Avoiding Unproven and Unsafe Remedies for COVID-19

| Posted On Jun 02, 2020 | By:

Much is unknown about the novel coronavirus known as COVID-19, including whether any existing medications will successfully prevent and treat infections caused by it. You may have heard speculation and even endorsement in the news of specific medications. The truth is that no clinical trials have yet proven any medication to be effective, and many trials are now underway. Some limited information is also available from drugs tried in COVID-19 infected patients, but these studies did not include a control group of equivalent patients who did not receive the drug making it impossible to compare and tell if the treatment was truly effective. Still, other information, in early analysis, is showing some evidence that these specific drugs do NOT help to treat COVID-19 infections and, in some cases, can even increase death rates.

One alarming trend is the availability of substances fraudulently advertised as useful for COVID-19. Reports of the use of medications intended for animals (e.g., some forms of chloroquine and ivermectin) have described serious and even fatal consequences. Do NOT use any of these products! The Food and Drug Administration (FDA) has issued several warnings to address this concern, such as Fraudulent Coronavirus Disease 2019 (COVID-19) Products and FDA Letter to Stakeholders: Do Not Use Ivermectin Intended for Animals as Treatment for COVID-19 in Humans. Some of these drugs are approved in other forms for use in humans for specific reasons – such as chloroquine for treating malaria and ivermectin for certain parasitic worms, head lice, and certain skin conditions – but these drugs can also have significant side effects. And there is no evidence that they are useful for treating or preventing COVID-19 infections.

Prescription hydroxychloroquine (with or without azithromycin) has also been in the news a lot lately. Hydroxychloroquine has been shown to prevent the growth of COVID-19 in the laboratory, but no human study has yet shown it to prevent or improve COVID-19 infections. Unfortunately, hydroxychloroquine is associated with several serious side effects, including serious and sometimes fatal heart rhythms. New data shows that patients with COVID-19 infections have a higher rate of death if they take hydroxychloroquine than if they do not.

Azithromycin is an antibiotic, so it doesn’t work against viruses such as COVID-19. Some patients with COVID-19 infections develop bacterial pneumonia at the same time, and azithromycin may be one of several antibiotics that could be used to treat the bacterial pneumonia. However, azithromycin also has some concerning side effects and can change heart rhythms in the same way that hydroxychloroquine can. Taking both drugs together can add to the risk of either one taken by itself, especially in people with heart or kidney disease.

For more information on concerns with hydroxychloroquine and azithromycin, see the FDA’s 4/24/2020 safety alert. In this alert, the FDA provides a public warning that hydroxychloroquine, with or without azithromycin, should be used ONLY in clinical trials or in treating certain hospitalized patients under Federal emergency use procedures.

In addition, a global study of hydroxychloroquine in COVID-19 was halted by the World Health Organization (WHO) on 5/25/2020 based on published data showing higher rates of death and dangerous heart rhythms with its use. The National Institutes of Health (NIH) and the Infectious Diseases Society of America (IDSA) recommend against its use unless it is part of a clinical trial. At Atrius Health, we strongly advise against patients being prescribed hydroxychloroquine in all outpatient settings.

We are all hopeful that clinical data show us that certain medications are genuinely helpful in treating COVID-19 soon, including a vaccine to prevent it. Until then, the most important therapeutic measures we can each take are physical distancing, wearing a mask in public places, hand-washing, and taking care of our health (including virtual visits to our health care team and taking your medications) to avoid visits to urgent care or the hospital.

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About Amy Vachon, PharmD

Amy Vachon, PharmD is Director of the Atrius Health Clinical Pharmacy Program and co-chair of the Atrius Health Pharmacy & Therapeutics Committee. She joined Harvard Vanguard in 1996 and has worked to grow the Clinical Pharmacy Program which provides services to patients at many of our Atrius Health locations. Prior to working at Atrius Health, Amy was the Assistant Director for Clinical Pharmacy Services at Beth Israel Hospital, and before that, she worked in the operating room at Tufts Medical Center as a Clinical Pharmacy Specialist in Anesthesia and Operating Room Pharmacy. Amy graduated with a Doctor of Pharmacy from the University of Michigan, and completed a residency in pharmacy practice at Tufts Medical Center in Boston. Amy is also passionate about creating the opportunity for work/life balance that allows every employee to be his or her best contributor to the workplace, and is the author, together with her husband, of Equally Shared Parenting: Rewriting the Rules for a New Generation of Parents (Perigee Penguin 2011). She’s the mother of two children and an avid amateur violinist in her spare time.

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