Hydroxychloroquine for the Prevention of Malaria While Traveling Hydroxychloroquine (Plaquenil™) 羟氯喹用于在旅行时预防疟疾 羟氯喹 (Plaquenil™)

Editor’s note:  Some front line doctors recommend that hydroxychloroquine (an antimalaria drug) and zinc sulfate be used to prevent and treat covid 19 infection.  They say that this combo is safe and highly effective in preventing covid 19, and early use of it can significantly reduce the risk of severe complications from covid 19 infection.   When hydroxychloroquine is unavailable, some medical organizations recommend use of ivermectin – another antimalaria medication.

However, the U.S. governmental agencies such as FDA and CDC recommend against use of hydrxychloroquine. The reasons?  They say that trials do not show any benefits from hydroxchloroquine and the drug is unsafe for some people.  Safety may not be too big a concern about this drug as alternative medicines such as vaccines have now claimed more than 15,000 deaths.  The efficacy remains largely unknown.  But why some front line doctors who know the best about prevention and treatment of covid 19 recommend hydroxychloroquine?

Hydroxychloroquine was developed in 1934 and used for a few decades.  The CDC guideline shown below does not provide any alert let alone warning about its safety.  It is hard to understand.

編者按:一些一線醫生建議使用羥氯喹(一種抗瘧疾藥物)和硫酸鋅來預防和治療 COVID 19 感染。他們說,這種組合在預防 covid 19 方面是安全且高效的,早期使用它可以顯著降低因 covid 19 感染而導致嚴重並發症的風險。當無法獲得羥氯喹時,一些醫療組織建議使用伊維菌素——另一種抗瘧疾藥物。

然而,美國政府機構如 FDA 和 CDC 建議不要使用羥氯喹。原因?他們說,試驗沒有顯示羥氯喹有任何好處,而且這種藥物對某些人來說是不安全的。這種藥物的安全性可能不是太大的問題,因為疫苗等替代藥物現已導致 15,000 多人死亡。療效在很大程度上仍然未知。但是為什麼一些最了解covid 19預防和治療的一線醫生推薦羥氯喹呢?

羥氯喹於 1934 年開發並使用了幾十年。下面顯示的 CDC 指南沒有提供任何警報,更不用說對其安全性的警告了。很難理解。

What is hydroxychloroquine?

Hydroxychloroquine (also known as hydroxychloroquine sulfate) is an arthritis medicine that also can be used to prevent malaria. It is available in the United States by prescription only. It is sold under the brand name Plaquenil and it is also sold as a generic medicine. It is available in tablets of 155mg base (200mg salt). You should know that the 155mg base tablet is the same as the 200mg salt tablet. It is just two different ways of describing the same thing. Hydroxychloroquine can be prescribed for either prevention or treatment of malaria. This fact sheet provides information about its use for the prevention of malaria infection associated with travel.

Center for Global Health
Division of Parasitic Diseases and Malaria

Who can take hydroxychloroquine?

Hydroxychloroquine can be prescribed to adults and children of all ages. It can also be safely taken by pregnant women and nursing mothers.

Who should not take hydroxychloroquine?

People with psoriasis should not take hydroxychloroquine.

How should I take hydroxychloroquine?

Both adults and children should take one dose of hydroxychloroquine per week starting at least 1 week before traveling to the area where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving. The weekly dosage for adults is 310mg base (400mg salt)  Your doctor will have calculated the correct weekly dose for your child based on the child’s weight. The child’s dose should not exceed the adult dose of 310mg base (400mg salt) per week

Where can I buy hydroxychloroquine?

Antimalarial drugs are available in the United States by prescription only. Medicines should be obtained at a pharmacy before travel rather than in the destination country. Buying medications abroad has its risks: the drugs could be of poor quality, contaminated, or counterfeit and not protect you against malaria.

In what parts of the world can hydroxychloroquine be used for prevention of malaria in travelers?

Hydroxychloroquine can only be used in places where chloroquine (a related medicine) is still effective. There are only a few places left in the world where hydroxychloroquine is still effective including parts of Central America and the Caribbean. CDC keeps track of all the places in the world where malaria transmission occurs and which malaria drugs that are recommended for use in each place. This information can be found using the malaria map on the CDC website: http://www.cdc.gov/malaria/map/index.html.

Malaria is a serious disease that can cause death if not treated right away. It is caused by a parasite that can infect a certain type of mosquito which feeds on humans.About 1,500 cases of malaria are diagnosed in the United States each year almost all in travelers to parts of the world where malaria occurs.

Will hydroxychloroquine interact with my other medications?

Some other drugs can interact with hydroxychloroquine and cause problems. Your doctor is responsible for evaluating the other medicines you are taking to ensure that there are no harmful interactions between them and hydroxychloroquine. In some instances, medicines can be adjusted to minimize the interaction. You can also ask your pharmacist to check for drug interactions.

What are the potential side effects of hydroxychloroquine?

Hydroxychloroquine is a relatively well tolerated medicine. The most common adverse reactions reported are stomach pain, nausea, vomiting, and headache. These side effects can often be lessened by taking hydroxychloroquine with food. Hydroxychloroquine may also cause itching in some people.All medicines may have some side effects. Minor side effects such as nausea, occasional vomiting, or diarrhea usually do not require stopping the antimalarial drug. If you cannot tolerate your antimalarial drug, see your health care provider; other antimalarial drugs are available.

Other considerations

A good choice for longer trips because you only have to take the medicine once per week.
Overdose of antimalarial drugs, particularly hydroxychloroquine, can be fatal. Medication should be stored in childproof containers out of the reach of infants and children.
Some people are already taking hydroxychloroquine regularly for other medical conditions such as arthritis. In those instances, they may not need to take an additional medicine to prevent malaria. Your doctor can advise you.

How long is it safe to use hydroxychloroquine?

CDC has no limits on the use of hydroxychloroquine for the prevention of malaria. When hydroxychloroquine is used at higher doses for many years, a rare eye condition called retinopathy has occurred. People who take hydroxychloroquine for more than five years should get regular eye exams.

Check out the CDC malaria website at www.cdc.gov/malaria Health-care providers needing assistance with diagnosis or management of suspected cases of malaria should call the CDC Malaria Hotline: 770-488-7788 or 855-856-4713 toll-free (M-F, 9am-5pm, eastern time). Emergency consultation after hours, call: 770-488-7100 and request to speak with a CDC Malaria Branch clinician.

Prevent Malaria
Take an antimalarial drug.
Prevent mosquito bites.
If you get sick, immediately seek professional medical care.

Republished in verbatim/originally posted on cdc.gov
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