Posted on 04/10/2020 10:43:12 AM PDT by SeekAndFind
The nation's leading cardiology associations urged caution with hydroxychloroquine and azithromycin for COVID-19 in patients with cardiovascular disease.
"Hydroxychloroquine and azithromycin have been touted for potential prophylaxis or treatment for COVID-19; both drugs are listed as definite causes of torsade de pointes" and increase in the risk of other arrhythmias and sudden death, the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society said in a joint statement April 8 in Circulation.
The statement came amid ongoing promotion by the Trump administration of hydroxychloroquine, in particular, for COVID-19 despite lack of strong data.
In addition to underlying cardiovascular disease, "seriously ill patients often have comorbidities that can increase risk of serious arrhythmias," including hypokalemia, hypomagnesemia, fever, and systemic inflammation, the groups said.
They recommended withholding the drugs in patients with baseline QT prolongation (e.g., QTc of at least 500 msec) or with known congenital long QT syndrome; monitoring cardiac rhythm and QT interval and withdrawing hydroxychloroquine and azithromycin if QTc exceeds 500 msec; correcting hypokalemia to levels greater than 4 mEq/L and hypomagnesemia to more than 2 mg/dL; and avoiding other QTc-prolonging agents when possible.
The groups noted that, "in patients critically ill with COVID-19 infection, frequent caregiver contact may need to be minimized, so optimal electrocardiographic interval and rhythm monitoring may not be possible." There is also a possible compounding arrhythmic effect when hydroxychloroquine and azithromycin are used together, but that has not been studied.
There's a known risk of torsade de pointes with chloroquine and a possible risk with the antiviral HIV combination drug lopinavir-ritonavir, two other candidates for COVID-19 treatment. Hydroxychloroquine and chloroquine, both antimalarials, might help prevent or treat infection by interfering with angiotensin-converting enzyme 2 receptors, which the COVID-19 virus uses for cell entry, the groups said.
"The urgency of COVID-19 must not diminish the scientific rigor with which we approach COVID-19 treatment. While these medications may work against COVID-19 individually or in combination, we recommend caution with these medications for patients with existing cardiovascular disease," Robert A. Harrington, MD, AHA president and chair of the department of medicine at Stanford (Calif.) University, emphasized in a press release.
SOURCE: Roden DM et al. Circulation. 2020 Apr 8. doi:10.1161/CIRCULATIONAHA.120.047521.
..... but what about all the people who don’t have heart issues?.....oh, it’s not a cure, you say?.... Well we don’t need a cure....we don’t have a cure for the flu or the common cold either..... all we need is an effective treatment so it can run its course without escalating into more serious problems..... apparently we’ve found that treatment and it’s making a lot of people mad
[[There has ALWAYS been a cardiac and intestinal aspect to this drug.]]
That means nothing without actual numbers of deaths due directly to HCQ- intestinal cramps are not a reason to deny a life saving drug-
Whoop-de-do. So does caffeine.
The possibility of this happening is tiny.
It's "unusual" that they don't issue this same exacerbated "concern" for those taking hydroxychloroquine for rheumatoid arthritis, lupus, and malaria.
“Yet, when a Rheumatologist with the largest practice in the country (>2000 Patients) writes to the FDA informing them that his patients which take HCQ every day have never experienced any heart-related problems. Not one time.”
That rheumatologist also said that a preliminary EKG is not part of the guidance for starting a patient on HCQ.
How many people who die from/with the C-virus were already in the care of hospice? That is not a piece of data that we have heard anything about.
[[I think every doctor should be aware of the possible side effects of the drugs they prescribe.]]
Doctors prescribing HCQ for lupus and arthritis are aware of the risks and have stated emphatically that the risk is so small they don’t even consider a legitimate concern
“Whoop-de-do. So does caffeine.”
Are you serious? I must stick my finger down my throat to get rid of the half a pot of coffee I drank this morning.
It sounded to me that this was a cardiac group and they were mostly advising caution when prescribing HCG and Zpak for someone with extensive cardiac history. It’s not being critical of the drugs. The press will misrepresent the statement, however.
If i have the virus and have a 99.99% chance it iwll kill me, and soemone offers me a drug that has a very high success rate, BUT has a 0.00136% chance it MIGHT cause an artythmia episode that MIGHT kill me-
It’sw a no brainer
99.99% (Or whatever % it is when the virus is rapidly movign towards serious and deadly) chance of death, or 0.00136% (Or however low the chance of deaTH from the drug is) chance of death from drug- Gee- lemme think about it- Nope- gotta go with the drug on this one!
“That would be the same group that hates Keto diets and long promoted sugar as heart friendly - that used to give PopTarts their “Heart Healthy” label (in exchange for cash).”
Wow they did that!
Almost as bad as the old advertisements where Doctors recommended their brand of cigarette.
But you should always trust authority! /s
While this is serious, the hysterical "crisis" response to it is man made.
Since the majority of people have clearly demonstrated they will passively give up liberties if the government tells them they must because of a "crisis", we can now be assured of more "crises" to come. Many more. One or more of which will require the surrender of firearms.
Torsade des Pointes is quite rare generally in the populations in the US. It is true that drug interaction can generate it in certain cardiac arryhthmia patients. But not on a singe dose regimen of azithromycin. There are numerous other antibiotics which are on the list as potentially causative of this.
Not a reason, if positive for SARSCOV2-CCP virus- unless one is a fragile arrythmia patient... particularly with already prolonged Q-T interval on a EKG. Even then, single dose regiment is not absolutely going to cause this.
I believe Erythromycin, especially in the presence of low Potassium and/or Magnesium, has also been associated with this potential arrhythmia. The takeaway is patients and doctors need to be aware of the possibility.
Many patients take diuretics which can lower Potassium, Calcium and Magnesium. Diabetics taking insulin can also have similarly reduced levels.
Perhaps Azithromycin is the culprit, but caution is warranted.
Their cautions aren’t anything new, but a “credible” attack on HVQ was badly needed by Ds and media. (but I repeat myself)
I’d check out who their medical and foundation affiliations are.
I’m amazed how many doctors who have been prescribing this drug for years are just now reading the label and are shocked to find how horribly dangerous it is.
As a heart attack survivor I have been warned to stay away from black licorice, grapefruit juice and certain over the counter decongestants.
Headline is a bit misleading. The AHA suggests exercising commonsense caution in a limited population with a prolonged QT-interval. I would hardly call that wholesale “push-back” against a treatment regimen.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.