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Poison center precautions regarding hydroxychloroquine and chloroquine

COVID-19 wording

FOR RELEASE: March 20, 2020

SYRACUSE, N.Y. - The World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the U.S. Food and Drug Administration (FDA), have reported there are currently no medications or vaccines proven to be effective for the treatment or prevention of the COVID-19 pandemic (also known as SARS-CoV-2)123.

However, hydroxychloroquine and chloroquine have been extensively discussed in the news over the past several days as possible treatments for COVID-19. For their prescribed indications these are highly effective drugs. The data regarding their efficacy for the treatment of COVID-19, however, is very preliminary. At this time, it is not at all certain that these medications will prove to be effective. Further investigation is ongoing and urgently needed.

The Upstate New York Poison Center Medical Director, Dr. Michael Hodgman, says there are important precautions physicians, pharmacists and individuals who may be using these medications need to be aware of. There are potential drug interactions, particularly with chloroquine and a careful review of other medications used is imperative. Additionally, when used excessively there are serious potential neurologic and cardiac complications that may occur. In toddlers, chloroquine is a "one pill can kill" medication4. The data for toddler exposure to hydroxychloroquine is more limited and we would have the same concerns for even a single pill exposure in a toddler.

Physicians and pharmacists need to review for potential drug interactions. Patients should be counseled regarding safe medication use and safe storage, particularly in households with young children.

***The Upstate New York Poison Center does not condone the use of these medications for treating COVID-19 illness outside of a properly designed clinical study.***

UPDATE: The American Association of Poison Control Centers responds with the side effects from the two drugs

References:
  1. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. WHO.int. https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected.
  2. Centers for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). CDC.gov. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html.
  3. U.S. Food and Drug Administration. Coronavirus Disease 2019 (COVID-19). FDA.gov. https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/coronavirus-disease-2019-covid-19.
  4. Smith ER, Klein-Schwartz W. Are 1-2 dangerous?Chloroquine and hydroxychloroquine exposure in toddlers. J Emerg Med. 2005 May;28(4):437-43.

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In the case of a poisoning or for information purposes, call the Upstate New York Poison Center at 1-800-222-1222. We are open 24/7, 365 days a year. Each year our center manages more than 50,000 calls from health care providers, 911 operators, hospitals, industry, schools, and the general public in our 54-county service area.

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About Upstate New York Poison Center

Housed inside Upstate Medical University in Syracuse, NY, the Upstate New York Poison Center is dedicated to reducing the number, cost and severity of poisonings within its designated 54-county service area as mandated by New York State Law. The Center is available 24 hours a day, 365 days a year to both health professionals and the general public at 1-800-222-1222.

About Upstate Medical University

SUNY Upstate Medical University in Syracuse, NY, is the only academic medical center in Central New York. It is also the region's largest employer with 9,460 employees. Affiliated with the State University of New York, Upstate's mission is to improve the health of the community through education, biomedical research and health care.

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