New prescriptions for hydroxychloroquine and chloroquine skyrocketed in the early stages of the COVID-19 pandemic, according to new data out of the CDC. Specialists who do not typically prescribe the two drugs were responsible for 1,143 new prescriptions in February 2020 and 75,569 in March 2020, good for a 6,511% increase from one month to the next.
The massive change shows the power of a once-in-a-generation pandemic and a little bit of controversy.
Hydroxychloroquine and chloroquine, two antimalarial medications, started making national headlines when researchers in France suggested the combination hydroxychloroquine and azithromycin could effectively treat COVID-19. President Donald Trump started advocating for hydroxychloroquine just days after that French study was published, and one of the wildest healthcare stories of the year was officially underway.
Ultimately, numerous medical societies and even the FDA determined that the risks of hydroxychloroquine—specifically its potential side effects related to cardiovascular health—did not outweigh the drug’s potential benefits.
The full CDC report, published Sept. 4, paints a thorough picture of just how popular these antimalarial medications became once COVID-19 started affecting patients in the United States. Overall, the total estimated number of prescriptions dispensed in March and April 2020 was more than 1.3 million—a significant jump from the more than 819,000 prescriptions dispensed in March and April 2019. Prescriptions dispensed by mail order or prescribed by veterinarians were excluded from the analysis.
The authors also provided advice for any healthcare providers working with hydroxychloroquine or chloroquine.
“The importance of obtaining a patient’s complete medical and medication history to evaluate risks should be emphasized to nonroutine prescribers of hydroxychloroquine or chloroquine,” wrote Lara Bull-Otterson, PhD, and colleagues from the CDC COVID-19 Emergency Response Team. “In the setting of polypharmacy and comorbid conditions, such as preexisting heart conditions, performing an electrocardiogram to evaluate the QT interval before starting these medications is advisable, because hydroxychloroquine or chloroquine can prolong the QT interval, leading to malignant arrhythmias such as torsade de pointes or ventricular fibrillation. Because of the long-terminal half-life of hydroxychloroquine, patients could continue to be at risk for drug interactions and adverse cardiac events after the course of therapy is completed.”
The authors also emphasized that “federal guidelines now recommend against using hydroxychloroquine or chloroquine for the treatment or prevention of COVID-19.”
The full CDC report is available here.
Back in June, a JAMA study also highlighted pandemic-related prescriptions trends for hydroxychloroquine and chloroquine. Read more about that analysis here.