What statistical evidence are you seeing that it is?

Yes, early disseminated disease (weeks to months) and late disease (months to years) can cause neurological symptoms. This doesn't happen often though. Most people get treated before those manifestations.

Yes, we had to start doing this a few weeks after information came out about hydroxychloroquine. They were worried about shortages (specifically for patients with autoimmune disease) due to physicians writing the medications in bulk for Friends and family without the diagnosis of COVID or an autoimmune disorder. Your physician must write the diagnosis code on the script or electronic order( an example is M32.9 systemic lupus erythematosus.) The VA also requires you write medical necessity. Walgreens was the worst about this. I had 5 patients call in one day only get a 15 day supply from them for Lupus, which they take two a day for. I'm in a low income area as well. Some patients have to drive an hour to the closest pharmacy.

Thank you for posting this. I had been following this story since The Lancet published their study. I also had talks with several colleagues discussing the legitimacy of the findings. (Yes, i thought it was shit and I was concerned about the timing. And yes, it caused a long week for me having to explain that hydroxychloroquine won't give you a heart attack.) People do need to understand there are also politics involved in medicine. It sucks, but it is reality. Luckily, I was trained to understand this, as well as, many of colleagues. Its our job as clinicians to read the data and apply it to our patient population evaluated risks and benefits. We do need more research in regards to COVID, but i felt this release to be political. Over the past week, I have seen several medical websites i use for research question the findings. It has been interesting. If anyone has any questions about hydroxychloroquine please feel free to ask. I dont have much experience in regards to treating COVID, but I use this medication daily in treating rheumatologic diseases.

Don't worry, we still use it plenty. I prescribed this at least 5 times for Lupus/inflammatory arthritis just last week. We get a good chuckle at how many Rheumatologist have been consulted about the medication. Lots of things can cause qt prolongation, azithromycin being one of them. As well as sedatives/hypnotic, that's not counting disease/electrolyte abnormalities that can cause it as well. Again Clmhloroquine has been well documented to cause qt prolongation. It is much more toxic than hydroxychloroquine, which in literature is VERY rare to see qt prolongation with use.

Doxycycline has well known anti-inflammatory effects similar to azithromycin.

Yes, that's been unfortunate about the Quinacrine. I had several patients on it, mainly because they had adverse reactions to hydroxychloroquine, also much safer for patients who had concerns about their eyes. I had to switch several to Methotrexate or Imuran, which you know has many more side effects.

Hydroxychloroquine is much less toxic than chloroquine. I have not read any comparative studies of their effectiveness however, so on that, I cannot comment.

Edit -Also, depends on what other diseases the patient has. Renal disease will increase the risk of side effects. Or even previous macular disease. Dose adjustments would be necessary in those cases.

*I work in Rheumatology. Use this drug daily. One case of retinopathy that I have seen. One case of corneal deposits. This was reversed on dose reduction. Retinopathy can be reversed in certain cases. Unlikely with severe retinopathy. But this is rare with the screening measures we have now.

Agreed. This was my post in one of the other threads. You are correct and yes something has to be done.

I think there is some confusion here. I dont believe they are banning the use, simply prescribers need to add the appropriate diagnosis code(for what you are treating). We already have to do this in medicine for certain scheduled drugs. The reason for this is providers are sending in prescriptions of hydroxychloroquine for themselves and family members, without being diagnosed with COVID. This is causing a shortage for patients who HAVE to take this medication daily to control their autoimmune disorder. Pharmacies in my state are already limiting the amount of hydroxychloroquine they are dispensing, capped at 30. My patients who take this drug typically require taking the drug twice daily. If they cannot take this due to shortages, I then have to prescribe a much stronger immunosuppressive. I have seen stories of pharmacists refusing to dispense without appropriate diagnosis code. I have recently started added my patients diagnosis code for whatever autoimmune they have to make sure they get their medication. Source - I am a provider in Rheumatology and wanted to share what we are experiencing. I had 5 patients call just yesterday not able to fill their hydroxychloroquine. This is a serious issue.

I think there is some confusion here. I dont believe they are banning the use, simply prescribers need to add the appropriate diagnosis code(for what you are treating). We already have to do this in medicine for certain scheduled drugs. The reason for this is providers are sending in prescriptions of hydroxychloroquine for themselves and family members, without being diagnosed with COVID. This is causing a shortage for patients who HAVE to take this medication daily to control their autoimmune disorder. Pharmacies in my state are already limiting the amount of hydroxychloroquine they are dispensing, capped at 30. My patients who take this drug typically require taking the drug twice daily. If they cannot take this due to shortages, I then have to prescribe a much stronger immunosuppressive. I have seen stories of pharmacists refusing to dispense without appropriate diagnosis code. I have recently started added my patients diagnosis code for whatever autoimmune they have to make sure they get their medication. Source - I am a provider in Rheumatology and wanted to share what we are experiencing. I had 5 patients call just yesterday not able to fill their hydroxychloroquine. This is a serious issue.

This is correct. I work in Rheumatology. This is probably our most prescribed medication. It is used in many different Rheumatologic disorders. Prevalence of retinal damage at 5 years of use at recommended dose of 5mg/kg is 7.5 percent. I have only seen one case of this in 3 years. The other risk to the eyes is corneal deposits. Very rare at the recommended dosing. Both retinal toxicity and corneal deposits can be reversible in many cases following cessation of the medication. Though the half life is around 54 days. Generally a well tolerated medication without significant side effects.