• Malaria prophylaxis: 400 mg weekly • Malaria treatment per CDC: 800 mg initially and then 400 mg at 6, 24, and 48 hours thereafter for a total dose of 2,000 mg • Lupus: 200 mg - 400 mg daily • Rheumatoid arthritis: 400 mg – 600 mg daily While staying out of the debate regarding efficacy against COVID-19, a brief mention of some protocol doses suggested by hydroxychloroquine advocates seems worthwhile. These are both intended for use early on as outpatients: 13,14,15 • Vladimir Zelenko protocol: 200 mg HCQ twice daily for 5 – 7 days • America’s Front Line Doctors: Zelenko protocol • Front Line COVID Critical Care Alliance I-MASK+ protocol: 400 mg HCQ on day 1, then 200 mg twice daily for the subsequent two days
What serious side – effects occur with hydroxychloroquine?
The above paragraphs describe common side effects. Retina damage can occur with long–term use, mainly above the recommended doses. The main concern relates to potentially lethal heart rhythms: ventricular tachycardia and torsades de pointes. 16 The cardiac electrical activity of a normal heartbeat consists of several parts labelled P through U as below. The upper chambers of the heart (atrium) contract first and then, after a delay to allow blood to flow into the lower chambers, the ventricles contract. The P wave is associated with the electrical activity of the atrium and the T wave with the ventricle. The concern relates to the distance between the Q and T waves – i.e. the QT interval and when it is elongated or, prolonged (red arrow, below left). A “vast” number of medications can prolong the QT interval, including hydroxychloroquine, azithromycin, other antibiotics, psychiatric medications, and others. 17 This can disrupt the normal rhythm and cause the ventricle to rapidly and repeatedly contract with very high heart
Anchorlines, June/July 2022
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