Q: Recently I saw an interview on a major cable-news station. The expert stated that chloroquine and hydroxychloroquine were very promising drugs for treating coronavirus.
When I looked these drugs up online, I saw that they have been used to treat conditions like malaria for years. But the side effects were scary. The idea of putting these drugs into my system is not appealing. What can you tell us about the pros and cons of these potential treatments for COVID-19?
A: Chloroquine (CQ) and its chemical cousin hydroxychloroquine (HCQ) have been used to treat malaria, rheumatoid arthritis and lupus for more than half a century. Researchers have been investigating the antiviral activity of these medications for over 30 years (International Journal of Antimicrobial Agents, online, March 12, 2020).
Nobody yet knows whether either of these drugs will prove effective against the virus that causes COVID-19. Preliminary studies are tantalizing, though (International Journal of Antimicrobial Agents, online, March 17, 2020). In a small French study, the combination of HCQ and azithromycin cleared virus from infected people in three to six days.
These drugs do have serious side effects, however. They include gastrointestinal problems such as nausea, vomiting and diarrhea; visual disturbances; serious skin reactions; headache, tinnitus and hearing loss; blood disorders; and heart rhythm changes. Doctors refer to the cardiac reaction as “prolonged QT interval.”
Because the medications are in short supply, they should be reserved for the sickest COVID-19 patients and their health care providers. We hope there will also be controlled trials to determine the benefit/risk ratio for the future.
Editor’s note: An Arizona man died after ingesting chloroquine phosphate to ward off coronavirus. His wife is under critical care.The toxic ingredient they consumed was not the medication form of chloroquine, but an ingredient in a parasite treatment for fish.
Q: I have been having a terrible time falling asleep. The nonstop grim news stories about the virus have me on edge. I am tempted to go back on Ambien even though I had a hard time getting off it last year. Do you have any other suggestions?
A: We completely understand why you and millions of other people are feeling anxious. Finding some quiet time to relax before bed is more important now than ever before. That means no news or video at least an hour before bed. Devoting that time to a hot bath instead can help your body prepare for sleep. Magnesium and melatonin may also be beneficial.
You will find details on these and many other suggestions in our eGuide to Getting a Good Night’s Sleep. Look for it in the Health eGuides section at www.PeoplesPharmacy.com.
Q: I had been taking atenolol for several years when it became unavailable. My doctor switched the prescription to metoprolol.
After taking it for about six months, I realized I was feeling depressed. I asked my cardiologist if it could be the metoprolol. He said definitely because that medicine crosses the blood/brain barrier.
Fortunately, atenolol is available now, so I am taking it again and doing fine. My blood pressure is very well controlled.
A: Metoprolol has a greater affinity for brain tissue than atenolol. This might explain your experience with depression (Pharmacology & Therapeutics, 1990, Vol. 46, No. 2). Other side effects of beta blockers like atenolol, metoprolol or propranolol include sleep disturbances and nightmares, as well as fatigue, cold hands and feet, shortness of breath and slow heart rate.