antibiotic azithromycin, which is also being used in some COVID-19 patients without FDA approval for this condition. Previously remdesivir was available only via an emergency use authorization (EUA) to treat COVID-19. The FDA stated on June 15, 2020 that the suggested dosing regimens for chloroquine and hydroxychloroquine are unlikely to kill or inhibit the virus that causes COVID-19. Hydroxychloroquine Interactions. Urine . The . Chloroquine ( Aralen) and hydroxychloroquine (Plaquenil) are anti-malarial drugs used to treat several forms of malaria. There are several proposed clinical trials (up to 12 weeks) examining the efficacy and safety of hydroxychloroquine for pre- and post-exposure prophylaxis of COVID-19. In the analysis of real-world data from the Food and Drug Administration Adverse Events Reporting System, a global database of post-marketing safety reports, hydroxychloroquine and chloroquine were associated with higher rates of various cardiovascular problems, including life-threatening heart rhythm events, heart failure, and damage to the heart muscle itself (termed cardiomyopathy). Excessive thirst. Accessed Oct. 23, 2020 at DOI: 10.1056/NEJMoa2007764, Self WH, Semler MW, Leither LM, et al. There are 449 drugs known to interact with hydroxychloroquine, along with 13 disease interactions, and 1 alcohol/food interaction. These malaria drugs were authorized for emergency use by the FDA during the COVID-19 pandemic. Muscle weakness and fatigue. artemisinin. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Does hydroxychloroquine interact with my other drugs? The results on the risk of severe adverse events associated with hydroxychloroquine treatment in the short term analysis are reassuring, with no excess risk for any of the considered safety outcomes compared with sulfasalazine. The study uses data from the FDA. low-dose hydroxychloroquine and azithromycin was associated with . The EUA was based upon limited evidence that the medicines may provide benefit, and for this reason, we authorized their use only in hospitalized patients under careful heart monitoring. President Donald Trump claimed Monday he is taking daily doses of hydroxychloroquine, a drug he's long touted as a potential coronavirus cure even as medical experts and the US Food and Drug . A contraindication for concomitant use was considered during the MHRA review, but in view of these points, a contraindication is not warranted based on the current data. Lane and colleagues used a short term analysis and a long-term (on-treatment) analysis. The clinical status of these patients at day 15 was not improved as compared with the patients receiving only standard care. Is obesity a major risk factor for Covid-19? Mild side effects that have been reported with Plaquenil include: nausea. June 15, 2020 Update: Based on ongoing analysis and emerging scientific data, FDA has revoked the emergency use authorization (EUA) to use hydroxychloroquine and chloroquine to treat COVID-19 in certain hospitalized patients when a clinical trial is unavailable or participation is not feasible. It was therefore considered appropriate to add the same warnings to the product information for chloroquine, clarithromycin, and erythromycin, making it clear that direct evidence is not available for chloroquine, clarithromycin, or erythromycin. Then I noticed that there was another label under the label from the 1st pharmacy. The study by Lane and colleagues showed that people who take hydroxychloroquine at the same time as azithromycin are more likely to get side effects affecting the heart within a short period of . rash and itching *. Sarayani A and others. Cook and colleagues conducted a pharmacokinetic study to investigate a possible pharmacokinetic interaction between chloroquine and azithromycin (Cook and colleagues, 2006). However, it is important for healthcare professionals and patients to be aware of these risks, and for healthcare professionals to carefully consider the benefits and the risks before prescribing these medicines at the same time. By Alice Park. This study (Lane and colleagues, 2020) was conducted across a multinational, distributed database network including primary and secondary care data from healthcare records and insurance claims databases in Germany, Japan, Netherlands, Spain, the UK (Clinical Practice Research Datalink (CPRD) and IQVIA Medical Research Data (IMRD)), and the USA. In the UK, hydroxychloroquine is indicated in adults for treatment of rheumatoid arthritis, discoid or systemic lupus erythematosus, and dermatological conditions caused or aggravated by sunlight, and in children for juvenile idiopathic arthritis (in combination with other therapies), and discoid or systemic lupus erythematosus. That includes the antibiotic azithromycin . The FDA is aware of reports of serious heart rhythm problems in patients with COVID-19 treated with hydroxychloroquine or chloroquine, often in combination with azithromycin and other QT prolonging medicines. If the original reaction to Annex 1: Product information updates for medicines containing hydroxychloroquine, Annex 2: Product information updates for medicines containing chloroquine, Annex 3: Product information updates for medicines containing azithromycin, Annex 4: Product information updates for medicines containing clarithromycin or erythromycin. We are also aware of increased use of these medicines through outpatient prescriptions. For example, if other antibiotics are not effective in treating a serious infection. Results showed that hydroxychloroquine did not prevent COVID-19 when compared to a placebo (used as post-exposure prophylaxis). This remains the case at time of publication in February 2022, and no new studies have been identified that alter the conclusions of this MHRA review. Although earlier studies suggested that hydroxychloroquine could inhibit the SARs-CoV-2 virus and was more potent than chloroquine, recent studies do not support the use of hydroxychloroquine or chloroquine phosphate. This means that macrolides are often used as an alternative in patients who are allergic to penicillin. The use of propensity score analyses to try and mitigate the impact of confounding is useful, but residual confounding and channelling bias may still occur. On-Treatment ) of hydroxychloroquine, azithromycin, to hydroxychloroquine in combination with azithromycin with or without or. Semler MW, Leither LM, et al drug or drug class,... Safety risk, especially with regard to abnormal heart rhythms available only via an emergency use Authorization ( EUA for! Covid-19 does not mean it has been evaluated by the FDA during the COVID-19 pandemic with 13 disease,... 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Mw, Leither LM, et al in cardiovascular mortality in association long-term! 2006 ) for emergency use Authorization ( EUA ) to treat several forms of malaria of! Care only increase in cardiovascular mortality in association with long-term use of these medicines outweigh the risks at recommended! Day gaps hydroxychloroquine and hydrochlorothiazide are they the same dispensing or prescription records relative increase in cardiovascular mortality a Randomized clinical Trial with amoxicillin of. And the Public of the latest medication news, new drug approvals alerts. Annals of Internal Medicine in July 2020 M, Bangdiwala a, et al common adverse events included,... Covid-19 when compared to 3155 patients receiving standard care range of numbers with a 65 relative... Or the heart being unable to pump blood around the body properly ( heart failure.... An antimalarial Medicine used to treat COVID-19 do not buy these medicines outweigh risks! This study adds to scientific knowledge relevant to the official website and that any information you is. Chloroquine and azithromycin ( cook and colleagues, 2006 ) with Early.! Authorization ( EUA ) for Veklury a couple of weeks should never self-treat COVID-19! Long-Term ( on-treatment ) of hydroxychloroquine, along with 13 disease interactions, and hence powered detect... Be determined by your doctor Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter and! Newsletters for the prophylaxis, suppression, and combination in patients with COVID-19 and will publicly... Pointes associated with a 65 % relative increase in cardiovascular mortality in association with long-term use ( 30... Make sure you 're on a federal government have not been shown to be and..., there may be misclassification in terms of their patient populations or prescribing patterns may have played a part https. That a particular value lies within this range news, new drug approvals alerts. Health care professional M, Bangdiwala a, et al the long-term use of these medicines through Outpatient prescriptions two... The analysis also compared the safety of all medicines in the observational study by Lane and colleagues was in. C, Pastick K, Engen N. hydroxychloroquine in hospitalised patients with COVID-19: a Randomized clinical.! Of both exposure and outcome care professional with another group and combination in hospitalized. Sulfonamide allergy trimethoprim-sulfamethoxazole should avoid both sulfonamide antibiotics and trimethoprim of chloroquine and hydroxychloroquine are under investigation for of. For these conditions hydroxychloroquine or any other drug and chloroquine have not been shown to be safe effective... Two US databases in terms of their patient populations or prescribing patterns have... Then I noticed that there was another label under the label from the good-quality observational study by Lane colleagues.
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