The Hydroxychloroquine Controversy: Half 2

[Editor’s Note: In The Hydroxychloroquine Controversy: Part 1, we learned the initial limitations of HCQ. In part we’ll learn the contraindications for HCQ.]

The cure is worse than the disease

The potential risk / benefit ratio of introducing off-label prescription drugs for a new, as yet incompletely understood disease must be carefully weighed.

Hydroxychloroquine (HCQ) is a powerful immunomodulator and immunosuppressant. This is one of the reasons for its use in autoimmune diseases such as arthritis. However, the drug’s immunosuppressive effects are still a wild card when it comes to COVID-19. Further research is required before further safety and effectiveness claims are made.

Although the exact mechanism of action is unknown, HCQ can suppress the function of the immune system and possibly cause an immune deficiency in a patient who needs an optimally functioning immune system, especially with a disease like COVID-19.

The recovery rate for COVID19 is currently estimated at 99.8 percent, which leaves 0.2 percent for mortality. It was found that 99 percent of severe and critical cases are people with one to three pre-existing comorbidities. The average age of those affected by COVID-19 is 83 years.

People with chronic underlying diseases like cardiovascular disease, diabetes, COPD, asthma, cancer, and other debilitating diseases are among the most at risk. The risk of infection of any kind, including COVID-19, is significantly higher for this immunocompromised segment of the population. They are also more likely to experience serious and potentially fatal side effects when subjected to experimental treatments.

It is imperative that the drugs approved to treat COVD-19 patients are carefully selected and monitored for contraindications and possible side effects that may prove harmful rather than therapeutic.

Several “in vitro” studies have claimed success in inhibiting viral replication of the SARS-CoV-2 virus with HCQ and ramdesivir. Ramdesivir has been readily accepted by many without critical assessment of what these results actually mean. Successful in vitro inhibition of the virus does not predict clinical efficacy and certainly does not automatically lead to a cure.

HCQ contraindications


Hydroxychloroquine increases the QT interval. The drug can cause serious complications in patients with conditions that may increase the risk of QT prolongation, including congenital long QT syndrome, bradycardia, AV block, heart failure, stress-related cardiomyopathy, myocardial infarction, stroke, hypomagnesaemia, hypokalaemia, or hypocalcemia in patients receiving medications known to increase QT intervals or cause electrolyte imbalances.

In cases where cardiotoxicity is suspected, immediate discontinuation of HCQ can prevent life-threatening cardiac complications. Concomitant use of drugs such as tamoxifen, lopinavir, azithromycin, ciprofloxacin, and risperidone should be considered with caution due to the increased risk of QT prolongation.


The drug must be used with caution in patients with hypoglycemia or diabetes mellitus. Hydroxychloroquine can cause severe, life-threatening hypoglycaemia in patients treated with or without antidiabetic drugs.

Monitoring blood glucose and adjusting treatment as needed is critical in patients with clinical symptoms of hypoglycaemia during treatment with hydroxychloroquine.

Eye toxicity

Hydroxychloroquine can cause eye toxicity. In some cases, severe irreversible retinal damage occurs when used in daily doses greater than 6.5 mg / kg. The risk of contraindications is particularly high in patients with pre-existing macular disease.


Hydroxychloroquine should be used with caution in patients with liver disease, a history of alcoholism, or in association with known hepatotoxic medicinal products, and the dosage should be adjusted accordingly, and regular blood tests will be performed to monitor for possible abnormalities.

HCQ-induced psychosis

HCQ is a powerful drug that can cause significant neuropsychiatric side effects. known as “psychosis after chloroquine” and thoughts of suicide – an aspect that must not be overlooked and taken into account in individual cases.

Other contraindications

Severe reactions to hydroxychloroquine include:

  • Liver failure
  • Suicidal ideation
  • Macular degeneration
  • Visual impairment
  • Retinopathy
  • Bronchospasm
  • Angioedema
  • ventricular tachycardia
  • Ventricular fibrillation
  • AV block
  • and seizures.

The drug can cause mild to moderate side effects such as photophobia, nausea, vomiting, diarrhea, headache, tremors, dizziness, and fatigue.

Due to the risk of haemolysis, hydroxychloroquine is also contraindicated in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency).

Despite common sense and the abundance of well-documented horrific side effects, HCQ is relentlessly touted as a cure for COVID-19.

HCQ can cause serious reactions and complications in people without any obvious chronic health problems. The most vulnerable populations are those with comorbidities. Patients with cardiovascular disease, COPD, and asthma top the list.

Individuals with underlying cardiovascular disease could be at greater risk of inappropriate blood clot formation, which is seen in COVID-19 patients. This can lead to serious complications such as pulmonary embolism and even death.

Hydroxychloroquine, which is known to prolong the QT interval, can cause cardiac toxicity and cardiomyopathy. This could make the person’s condition even worse and worsen their underlying illnesses.

The risk is even higher as many of these people are taking multiple medications that have been prescribed for their chronic problems, which can potentially lead to an issue with interactions with HCQ.

Ideally, patients need to be carefully evaluated to ensure that their pre-existing conditions, as well as their daily medication, do not conflict with the use of HCQ.

Proclamation of a drug as a heal While it has been shown to cause harm, it makes a person more vulnerable and likely to succumb to the disease for which it is intended heal, is seriously misleading.

The use of experimental “off-label” drugs must always be carefully assessed and assessed for possible contraindications to the disease in question as well as on an individual basis. In other words, in most things, but especially in medicine, “one size fits all” almost never works. An individual approach that takes into account the specific circumstances and needs of the patient is essential to successful patient outcomes and COVID-19 is no exception.

Tween80: A dreaded vaccine ingredient

Another point of concern is the presence of polysorbate80 in some of the widely used HCQ formulations. Polysorbate80 (Tween80 detergent) is a common vaccine ingredient.It has been very controversial because of its solubilizing properties, which are very controversial causes solvent-mediated disorders and increased permeability of the BBB (blood-brain barrier).

The solvent has been used in drug development for decades as an enhancer of drug delivery to the brain by bypassing the protective BBB. Tween80 also enables the transport of nanoparticles and the accumulation of aluminum in the brain matter, which is an extremely problematic problem for vaccines with aluminum adjuvant. This aspect definitely requires further research for possible harm before promoting HCQ as a viable cure for a disease that may remain here.

HCQ A Potential Nanoparticle Enhancer: Implications for mRNA Vaccines

Another rapidly emerging problem with the widespread use of HCQ as a nanoparticle enhancer has to do with this new experimental mRNA COVID19 vaccine and its lipid nanoparticle delivery system. The Moderna vaccine has met with great concern and opposition from the general population, primarily because of its novel use, the lack of adequate safety and efficacy tests, and the unusually rapid development process of this new vaccine.

There is concern about the reactogenicity of the mRNA vaccine and the potential to produce a potent immunological response and possibly a cytokine-type response with undesirable consequences. This is where HCQ can play the role of a Trojan horse. The drug can efficiently cross lipid cell membranes and act as a vector for the delivery of nanoparticles into cells.

A 2016 NIH-funded study conducted by Moderna’s co-founder MIT professor Robert Langer looked at efficient pathways mRNA vaccine delivery via lipid nanoparticles.HCQ is also a means of disrupting the endosomal membrane This can lead to vesicular swelling and membrane permeabilization, which is likely to facilitate the release of therapeutics from lysosomes into the cytoplasm. “

Hydroxychloroquine can also accumulate in endosomes and bind to the minor groove in double-stranded DNA. It can be argued that HCQ could potentially improve the distribution and effectiveness of the mRNA vaccine. Previous research shows the potential of modified RNA to alter host DNA. In the case of Moderna’s mRNA COVID-19 vaccine, this can lead to unforeseen side effects and an explosion in vaccine-induced autoimmune diseases, neurological diseases and cancer epidemics.

Are There Safer Natural Alternatives To HCQ?

Quercetin is a flavonoid found in many plants and foods such as green tea, red wine, apples, berries, ginkgo biloba, St. John’s wort, and others. Quercetin is most commonly taken orally as an adjunct treatment for cardiovascular disease, diabetes, arthritis, and for cancer prevention.

The flavonoid has antioxidant and anti-inflammatory effects, but what makes it an exciting safer alternative to HCQ is its ionophoric properties. A recent study sheds light on the potential use of quercetin as a powerful zinc ionophore and provides insights into the potential application of this natural combination as a potential COVID-19 therapeutic. Quercetin appears to be a powerful HCQ alternative that is free of side effects and is suitable for patients with underlying medical conditions that contraindicate the use of HCQ.

As the world races desperately for cures and vaccines for a disease with a 99.8 percent survival rate, we need to pause and consider these therapeutic agents and weigh the pros and cons before we blindly jump on what is currently the most popular bandwagon. Finding safe natural alternatives has always been an option that deserves equal attention.

The best way to prevent disease is to maintain good health through diet and healthy lifestyle. That doesn’t mean you can’t get sick, but it does give you the benefit of a healthy, robust immune system. Really helped your. The immune system will likely get you through the disease.

The introduction of HCQ as a cure for COVID-19 is very exciting, but these days one has to be careful about blindly following trends as they can easily get you wrong. A critical examination of the risk-benefit ratio and the possible negative consequences is necessary.

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