Ethical prescribing: Hydroxychloroquine for family and friends during COVID-19?

Should a doctor prescribe hydroxychloroquine for family and friends to treat COVID-19? According to an editorial published today in Australian Prescriber, the answer should be ‘no’, from medical, ethical and possibly even legal perspectives.

Hydroxychloroquine is a medicine approved in Australia to treat malaria as well as some autoimmune diseases such as rheumatoid arthritis and lupus. It has received much media attention about its potential use for treating COVID-19. It is, however, not approved to treat or prevent COVID-19.

“Although there are major clinical trials now underway, there is currently little evidence that hydroxychloroquine is safe or effective for COVID-19,” says one of the authors Associate Professor Ian Coombes from the Royal Brisbane and Women’s Hospital.

“Using this medicine incorrectly and at the wrong dose could lead to serious side effects like seizures and heart problems.

“As an additional concern, the current hype around hydroxychloroquine and subsequent hoarding has led to shortages of the medicine. For some people with autoimmune diseases like lupus, there is no effective alternative to hydroxychloroquine, and stopping treatment can lead to serious harm and even death,” says Assoc Prof Coombes.

Doctors may feel pressured by patients, as well as family and friends, to prescribe hydroxychloroquine for COVID-19. However this raises ethical questions and hydroxychloroquine should not be prescribed outside of a clinical trial.

Read the full editorial in Australian Prescriber and also listen to the podcast.

An NPS MedicineWise COVID-19 information hub is being regularly updated with the latest information on quality use of medicines during the COVID-19 pandemic.