This article is up to date as of 3/25/2020. As new information becomes available, please reach out to your pharmacy to learn more about the role of these medications for COVID-19.
By now, you may have heard about potential treatments for the COVID-19 pandemic. Among these treatments, three medications are making headlines: azithromycin, hydroxychloroquine, and chloroquine.
Sona Pharmacy is committed to keeping our patients and community informed with the most up-to-date and trustworthy information regarding new medications and treatments. And while new information is continually being shared regarding COVID-19, we want to ensure that you have a clear understanding about: what these medications are used for, the interest surrounding them as treatment options, and who these medications are currently available to.
It is critically important to understand that no drugs or treatments have been proven as effective for either the prevention of contracting COVID-19 or for its treatment. The following information is shared solely to educate our community and to reassure patients currently being treated with these medications that steps are being taken to ensure they remain available to them.
What are chloroquine, hydroxychloroquine, and azithromycin? What are they currently approved to treat?
Azithromycin (Z-pak™, Zithromax™) is an antibiotic most commonly used for respiratory tract infections.
Both chloroquine and hydroxychloroquine (Plaquenil™) are medications used to treat and prevent malaria. Hydroxychloroquine is also commonly used as a maintenance medication for autoimmune conditions like lupus and rheumatoid arthritis.
Each of these medications are available in the United States and are generic.
How could antibiotics or antimalarial medications help treat a virus like COVID-19?
Much of the potential benefit of hydroxychloroquine and chloroquine for COVID-19 comes from studies related to their use in Severe Acute Respiratory Syndrome (SARS). The virus that caused SARS is a coronavirus similar to the one responsible for the COVID-19 outbreak. For more information on what a “coronavirus” is, read our previous blog post here.
Recent lab studies have shown that hydroxychloroquine and chloroquine may have benefit in treating COVID-19 by two proposed mechanisms:
- Inhibition of viral replication by: 1) slowing or reducing viral entry into the cell (where it replicates), and 2) slowing other important steps in viral replication within the cell.
- It is thought that these medications may also help to reduce immune-mediated organ damage that can harm vital organs such as the lungs.
Viral illness, like the flu or coronaviruses, can often increase risk of other infections like pneumonia. For this reason, azithromycin has been used in studies to reduce risk of bacterial infection in patients with COVID-19.
How likely is it that these drugs will work as a treatment for COVID-19?
At this point, there is not enough definitive information or testing to know if these medications successfully treat COVID-19. While there is some promising evidence of benefit, studies for these medications in COVID-19 have significant limitations, including a limited number of treatment studies. Additional research is currently in progress to expand upon these early studies.
What is being done to ensure people have access to these medications?
NC Health and Human Services is working with the State Medical and Pharmacy Boards to adopt rules aimed at ensuring appropriate patients have access to these medications. These rules cover several “restricted” medications including azithromycin, hydroxychloroquine, chloroquine, and oseltamivir (Tamiflu™).
For the treatment of chronic conditions: These new rules do NOT apply to patients who have been taking a restricted medication for an established condition like rheumatoid arthritis. At Sona, we have been limiting these medications to a 30 day supply to help ensure access to these medications.
For the potential treatment of COVID-19: These medications should ONLY be used under the supervision of a medical provider – such as a doctor, physician assistant or nurse practitioner – for an appropriate diagnosis. Patients should NEVER self-treat with prescription medications. Additionally, pharmacies must have an appropriate, written diagnosis from the prescriber in order to dispense new prescriptions for “restricted” medications.
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