Hydroxychloroquine...........

336,510 Views | 1854 Replies | Last: 11 mo ago by Jabin
Pelayo
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Marcus Aurelius said:

Our ID docs not recommending azithromycin or other IL-6 inhibitors . Not sure why other than theoretical QT issues. Daily EKGs. I'm still Rxing HCQ and azithro. Personally never seen alot of QT prolongation with azithro and I've Rx'd tons of the stuff.
Water might as well cause qt prolongation with as many drugs that affect the qt interval to some extent. Baseline qtc of 430 or less, 1 week of plaquenil and Zithromax isn't going give the patient torsades. Now they come in on amio and sotalol and you have a concern.
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cone
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is the HCQ having any visible efficacy?
Marcus Aurelius
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Have you read the French paper? Yes. Increased viral clearance with HCQ plus azithro. Some other small Asian data that is positive. Anecdotally I have 2 confirmed COVID-19 pt on the combo. See that thread for details.
hellapark
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Thanks for all the updates Marcus, we appreciate all the info you and others like you are sharing. Praying hard for all the folks out there on the front lines. God speed!
cone
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that French paper was really really thin, dropping cases that got worse out of the study, total N of ~30, not randomized not blind

I put more stock in China and SoKo protocols and lived experience

Can't hurt might help is good enough in this fog if war
HouAggie2007
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Yes sorry, I was trying to say at this point I time with all the sacrifices and heroic actions of doctors it's a shame that there are some selfish people out there
Exsurge Domine
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HouAggie2007 said:

Yes sorry, I was trying to say at this point I time with all the sacrifices and heroic actions of doctors it's a shame that there are some selfish people out there


Don't worry just pop over to the politics board where Agnzona is explaining why it's beneficial to have people hoarding n95 masks and selling them for $30/pop on eBay
Marcus Aurelius
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cone said:

that French paper was really really thin, dropping cases that got worse out of the study, total N of ~30, not randomized not blind

I put more stock in China and SoKo protocols and lived experience

Can't hurt might help is good enough in this fog if war
Exactly. This aint "TIMI" cardiology 30,000 pt trials. Desperate times. Desperate measures. Both drugs low side effect profiles. Watch QT interval.
74Ag1
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Hurry up FDA and stop this
https://www.google.com/amp/s/www.wsj.com/amp/articles/these-drugs-are-helping-our-coronavirus-patients-11584899438
74Ag1
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Get it together FDA... hurry up
https://www.google.com/amp/s/www.forbes.com/sites/marybethpfeiffer/2020/03/22/one-patient-dodges-a-covid-bullet-is-she-a-harbinger-or-outlier/amp/
74Ag1
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Let's go FDA
https://www.google.com/amp/s/amp.washingtontimes.com/news/2020/mar/22/daniel-dae-kim-credits-hydroxychloroquine-coronavi/
Exsurge Domine
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Lotsa good news coming out
Palovic
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I become a bigger advocate of HCQ by the day and everyday that goes by that we do not have this product being administered to all that have either tested positive for CV-19 or are showing clinical symptoms before a confirmed test is a risk to the hospital system and the patient.

This is not an FDA issue solely as it is more an availability issue due to the exponential demand we have seen domestically. It is being prescribed without FDA approval for CV-19 today as it is used for other ailments.
Pasquale Liucci
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Sorry if I missed it, but are you a doctor? Do you have patients who are receiving HCQ to treat COVID?
Infection_Ag11
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Marcus Aurelius said:

Our ID docs not recommending azithromycin or other IL-6 inhibitors . Not sure why other than theoretical QT issues. Daily EKGs. I'm still Rxing HCQ and azithro. Personally never seen alot of QT prolongation with azithro and I've Rx'd tons of the stuff.


I haven't either, the risk is highest in patients on multiple prolonging agents. The cases I've seen are in combination with stuff like amio, sotalol, levaquin/cipro/moxi, certain antidepressants.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
DTP02
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NY starts widespread clinical trials on Tuesday. Interesting that they've acquired much more chloroquine than hydroxychloroquine. Possibly due to availability? But I read elsewhere that CVS has much more availability of hydroxychloroquine than chloroquine, so I'm not sure the explanation.

https://www.forbes.com/sites/lisettevoytko/2020/03/22/new-york-to-begin-clinical-trials-for-coronavirus-treatment-tuesday-cuomo-says/#115771c54203

Another anecdotal success story from a NY nurse:

https://www.forbes.com/sites/marybethpfeiffer/2020/03/22/one-patient-dodges-a-covid-bullet-is-she-a-harbinger-or-outlier/#19ac10245b84
Not a Bot
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With the time it takes to plan, implement, and publish RCTs we likely won't be seeing a lot of RCT data on this for a while, and that is for the studies already underway. To get a more clear picture we would need to synthesize the data from many RCTs together. This sort of meta-analysis (when done well) is considered a gold standard in clinical research. We don't really have the luxury of time to do all of that.

What we can be doing much sooner is publishing data in similar fashion the French report. While not being the gold standard, these smaller studies (when done en masse) can be synthesized to provide quite a bit of evidence. I'm hopeful hospitals that implemented this protocol will be able to soon publish some data on its effectiveness. It's nice to see the doctors going on Fox to say that it's working well and celebrities tweeting about how quickly they got over it using hydroxychloroquine, but the hard numbers need to be out there.

The key figures we need to watch are not only mortality, but length of hospital stay and need for ICU/vents. If multiple studies from around the country show this protocol can limit the strain on hospitals, we may be able to get back to business as a country much sooner. I would suspect there will be no major decisions made on this without several RCTs. Fauci isn't going to recommend a let up until those finish.
Not a Bot
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DTP02 said:

NY starts widespread clinical trials on Tuesday. Interesting that they've acquired much more chloroquine than hydroxychloroquine. Possibly due to availability?

https://www.forbes.com/sites/lisettevoytko/2020/03/22/new-york-to-begin-clinical-trials-for-coronavirus-treatment-tuesday-cuomo-says/#115771c54203

Another anecdotal success story from a NY nurse:

https://www.forbes.com/sites/marybethpfeiffer/2020/03/22/one-patient-dodges-a-covid-bullet-is-she-a-harbinger-or-outlier/#19ac10245b84


Bayer donated 3 million tablets of chloroquine to the government for this purpose. Has a higher risk profile for side effects, but should have a very similar action against the virus. Data comparing chloroquine (and the side effects) compared to placebo, compared to hydroxychloroquine and in combination with drugs like azithromycin will provide us the best data. It could turn out the chloroquine is much more effective and maybe it should be recommended in people who can tolerate the side effects. Maybe not. We won't know until we get good RCTs done. The good thing about these drugs is that they've been around forever and we generally know what to expect when people take them.

The study process for newer drugs will take a lot more time.
Reginald Cousins
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S
Infection_Ag11 said:

Marcus Aurelius said:

Our ID docs not recommending azithromycin or other IL-6 inhibitors . Not sure why other than theoretical QT issues. Daily EKGs. I'm still Rxing HCQ and azithro. Personally never seen alot of QT prolongation with azithro and I've Rx'd tons of the stuff.


I haven't either, the risk is highest in patients on multiple prolonging agents. The cases I've seen are in combination with stuff like amio, sotalol, levaquin/cipro/moxi, certain antidepressants.
Fleicainide?
Palovic
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Some additional information for those looking at incorporating Quercetin into their daily routine to boost zinc intake into the cellular membrane with its ability to act as a zinc ionophore or just increase overall immunity.

https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176

Quercetin's ability to stop Influenza viral replication
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728566/


Bioavailability is the largest challenge for the effectiveness of this supplement as is the half-life. Here are some studies for review.


http://quercetinscience.com/2009-Nieman-Effects%20of%20Quercetin-EGCG-MSSE.pdf

DARPA funded study

http://quercetinscience.com/2007-Nieman-Quercetin-MSSE.pdf

Just some good information for those looking for preventative measures today
Player To Be Named Later
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I ordered this brand.... is the bio availability of this brand likely to be even worth taking?

https://www.amazon.com/dp/B0013OSQ5I/ref=cm_sw_r_apa_i_FalEEbYZWPG87
Infection_Ag11
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Reginald Cousins said:

Infection_Ag11 said:

Marcus Aurelius said:

Our ID docs not recommending azithromycin or other IL-6 inhibitors . Not sure why other than theoretical QT issues. Daily EKGs. I'm still Rxing HCQ and azithro. Personally never seen alot of QT prolongation with azithro and I've Rx'd tons of the stuff.


I haven't either, the risk is highest in patients on multiple prolonging agents. The cases I've seen are in combination with stuff like amio, sotalol, levaquin/cipro/moxi, certain antidepressants.
Fleicainide?


We don't use that much flecainide anymore (its contraindicated in those with underlying coronary or structural heart disease so we usually only see it in younger patients with atrial arrhythmias) but QT prolongation is usually caused by the class 1a and class 3 anti arrhythmia drugs. Flecainide is class 1c and we usually only use it in younger patients without coronary disease or heart failure so I wouldn't worry too much about it TBH.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Reginald Cousins
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I belong to the younger demographic and take it. Thanks for the info.
2wealfth Man
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Infection_Ag11 said:

Marcus Aurelius said:

Our ID docs not recommending azithromycin or other IL-6 inhibitors . Not sure why other than theoretical QT issues. Daily EKGs. I'm still Rxing HCQ and azithro. Personally never seen alot of QT prolongation with azithro and I've Rx'd tons of the stuff.


I haven't either, the risk is highest in patients on multiple prolonging agents. The cases I've seen are in combination with stuff like amio, sotalol, levaquin/cipro/moxi, certain antidepressants.
FDA needs to get on the ball and approve Actemra as well; it is an IL-6 inhibitor
Infection_Ag11
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Reginald Cousins said:

I belong to the younger demographic and take it. Thanks for the info.


I actually took it when I was younger for SVT before my ablation. It's a great drug in the right patient.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Reginald Cousins
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Infection_Ag11 said:

Reginald Cousins said:

I belong to the younger demographic and take it. Thanks for the info.


I actually took it when I was younger for SVT before my ablation. It's a great drug in the right patient.
Ugh, I need to go ahead and do that before insurance gets any crappier.
DTP02
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For those who missed it, interview with oncologist from well-known hospital in Manhattan, Lenox Hill, regarding hydroxychloroquine:



Bullet points:

- his hospital is currently prescribing hydroxychloroquine with or without azithromycin. He has spoken to colleagues at other NY metro hospitals and says they are doing the same.

- Isn't overly concerned about FDA approval or CDC recommendation. He's on the frontlines at ground zero and is going with what they think works.

- his hospital has roughly 100 patients with infection . (my assumption is this means 100 patients who have been admitted, not just tested and sent home. Fits with his other comments.)

- his hospital has not lost a patient. (My editorializing: if they've had 100 admitted patients for any significant length of time, and they're all on this protocol and haven't lost one, that's meaningful support for its efficacy. Hope they are going to pass along their documentation for analysis)

- fair to say that he shares optimism that this drug could be a game-changer. Discusses potential for prophylactic or early stage use which could get the country back to some normalcy
goodAg80
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Quote:

Lagos, Nigeria (CNN)Health officials in Nigeria have issued a warning over chloroquine after they said three people in the country overdosed on the drug, in the wake of President Trump's comments about using it to treat coronavirus.

A Lagos state official told CNN that three people were hospitalized in the city after taking the drug. Officials later issued a statement cautioning against using chloroquine for Covid-19 treatment.
DTP02
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Not sure that a political hit piece about 3 people in Nigeria overdosing on a drug without doctor's supervision really belongs on this thread or in this forum.
74OA
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goodAg80 said:

Quote:

Lagos, Nigeria (CNN)Health officials in Nigeria have issued a warning over chloroquine after they said three people in the country overdosed on the drug, in the wake of President Trump's comments about using it to treat coronavirus.

A Lagos state official told CNN that three people were hospitalized in the city after taking the drug. Officials later issued a statement cautioning against using chloroquine for Covid-19 treatment.

You can overdose on just about anything.

Using the implied logic, we should suspend all proven medicines because people might overdose from taking more than the prescribed amount.
Bryan98
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74Ag1 said:

Let's go FDA
https://www.google.com/amp/s/amp.washingtontimes.com/news/2020/mar/22/daniel-dae-kim-credits-hydroxychloroquine-coronavi/


Hard to credit this one much; you can't kill Johnny Gat!
fig96
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74Ag1 said:

Let's go FDA
https://www.google.com/amp/s/amp.washingtontimes.com/news/2020/mar/22/daniel-dae-kim-credits-hydroxychloroquine-coronavi/
I'm glad he's recovered, but I feel like a guy who's at like 6% body fat and maintains an insanely healthy lifestyle probably isn't a great case to use as an example for this. Also doesn't sound like he really had any serious symptoms to start with.

i.e. this is one that very much falls in the "anecdotal" category.
Not a Bot
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Just started another thread on this, but new study on virus interaction with human proteins offers more hope for treatment. A lot of FDA-approved drugs may help, including chloroquine.

https://www.biorxiv.org/content/10.1101/2020.03.22.002386v1.full.pdf+html
Aston04
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Player To Be Named Later said:

I ordered this brand.... is the bio availability of this brand likely to be even worth taking?

https://www.amazon.com/dp/B0013OSQ5I/ref=cm_sw_r_apa_i_FalEEbYZWPG87
Giving it a shot too.
Sq 17
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granted the actor is probably not high risk group but if he got better quickly, that is good news
 
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