In some countries of the world, people with severe coronavirus Covid-19 form began to be treated with Plaquenil, which was previously used to cure malaria. Despite the fact that this medicine supposedly shows positive results in the fight against coronavirus, doctors claim that the effectiveness of the drug has not been proven and more serious studies are needed. There is no longer any such drug in Ukrainian pharmacies, but the country received a batch of Plaquenil, which will be distributed throughout the country. In this case, after taking this medicine, multiple side effects may appear, including problems with vision, skin and nervous system. But first things first.
What is this?
Plaquenil is an antimalarial drug that belongs to the group of immunosuppressants. The main ingredient of the drug is hydroxychloroquine sulfate. Previously, Plaquenil was used to treat arthritis of varying severity, malaria, and skin and lupus diseases.
Before starting the course of treatment with Plaquenil, all patients must undergo an ophthalmic examination. In the future, such an examination should be carried out every 12 months. During an ophthalmological examination, it is necessary to check visual acuity, conduct thorough ophthalmoscopy and fundoscopy, as well as study the central field of view with a red target and color vision.
This drug is contraindicated to pregnant women, nursing mothers, as well as people with hypersensitivity to 4-aminoquinolone compounds. With caution, it could be taken by patients with liver or kidney disease, as well as for those who take drugs that can adversely affect the function of these organs, as well as people with severe gastrointestinal, neurological and hematological diseases.
In addition, Plaquenil has a number of side effects (all side effects occur at different frequencies and not in each case):
blood and lymphatic system problems: anemia, leukopenia, thrombocytopenia;
disorders of the immune system: urticaria, angioedema, bronchospasm;
metabolic and nutritional disorders: lack of appetite;
psyche: psychosis, increased irritability;
nervous system: headache, dizziness;
organs of vision: blurred vision due to impaired accommodation. It is a dose-dependent and reversible phenomenon. Infrequently, retinopathy may occur with changes in pigmentation and the appearance of visual field defects, but if the recommended daily dose is not exceeded, this phenomenon rarely occurs;
organs of hearing and balance: tinnitus, hearing loss is also possible;
heart: cardiomyopathy, which can lead to the development of heart failure, in some cases fatal;
gastrointestinal tract: abdominal pain, nausea, diarrhea, vomiting;
skin and subcutaneous tissue: skin rashes, itching. Infrequently there is a change in pigmentation of the skin and mucous membranes, hair bleaching, alopecia.
Overdose symptoms may include headache, visual impairment, cardiovascular collapse, convulsions, hypokalemia, rhythm and conduction disturbances, including prolonged QT interval, ventricular tachycardia torsade de pointe, ventricular tachycardia, and ventricular fibrillation, followed by sudden death.
Plaquenil vs. Coronavirus
On March 9, Clinical Infectious Diseases magazine published studies stating that the drug has good potential for controlling Covid-19 coronavirus. In clinical trials, it was found that hydroxychloroquine has the ability to withstand coronavirus.
Later, a study of French scientists appeared. It involved 36 patients. 20 patients were an experimental group where 600 mg of Plaquenil was given daily to volunteers. The remaining 16 patients were the control group, which was treated according to the protocol.
According to the study, on the third day, 50% of the participants who were treated only with Plaquenil received a negative result for coronavirus. And on the sixth day, 70% got a negative result.
In addition, 6 out of 20 patients were treated with Plaquenil in combination with the antibiotic azithromycin. Interestingly, they recovered even faster. Already on the third day, 83% of the participants received a negative result on coronavirus, and on the sixth day all 100% recovered.
Meanwhile, patients from the control group were sick longer. On the third day of the disease, only 6.3% of the participants recovered, and on the sixth - 12.5%.
Later, US President Donald Trump said that in the United States of America, hydroxychloroquine (Plaquenil) will be used as an experimental treatment of coronavirus.
"The drug hydroxychloroquine is used to treat malaria and arthritis, a very powerful drug. The drug has shown very encouraging results. We intend to immediately make the drug available," Trump said.
And the French government allowed to prescribe hydroxychloroquine for coronavirus infection.
"Hydroxychloroquine and the combination of lopinavir / ritonavir (anti-AIDS drugs) can be prescribed, and taken under the responsibility of the doctor", the French government decree says.
Patients can take these drugs in hospitals or as prescribed by a doctor at home. Plaquenil and other drugs based on hydroxychloroquine can be bought only with a prescription.
Similar treatment protocols began to be used in Italy.
Nevertheless, WHO has not yet approved any of the above drugs as suitable for the specific treatment of coronavirus. All of them undergo clinical research.
Coronavirus medicine in Ukraine
The website Tabletki.ua (used to monitor the availability of drugs in Ukrainian pharmacies) indicates that Plaquenil is no longer present in pharmacies. Previously, it could be bought for 500-600 hryvnia (21 USD) per pack (60 tablets).
The Minister of Health of Ukraine Maksym Stepanov reported that on April 2, the country received 3 000 packages of the drug. 2,250 will be sent to the regions, and 750 will remain in Kyiv - for quick response to the disease.
“Next week we will receive enough of these drugs to potentially treat up to 20 000 patients,” said Stepanov.
At the same time, the Ukrainian Ministry of Health emphasized that today there is no cure for Covid-19 coronavirus disease, symptomatic treatment is provided to patients. As for Plaquenil, it is used for severe and extremely severe forms of coronavirus.
The ministry also advises not to buy the drug without a doctor’s prescription and warn that self-medication can be dangerous to health.