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People’s Pharmacy: Can hydroxychloroquine prevent COVID-19?

UPDATED: Wed., Aug. 26, 2020

This April 6 photo shows an arrangement of hydroxychloroquine pills in Las Vegas. At least 13 states have obtained a total of more than 10 million doses of malaria drugs to treat COVID-19 patients despite warnings from doctors that more tests are needed before the medications that President Trump once fiercely promoted should be used to help people with the coronavirus.  (John Locher/Associated Press)
This April 6 photo shows an arrangement of hydroxychloroquine pills in Las Vegas. At least 13 states have obtained a total of more than 10 million doses of malaria drugs to treat COVID-19 patients despite warnings from doctors that more tests are needed before the medications that President Trump once fiercely promoted should be used to help people with the coronavirus. (John Locher/Associated Press)
By Joe Graedon, M.S., </p><p>and Teresa Graedon, Ph.D. King Features Syndicate

Q. We’re still hearing about hydroxychloroquine as a treatment for the coronavirus. Most medical authorities have concluded it is neither safe nor effective as a treatment for the virus.

Observational studies from some practitioners report it can be effective when used early on for treating the coronavirus – together with zinc and azithromycin – but it has limited effectiveness when a COVID-19 patient is seriously ill.

Have any researchers studied prescribing hydroxychloroquine prophylactically to at-risk people such as front-line medical workers? I ask because I fall into that category. I’m healthy with no heart issues, but I am 75.

I am involved with various volunteer activities working closely with others. (Yes, we wear masks, but strict social distancing is not always possible.) Is there any scientific research on the prophylactic use of hydroxychloroquine?

A. We could find only one randomized controlled trial of hydroxychloroquine to prevent COVID-19 in exposed individuals (New England Journal of Medicine, Aug. 6). The investigators recruited more than 800 people exposed for more than 10 minutes at a distance of less than 6 feet to infected coronavirus patients. Many were health care workers exposed on the job.

The volunteers started taking HCQ or placebo within four days of their exposure. After two weeks, there was no significant difference between the two groups in terms of symptoms or COVID-19 test results.

Q. What can you tell me about the safety and long-term use of Ozempic to treat Type 2 diabetes? My husband’s A1C is around 7.2.

The endocrinologist wants to try Ozempic along with his metformin and glimepiride to see if he can do better. He is not overweight and is careful with his diet. I’m worried about injectables at his age of 64. What are the long-term effects?

A. Ozempic (semaglutide) is prescribed to improve blood sugar control for people with Type 2 diabetes. It was approved in the U.S. in 2017, so we have only three years of experience on long-term effects.

We worry that your husband’s glimepiride, a sulfonylurea medicine, could interact with the Ozempic injection. This combination could increase the risk of a serious episode of low blood sugar (hypoglycemia). Symptoms can include fatigue, confusion, blurred vision, seizures and coma.

A common side effect is digestive distress. Other adverse reactions might include thyroid cancer and pancreatitis. If your husband has the eye disease diabetic retinopathy, using Ozempic might make it worse.

Q. Six years ago, my doctor prescribed Voltaren Gel for arthritis in my knee. She assured me that the warnings only applied to the oral form of the drug. I got excellent relief.

After three weeks, however, I suddenly developed swelling in that leg. My blood pressure went up to 220/110, and I ended up in the emergency room. They monitored me for six or seven hours until my blood pressure returned to normal. Voltaren, even topical, can cause some serious side effects.

A. Voltaren Gel for arthritis pain is available without a prescription. The Food and Drug Administration has warned that oral and topical NSAIDs like diclofenac (Voltaren Gel) can lead to edema and high blood pressure.

People who cannot tolerate NSAIDs like diclofenac, ibuprofen and naproxen might benefit from nondrug approaches to manage joint pain.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screoctors Make and How to Avoid Them.”

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