Pharmacists warn against malarial drugs as a cure for coronavirus

Pharmacy experts at the University of Huddersfield are urging caution over claims that widely-available antimalarial drugs could be a "magic bullet" to prevent and cure COVID-19. And the medicines can - if used rashly - have serious side effects.

Although there have been some encouraging signs from small-scale preliminary trials of the drugs chloroquine (CQ) and hydroxychloroquine (HCQ) when administered to coronavirus patients, the results are preliminary and should be treated with care, argue Dr Syed Shahzad Hasan and Dr Hamid Merchant.

They are co-authors - in collaboration with a pharmacist from Malaysia, Chia Siang Kow, of the International Medical University in Kuala Lumpur - of a new article in the British Journal of Pharmacy. It is freely available for all to read online.

The authors chart the excitement in press and social media over claims that CQ and HCQ could be effective COVID-19 treatments. But they also report how this had led to hoarding and therefore shortages of the drugs - available over the counter in some countries.

There have been reports of deaths in some parts of the world because of inappropriate self-use of CQ. And while the drugs have a good safety record, they can have seriously adverse side-effects, including loss of vision and fatal cardiovascular problems.

"It is the duty of pharmacists and other healthcare professionals to monitor the proper usage of these antimalarial drugs," states the British Journal of Pharmacy article.

As the evidence currently stands, write the authors, CQ/HCQ cannot be used as a general treatment for all COVID-19 patients.

"Its use should be restricted for the treatment of COVID-19-associated pneumonia in severely-ill patients only under a trial or clinical supervision of a licensed practitioner and close cardiac monitoring."

The article - titled Is it worth the wait? Should Chloroquine or Hydroxychloroquine be allowed for immediate use in COVID-19? - includes a bullet point list of key points and recommendations.

It is stated that "there is no evidence to support the mass use of CQ/HCQ to prevent the infection in public at large, therefore these drugs cannot be recommended for general use by the public to protect from acquiring SARS-CoV-2 infection. Social isolation and quarantine measures are still appropriate to control the infection until a reliable preventive option becomes available, for instance a vaccine".

The authors also point out that there had been only limited use of CQ/HCQ in clinical settings and no conclusive, randomly-controlled trials are yet available.

It is argued that "there is a need for an open-access central repository where clinicians can record the use/outcomes of CQ/HCQ or other pharmacological interventions for the thorough scrutiny of the data by the global scientific community".

The warnings sounded in the British Journal of Pharmacy article have since been reinforced by the U.S. Food and Drug Administration in a webpage that cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems.

Meanwhile, Dr Merchant, who is the Subject Leader at the University of Huddersfield's Department of Pharmacy, and Dr Hasan, who is a Senior Research Fellow, continue to research and write about the latest developments in the coronavirus pandemic.

Analysis of potential treatments for COVID-19

Another article by Dr Merchant published in the British Medical Journal analyses a World Health Organisation trial of four potential treatments for COVID-19.

The article - also freely available online - is an 11-point analysis of the project. Dr Merchant acknowledges that "the launch of WHO's Solidarity Trial came as good news for many, the public in general and clinicians in particular who are at the frontline to manage these crises".

But he provides a detailed critique of the drugs that are and are not included in the WHO trial.

And he concludes that: "There are as many as seven variants of human coronavirus that have been reported and there have been reports of CoV-2 being further genetically evolving during the current COVID-19 outbreak. If the global Solidarity Trial will not offer all drug options/combinations across the world in a single co-ordinated trial, we fear that the data from different countries may not be directly comparable to draw any meaningful comparison".

Hasan S, Kow CS, Merchant HA.
Is it worth the wait? Should Chloroquine or Hydroxychloroquine be allowed for immediate use in CoViD-19?
British Journal of Pharmacy. 5(1), 2020. doi: 10.5920/bjpharm.745

Most Popular Now

Scientists identify synthetic mini-antibody to com…

The ability of SARS-CoV-2 to infect cells depends on interactions between the viral spike protein and the human cell surface protein ACE2. To enable the virus to hook ont...

New drug candidate for the treatment of COVID-19

Researchers from the University of Kent, the Goethe-University in Frankfurt am Main (Germany), and the Hannover Medical School (Germany) have identified a drug with the p...

Cancer treatment could be replicated for COVID-19

Beta-blockers could potentially be used to treat COVID-19, according to a new international study by Italian and Australian scientists. University of South Australia c...

European Commission approves contract with BioNTec…

Today, the European Commission approved a fourth contract with pharmaceutical companies BioNTech and Pfizer, which provides for the initial purchase of 200 million doses ...

Lilly's neutralizing antibody bamlanivimab (LY-CoV…

The U.S. Food and Drug Administration (FDA) granted Emergency Use Authorization (EUA) for Eli Lilly and Company's (NYSE: LLY) investigational neutralizing antibody bamlan...

Medicago and GSK announce start of Phase 2/3 clini…

Medicago, a biopharmaceutical company headquartered in Quebec City, and GSK have announced the start of Phase 2/3 clinical trials of its plant-derived vaccine candidate f...

Pre-existing coronavirus antibodies could help pro…

Researchers at the Francis Crick Institute and University College London have found that some antibodies, created by the immune system during infection with common cold c...

Swissmedic begins rolling review of Moderna's mRNA…

Moderna, Inc., (Nasdaq: MRNA) a biotechnology company pioneering messenger RNA (mRNA) therapeutics and vaccines to create a new generation of transformative medicines for...

Fluvoxamine may prevent serious illness in COVID-1…

In a preliminary study of COVID-19 patients with mild-to-moderate disease who were attempting to recover in their homes, researchers at Washington University School of Me...

Remdesivir for COVID-19: FDA approved but still un…

The United States has become the epicenter of the world in the ever increasing pandemic of COVID-19. While public health prevention strategies of social distancing, crowd...

The Sputnik V COVID-19 vaccine efficacy amounted t…

The National Research Center for Epidemiology and Microbiology named after N.F. Gamaleya of the Ministry of Health of the Russian Federation (Gamaleya Center) and the Rus...

Novartis provides update on CAN-COVID trial in hos…

Novartis today announced new data from an interim analysis for the randomized, double-blind, placebo-controlled CAN-COVID trial evaluating the efficacy and safety of cana...