We have received hundreds of calls about prescription treatments for Covid-19 cases. Hydoxychloroquine (HCQ) has been the subject of most of those calls. Note: Hydroxychloroquine does requires a prescription from your physician. Las Colinas Pharmacy is fortunate to have been allotted a large amount of Hydroxychloroquine during the crisis. Hydroxychloroquine (HCQ) has been used in the U.S. since 1955 for the treatment of malaria and was later approved by FDA for treatment of auto-immune diseases like Lupus and Rheumatoid Arthritis. HCQ has been headline news as a proposed treatment protocol for Covid-19 disease (infections).
This pandemic is caused by the Severe Acute Respiratory Syndrome Coronavirus 2
(SARS-CoV-2) which is the infecting agent causing Covid-19 disease. Hydroxychloroquine has several effects which make it a very useful tool in fighting Covid-19 infections:
- modulates the immune system’s response to help calm Coronavirus-induced inflammatory reactions, especially in the lungs
- reduces the body’s overly excited signaling processes which can result in dangerous cytokine storms in the lungs
- has anti-infective and disruptive actions against Coronavirus (an RNA virus)
- promotes absorption of Zinc into cells which impairs Coronavirus replication
HCQ is well absorbed, hits peak levels all over the body in only 4 hours and is especially concentrated in lung tissues. It is slowly eliminated, taking more than 40 days to clear the body.
Physicians all over the world have been using a combination of Hydroxychloroquine plus Azithromycin, reporting excellent statistics of viral clearing from the body in 3-5 days after starting treatment. Doctors have noted the treatment works much better if started in the early stages of infection. Unfortunately, results have not been as promising when patients who were already critical were started on the treatment.
Azithromycin (Z-pak) is an antibiotic, useful in treating lung infections and pneumonia. Like Hydroxychloroquine, it concentrates in lung tissues. Azithromycin is an unusual antibiotic because it also possesses anti-viral activity. Additionally, its anti-inflammatory effects protect patients from the cytokine storms which result in severe lung inflammation.
Adding Zinc to the Covid-19 treatment protocol makes sense as Zinc has been shown to reduce viral penetration into healthy cells and reduces viral replication inside infected cells.
Although several variations of the Covid-19 treatment protocols have been used, the most common is:
- Hydroxychloroquine 200mg – take 400mg twice daily on day one then 200mg twice daily on days 2-5.
- Azithromycin 250mg – take 2 tablets on day one then 1 tab daily on days 2-5.
- Zinc (I prefer Zinc Bisglycinate, better absorbed and less stomach upset) – take 50mg twice daily until viral load declines then 50mg once daily thereafter
- This combination should be used with caution in patients with heart disease especially Q-T prolongation of greater than 450 milliseconds (ask your Dr about your ECG if you are unsure).
- If you are taking other medications that can cause Q-T prolongation (ask your pharmacist)
- Do not use if allergic to any of the medications in the treatment protocol.
- New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents. 2020 Mar 11:105938 Devaux, et al10.1016/j.ijantimicag.2020.105938
- In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020 Mar 9, Yao X et al
- Azithromycin induces anti-viral responses in bronchial epithelial cells, Gielen et al, European Respiratory Journal 2010 36: 646-654;
- Effect of Zinc Salts on Respiratory Syncytial Virus Replication, Antimicrob Agents Chemother. 2004 Mar; 48(3): 783–790.Rahaman O. et al