Hydroxychloroquine (Molecule of the Month for July 2020)
Plaquenil, Hydroquin, Axemal, Dolquine, Quensyl, Quinoric
Hydroxychloroquine is a medication used to prevent and treat malaria in areas where malaria remains sensitive to chloroquine. Other uses include treatment of rheumatoid arthritis, lupus, and porphyria cutanea tarda. It is taken by mouth, often in the form of hydroxychloroquine sulfate.
Hydroxychloroquine was approved for medical use in the United States in 1955. It is on the World Health Organization's List of Essential Medicines. In 2017, it was the 128th most commonly prescribed medication in the United States, with more than five million prescriptions.
Hydroxychloroquine is being studied to prevent and treat coronavirus disease 2019 (COVID‑19), but all clinical trials conducted during 2020 found it is ineffective and may cause dangerous side effects. The speculative use of hydroxychloroquine for COVID‑19 threatens its availability for people with established indications.
The drug label advises that hydroxychloroquine should not be prescribed to individuals with known hypersensitivity to 4-aminoquinoline compounds. There are several other contraindications, and caution is required if the person considered for treatment has certain heart conditions, diabetes, or psoriasis. Overdoses of hydroxychloroquine are extremely rare, but extremely toxic. Eight people are known to have overdosed since the drug's introduction in the mid-1950s, of which three have died.
Beginning in March 2020, US President Donald Trump began promoting hydroxychloroquine to prevent or treat COVID-19, citing small numbers of anecdotal reports. Trump stated in June that he was taking the drug as a preventive measure, stimulating unprecedented worldwide demand and causing shortages of hydroxychloroquine for its prescribed purpose of preventing malaria. After issuing an emergency use authorization for physicians to use the drug to treat hospitalized people with severe COVID-19 infection, the US Food and Drug Administration withdrew the authorization in June after finding hydroxychloroquine was unlikely to be effective and had serious side effects. During ensuing months, additional studies found the drug was not effective, and in late July, Anthony Fauci stated, "We know that every single good study — and by good study I mean randomized controlled study in which the data are firm and believable — has shown that hydroxychloroquine is not effective in the treatment of COVID-19."
Formal Chemical Name (IUPAC)
Update by Karl Harrison
(Molecule of the Month for July 2020 )
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