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Chloroquine Is Being Touted As A Miracle Drug For Coronavirus, But There Are Reasons To Be Wary

Your infection may not clear up if you stop using the medicine too soon. These medicines may keep azithromycin from working properly. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Keep from freezing. After water has been added to the powder, use the dose within 12 hours and throw away any unused liquid after your dose. Do not freeze the bottle. Do not keep the oral liquid for more than 10 days. Throw away any unused liquid after all doses are completed. It is very important that your doctor check the progress of you or your child at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. If you or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you take this medicine.

Serious skin reactions can occur with this medicine.

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Check with your doctor right away if you or your child have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine. Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin.

These could be symptoms of a serious liver problem. Call your child's doctor right away if your child feels irritable or vomits after feeding. These may be symptoms of a condition called infantile hypertrophic pyloric stenosis. Azithromycin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop using this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you or your child have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

This medicine can cause changes in heart rhythms, such as a condition called QT prolongation. Hydroxychloroquine may inhibit P-glycoprotein P-gp.

Digoxin is a substrate for P-gp transport. For patients on a stable digoxin regimen and initiating hydroxychloroquine, no initial dose adjustment of either drug has been advised; however, serum digoxin concentrations should be monitored and used for digoxin dose titration as clinically necessary.

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Dihydrocodeine; Guaifenesin; Pseudoephedrine: Moderate Concomitant use of dihydrocodeine with hydroxychloroquine may increase dihydrocodeine plasma concentrations, but decrease the plasma concentration of the active metabolite, dihydromorphine, resulting in reduced efficacy or symptoms of opioid withdrawal.

Dipeptidyl Peptidase-4 Inhibitors: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the dipeptidyl peptidase-4 inhibitors, are coadministered. Diphenhydramine; Hydrocodone; Phenylephrine: Moderate Concomitant use of hydrocodone with hydroxychloroquine may increase hydrocodone plasma concentrations and prolong opioid adverse reactions, including hypotension, respiratory depression, profound sedation, coma, and death. Disopyramide: Major Avoid coadministration of hydroxychloroquine and disopyramide. Disopyramide administration is also associated with QT prolongation and TdP.

Dofetilide: Major Coadministration of dofetilide and hydroxychloroquine is not recommended as concurrent use may increase the risk of QT prolongation. Dolasetron: Major Avoid coadministration of hydroxychloroquine and dolasetron. Dolutegravir; Rilpivirine: Major Avoid coadministration of hydroxychloroquine and rilpivirine.

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Donepezil: Major Avoid coadministration of hydroxychloroquine and donepezil. Case reports indicate that QT prolongation and TdP can occur during donepezil therapy. Donepezil is considered a drug with a known risk of TdP. Donepezil; Memantine: Major Avoid coadministration of hydroxychloroquine and donepezil.

Doxepin: Major Avoid coadministration of hydroxychloroquine and tricyclic antidepressants. Clinically significant interactions have been reported when doxorubicin was coadministered with inhibitors of CYP2D6, resulting in increased concentration and clinical effect of doxorubicin. Avoid coadministration of hydroxychloroquine and doxorubicin if possible. If not possible, closely monitor for increased side effects of doxorubicin including myelosuppression and cardiotoxicity. Dronedarone: Severe Dronedarone administration is associated with a dose-related increase in the QTc interval.

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The increase in QTc is approximately 10 milliseconds at doses of mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of mg twice daily. Although there are no studies examining the effects of dronedarone in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation. Because of the potential for torsade de pointes, use of hydroxychloroquine with dronedarone is contraindicated. Droperidol: Major Avoid coadministration of hydroxychloroquine and droperidol. Droperidol administration is associated with an established risk for QT prolongation and torsade de pointes TdP.


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Dulaglutide: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the incretin mimetics, are coadministered. Efavirenz: Major Avoid coadministration of hydroxychloroquine and efavirenz. QTc prolongation has been observed with the use of efavirenz. Efavirenz; Emtricitabine; Tenofovir: Major Avoid coadministration of hydroxychloroquine and efavirenz. Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: Major Avoid coadministration of hydroxychloroquine and efavirenz.


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Eliglustat: Major Avoid coadministration of hydroxychloroquine and eliglustat. Coadministration with CYP2D6 inhibitors may increase eliglustat exposure and the risk of serious adverse events e. If coadministration is necessary in extensive or intermediate CYP2D6 metabolizers EMs or IMs , a dose reduction of eliglustat to 84 mg PO once daily is necessary; however, coadministration of eliglustat with both hydroxychloroquine and a strong or moderate CYP3A inhibitor is contraindicated.

Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide: Moderate Caution is warranted when cobicistat is administered with hydroxychloroquine as there is a potential for elevated cobicistat concentrations.

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Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: Moderate Caution is warranted when cobicistat is administered with hydroxychloroquine as there is a potential for elevated cobicistat concentrations. Empagliflozin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the SGLT2 inhibitors, are coadministered. Empagliflozin; Linagliptin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the dipeptidyl peptidase-4 inhibitors, are coadministered.

Empagliflozin; Linagliptin; Metformin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including metformin, are coadministered. Empagliflozin; Metformin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including metformin, are coadministered. Emtricitabine; Rilpivirine; Tenofovir alafenamide: Major Avoid coadministration of hydroxychloroquine and rilpivirine.

Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Major Avoid coadministration of hydroxychloroquine and rilpivirine. Caution is recommended when administering encainide with CYP2D6 inhibitors, such as hydroxychloroquine, since encainide exhibits a narrow therapeutic range and large increases in serum concentrations may be associated with severe adverse reactions. Encorafenib: Major Avoid coadministration of encorafenib and hydroxychloroquine due to QT prolongation. Encorafenib is associated with dose-dependent prolongation of the QT interval.

Hydroxychloroquine prolongs the QT interval and should not be administered with other drugs known to prolong the QT interval. Enflurane: Major Avoid coadministration of hydroxychloroquine and halogenated anesthestics. Entrectinib: Major Avoid coadministration of entrectinib with hydroxychloroquine due to the risk of QT prolongation. Entrectinib has been associated with QT prolongation.

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Hydroxychloroquine also prolongs the QT interval. Eribulin: Major Avoid coadministration of hydroxychloroquine and eribulin.