Hydroxychloroquine + azithromycin combination being touted as a Corona treatment

Fleetwoodmac · 01-04-2020 1:21am

iguana wrote: »

From what I've read the medication is tough on your system. If a person is likely to recover without taking them that's a better option.

But are they not repurposed drugs with known safety parameters..that's what confused me. Given that we are being told covid19 can cause long term lung damage..

The Hound Gone Wild · 01-04-2020 1:27am

JP Liz V1 wrote: »

Is Teva antibiotics?

Teva is a pharmaceutical company

The Hound Gone Wild · 01-04-2020 1:28am

JP Liz V1 wrote: »

I was on a bottle, Bisolvon which contained Bromhexine Hydrochloride, would this be a lower form of Hydroxychloroquine?

These are in no way related.

Arrival · 01-04-2020 1:39am

EDit wrote: »

Good point. Forgot both of these are generic, so should be relatively cheap. Apparently they are being tested in larger trials with results expected in ~20 days. Fingers crossed the data look good.

Any update on this, should we still be expecting this this week?

Arrival · 01-04-2020 2:03am

begbysback wrote: »

Im baffled too as to why more isnt being discussed about drug treatment of COVID19 - theres no doubts its going on in countries, when I questioned the HSE consultant in the AMA thread on their exaggerated death forecast in Ireland I got the below as a source for the predictions - what I consider to be strange is this specifies non pharmaceutical intervention, as if there was nothing available - I find it bizzare to be honest that nobody as yet has produced a larger scale report than the french one about drug treatments. Ive no doubt the Chinese have such reports, but dont seem to be sharing them, or at least us public are not told about them.

I would hate to think that the large discrepancies in death numbers when comparing countries is caused by lack of shared information about a treatment.

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

This is genuinely a huge anxiety of mine during all of this, I'm worried that something will be announced to work well in other countries and we won't have had that information shared quickly and be slow on the uptake

Surely there's a big effort, in European countries at least, going into sharing the data they all have to come to the best conclusions and help each other?

JP Liz V1 · 01-04-2020 2:32am

Esel wrote: »

IANAD, but that seems to be a mucolytic cough medication, with absolutely no connection to Hydroxychloroquine.

The Hound Gone Wild wrote: »

These are in no way related.

mvl · 01-04-2020 8:42am

Arrival wrote: »

This is genuinely a huge anxiety of mine during all of this, I'm worried that something will be announced to work well in other countries and we won't have had that information shared quickly and be slow on the uptake

Surely there's a big effort, in European countries at least, going into sharing the data they all have to come to the best conclusions and help each other?

well, think we rather need to stay away from misinformation (so glad I don't have a TV these days !!!).
I posted earlier the HSE link about treatment options for this, the directive was available next day after WHO announced the pandemic situation (before this thread started)

then seeing a recommendation for tocilizumbab also exists (but preliminary) - https://www.hse.ie/eng/about/who/acute-hospitals-division/drugs-management-programme/interim-recommendations-for-the-use-of-tocilizumab-in-the-management-of-patients-with-severe-covid-19.pdf

plodder · 01-04-2020 9:55am

FDA authorizes widespread use of unproven drugs to treat coronavirus, saying possible benefit outweighs risk

Millions of doses of anti-malarial drugs hydroxychloroquine and chloroquine will be distributed to hospitals across the country to try to slow the disease in seriously ill patients

Side-effect is that 10% of people taking it may risk heart problems, with 1% at especially high risk.

Ackerman said in an interview that identifying at-risk patients for heart problems caused by the drugs will be a crucial mission for front-line health-care providers. About 10 percent of the population is at risk of a side-effect of prolonging the split-second interval between electrical recharges of the heart, he said. One percent of the population is at especially high risk, he said.

If the interval reaches 500 milliseconds, the heart gets close to “getting tripped up and spiraling out of control'' in an arrhythmia that can lead to sudden heart attack and death, he said.

Wibbs · 01-04-2020 10:12am

As an aside aren't our bodies incredibly complex and precise. I mean when a deviation of just 500 milliseconds can cause things to go south, that's incredibly finely balanced. We're all sitting around reading these threads, living our lives, doing what we do and our hearts and autonomic systems are there going, be cool mofo, we got this, no bother. And we expect them to do this quietly in the background through good times and bad for around 80 years. Even in this current crisis, the vast majority of us, even if we get this virus our even more crazily complex immune system will kick in and kick its teeth in. Oh and while doing all that still keeping an eye out for any other biological **** who want to take up residence. How fantastically effin cool is that?

Your immune system. As we speak.

iguana · 01-04-2020 10:12am

Fleetwoodmac wrote: »

But are they not repurposed drugs with known safety parameters..that's what confused me. Given that we are being told covid19 can cause long term lung damage..

We've literally known for 92 days that this virus exists. We have no idea whatsoever that it causes long term lung damage. The more we do learn about Covid-19, the more we are learning that the vast majority of cases are either asymptomatic or genuinely mild. The odds are that most people who have had the virus will only ever know for sure when a reliable antibody test is made available. I honestly find it very hard to believe that all of those people are left with permanent lung damage. They might have lung inflammation that's visible in scans in the weeks after their recovery but it's very unlikely that a mild illness that their body fought off successfully without intervention in a matter of days/weeks causes them lifelong issues. I could be wrong but anyone saying people are left with lifelong problems from a mild experience with a virus that didn't exist 6 months ago is more likely to be scaremongering or catastrophising. Because nobody knows enough right now to be sure of something so unlikely.

plodder · 01-04-2020 10:14am

iguana wrote: »

We've literally known for 92 days that this virus exists. We have no idea whatsoever that it causes long term lung damage. The more we do learn about Covid-19, the more we are learning that the vast majority of cases are either asymptomatic or genuinely mild. The odds are that most people who have had the virus will only ever know for sure when a reliable antibody test is made available. I honestly find it very hard to believe that all of those people are left with permanent lung damage. They might have lung inflammation that's visible in scans in the weeks after their recovery but it's very unlikely that a mild illness that their body fought off successfully without intervention in a matter of days/weeks causes them lifelong issues. I could be wrong but anyone saying people are left with lifelong problems from a mild experience with a virus that didn't exist 6 months ago is more likely to be scaremongering or catastrophising. Because nobody knows enough right now to be sure of something so unlikely.

An Italian doctor on RTE last week said that it does not cause permanent lung damage in survivors.

stockshares · 01-04-2020 10:25am

plodder wrote: »

An Italian doctor on RTE last week said that it does not cause permanent lung damage in survivors.

It's far too early to know.

plodder · 01-04-2020 10:31am

stockshares wrote: »

It's far too early to know.

What we know is that one reputable doctor in an Italian hospital has said that he found no evidence of fibrosis in surviving patients. I'll go with that until I see evidence to the contrary.

Sweet.Science · 01-04-2020 10:38am

https://www.michiganradio.org/post/henry-ford-uses-hydroxychloroquine-treat-covid-19-symptoms-says-benefits-outweigh-risks

Im sure this will be widespread soon

The Hound Gone Wild · 01-04-2020 11:21am

plodder wrote: »

What we know is that one reputable doctor in an Italian hospital has said that he found no evidence of fibrosis in surviving patients. I'll go with that until I see evidence to the contrary.

This is not how we inform clinical judgements. Andrew Wakefield was one reputable doctor so was Harold Shipman.

silverharp · 01-04-2020 11:27am

any update on its (the virus) testicle damaging properties?

plodder · 01-04-2020 11:46am

The Hound Gone Wild wrote: »

This is not how we inform clinical judgements. Andrew Wakefield was one reputable doctor so was Harold Shipman.

Nobody is claiming that the information is conclusive*. It's obviously anecdotal at this point.

I'm not sure what your point is. Should the doctor not have said it on the radio?

Should we not reply to the post above which said "..Given that we are being told covid19 can cause long term lung damage.." Are you saying there is evidence that it does cause long term lung damage in surviving/recovered patients?

* though maybe my post sounded that way

begbysback · 01-04-2020 2:38pm

Arrival wrote: »

This is genuinely a huge anxiety of mine during all of this, I'm worried that something will be announced to work well in other countries and we won't have had that information shared quickly and be slow on the uptake

Surely there's a big effort, in European countries at least, going into sharing the data they all have to come to the best conclusions and help each other?

from a link posted earlier WHO seem to have now coordinated treatment studies across countries

interesting to note that Czech Republic have relatively low mortality rates at the moment and they have been approved a couple of weeks ago for the use of remdesivir as a trial - I say interesting from an Irish perspective as they have first reported case roughly same as ours, Dublin & Prague are comparable in population, and they have transparent wikipedia page - one thing for sure though is that there is, or are, effective treatments out there, at least we are in a much better place than a couple of weeks ago when health officials were reporting as if nothing could be done except put people on ventilators.

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_Czech_Republic#Policies_to_fight_the_contagion

Jurgen Klopp · 01-04-2020 2:53pm

The Czech Republic also believe mandatory mask wearing in public is as important as washing hands and social distancing, for preventing people from shedding the virus more than preventing getting it.

It's why they've made it mandatory

begbysback · 01-04-2020 3:09pm

Jurgen Klopp wrote: »

The Czech Republic also believe mandatory mask wearing in public is as important as washing hands and social distancing, for preventing people from shedding the virus more than preventing getting it.

It's why they've made it mandatory

This is surely the next step here, can only assume there is a shortage at the moment, which is why the directive has not yet been given.

Jurgen Klopp · 01-04-2020 3:14pm

begbysback wrote: »

This is surely the next step here, can only assume there is a shortage at the moment, which is why the directive has not yet been given.

What gets me Begby is the HSE deliberately spreading the "masks don't protect you" and it's amazing how many people have swallowed it hook, line and sinker

I used work in healthcare and even a surgical mask will offer a little protection compared to nothing and they know this.

Most importantly as I said is it cuts down on spreaders by containing droplets.

If they had just been honest and said home made masks and wash at 90c after use offer good protection as we need proper PPE for hospitals as they are exposed more

What worries me now is when it's acknowledged we need to wear masks even officially we'll now have lots saying "ah **** that sure they said a mask wouldn't help and now they do sure they don't know their arse from their elbow"

iguana · 01-04-2020 4:52pm

Jurgen Klopp wrote: »

What gets me Begby is the HSE deliberately spreading the "masks don't protect you" and it's amazing how many people have swallowed it hook, line and sinker

I used work in healthcare and even a surgical mask will offer a little protection compared to nothing and they know this.

Most importantly as I said is it cuts down on spreaders by containing droplets.

Wouldn't anything wrapped around your mouth and nose help avoid spreading the virus? I had been wrapping a scarf a few times around my mouth and nose, sometimes with a dust mask under it for the last week that I was out. I've had a respiratory illness of some sort since the 18th and was last shopping a few hours before my symptoms started. If I do have Covid I'm hoping that having the scarf around my face will have protected anyone who was around me that day and the days before.

silverharp · 01-04-2020 6:25pm

https://twitter.com/Real_Israeli/status/1245343294491680768

Wibbs · 01-04-2020 8:38pm

I had a totally oddball and almost certainly daft as fook thought about common drugs and this dose... This virus attaches to the ACE enzyme on your lung surfactant cells, that's how it gets in. What about the ACE inhibitor drugs commonly used worldwide for the regulation of high blood pressure? I noted early on one of the main conditions that suffer worse with this virus is people with high blood pressure. Now of course their bodies are already under stress and likely have cardiovascular problems too so any extra stress... Do people with certain types of high blood pressure have more ACE enyzme floating about? Could those class of drugs inhibit enough of the ACE enzyme to reduce the amount the virus could latch onto, or at least reduce levels alongside other therapies? I wonder are there any figures for any difference in progression and outcome between people with high BP on beta blockers compared to those on ACE inhibitors?

bo0li5eumx12kp · 01-04-2020 8:41pm

Curious what the effective dose of azithromycin is.

Typically it's 500 mg daily, up to 1 or 2 grams maximum - but for this virus, can't find any reports.

Hydroxychloroquine is normally dosed at 600 mg daily.

odyssey06 · 01-04-2020 8:43pm

Re: ACE inhibitors...it is being monitored. Concerns it could increase risk but in theory should protect against severe complications.
https://www.healio.com/cardiology/vascular-medicine/news/online/%7Bfe7f0842-aecb-417b-9ecf-3fe7e0ddd991%7D/cardiology-societies-recommend-patients-taking-ace-inhibitors-arbs-who-contract-covid-19-should-continue-treatment?page=2

BanditLuke · 01-04-2020 8:45pm

I know zero zip nadda about medicine. Is it possible this is enough of a "wonder drug" that it could allow normal life to resume within the next say two months? The figures being posted look very promising

cunnifferous · 01-04-2020 8:49pm

Wibbs wrote: »

I had a totally oddball and almost certainly daft as fook thought about common drugs and this dose... This virus attaches to the ACE enzyme on your lung surfactant cells, that's how it gets in. What about the ACE inhibitor drugs commonly used worldwide for the regulation of high blood pressure? I noted early on one of the main conditions that suffer worse with this virus is people with high blood pressure. Now of course their bodies are already under stress and likely have cardiovascular problems too so any extra stress... Do people with certain types of high blood pressure have more ACE enyzme floating about? Could those class of drugs inhibit enough of the ACE enzyme to reduce the amount the virus could latch onto, or at least reduce levels alongside other therapies? I wonder are there any figures for any difference in progression and outcome between people with high BP on beta blockers compared to those on ACE inhibitors?

I think it's the opposite of what you think actually. Often when you reduce a signal within a system the cell responds by upregulation of the receptor to try and restore the signal to the normal level.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext

Esel · 01-04-2020 9:04pm

Eliezer Shrilling Grassland wrote: »

Curious what the effective dose of azithromycin is.

Typically it's 500 mg daily, up to 1 or 2 grams maximum - but for this virus, can't find any reports.

Hydroxychloroquine is normally dosed at 600 mg daily.

Are you planning to self-medicate?

Arrival · 01-04-2020 9:05pm

Jurgen Klopp wrote: »

The Czech Republic also believe mandatory mask wearing in public is as important as washing hands and social distancing, for preventing people from shedding the virus more than preventing getting it.

It's why they've made it mandatory

I really don't understand why we didn't/don't make a similar effort here to be honest

Wibbs · 01-04-2020 9:12pm

cunnifferous wrote: »

I think it's the opposite of what you think actually. Often when you reduce a signal within a system the cell responds by upregulation of the receptor to try and restore the signal to the normal level.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext

Ah right C thanks, cool read. That makes perfect sense of course. Like if you take testosterone for body building your nuts shrink and your natural production falls off a cliff as your body looks to getting back to stasis.

Though you may have missed the part where I said "oddball and almost certainly daft as fook". That's my baseline, anything beyond that is occasional and occasionally miraculous.

Wibbs · 01-04-2020 9:14pm

Arrival wrote: »

I really don't understand why we didn't/don't make a similar effort here to be honest

Not enough reserves of stock for medical staff, so they didn't want a run on the stuff in shops. Simple as that. It wasn't based on clinical opinion, much more on practical. Ditto for the CDC in the US, the NHS in the UK and so on.

bo0li5eumx12kp · 01-04-2020 9:14pm

Esel wrote: »

Are you planning to self-medicate?

I just want to know precisely what to yell at some student doctor before I undergo invasive ventilation.

Esel · 01-04-2020 9:17pm

Eliezer Shrilling Grassland wrote: »

I just want to know precisely what to yell at some student doctor before I undergo invasive ventilation.

You will be rasping, not yelling. Be sure to gasp "Stat!" too.

Deep Thought · 01-04-2020 9:18pm

Eliezer Shrilling Grassland wrote: »

I just want to know precisely what to yell at some student doctor before I undergo invasive ventilation.

Strange.. going by the comments in here thought every person on here was a qualified medical doctor.

Arrival · 01-04-2020 9:19pm

BanditLuke wrote: »

I know zero zip nadda about medicine. Is it possible this is enough of a "wonder drug" that it could allow normal life to resume within the next say two months? The figures being posted look very promising

I'd say the best approach would be for them to actually treat people with it and get on top of things before they even announce that this is likely going to help the majority of people, simply because if they announce it before that point then we'll have so many idiots running around disregarding the possibility of it spreading further. Once they get things in control, they could have the contact tracing and isolation situation setup to work very well and gradually lift the restrictions

Arrival · 01-04-2020 9:21pm

Wibbs wrote: »

Not enough reserves of stock for medical staff, so they didn't want a run on the stuff in shops. Simple as that. It wasn't based on clinical opinion, much more on practical. Ditto for the CDC in the US, the NHS in the UK and so on.

Neither did Czechia, that's why they had a huge increase in people sewing their own homemade masks, and that's what I'm mostly talking about. Hopefully the Frontline staff have enough PPE now, I wonder if there's any news on that

sadie1502 · 01-04-2020 9:22pm

cunnifferous wrote: »

I think it's the opposite of what you think actually. Often when you reduce a signal within a system the cell responds by upregulation of the receptor to try and restore the signal to the normal level.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext

So beta blockers and ace inhibitors do the same job, but in a different way? But people taking ace inhibitors have had a worse outcome against covid 19? Or am I reading it wrong?

01-04-2020 9:55pm

sadie1502 wrote: »

So beta blockers and ace inhibitors do the same job, but in a different way? But people taking ace inhibitors have had a worse outcome against covid 19? Or am I reading it wrong?

Beta blockers are better at controlling her heart rate which has a side effect of reducing your blood pressure. ACE inhibitors are first line medication for high blood pressure in under 55s.

cunnifferous · 01-04-2020 10:38pm

Wibbs wrote: »

Ah right C thanks, cool read. That makes perfect sense of course. Like if you take testosterone for body building your nuts shrink and your natural production falls off a cliff as your body looks to getting back to stasis.

Though you may have missed the part where I said "oddball and almost certainly daft as fook". That's my baseline, anything beyond that is occasional and occasionally miraculous.

Haha there was some method in the madness I'll give you that

I was looking at that paper as it also offered a mechanism by which ibuprofen could make Covid symptoms worse. I'm personally skeptical and think NSAIDs will prove beneficial in relieving symptoms but we shall see!

sadie1502 · 01-04-2020 10:46pm

[Deleted User] wrote: »

Beta blockers are better at controlling her heart rate which has a side effect of reducing your blood pressure. ACE inhibitors are first line medication for high blood pressure in under 55s.

So they basically do the same thing. And the highest deaths seem to be in that category of people on those medications.

The Hound Gone Wild · 01-04-2020 10:53pm

sadie1502 wrote: »

So they basically do the same thing. And the highest deaths seem to be in that category of people on those medications.

Beta blockers and ACEi do the same thing the same way a tommy gun and a sniper rifle do the same thing

The Hound Gone Wild · 01-04-2020 11:10pm

Wibbs wrote: »

I had a totally oddball and almost certainly daft as fook thought about common drugs and this dose... This virus attaches to the ACE enzyme on your lung surfactant cells, that's how it gets in. What about the ACE inhibitor drugs commonly used worldwide for the regulation of high blood pressure? I noted early on one of the main conditions that suffer worse with this virus is people with high blood pressure. Now of course their bodies are already under stress and likely have cardiovascular problems too so any extra stress... Do people with certain types of high blood pressure have more ACE enyzme floating about? Could those class of drugs inhibit enough of the ACE enzyme to reduce the amount the virus could latch onto, or at least reduce levels alongside other therapies? I wonder are there any figures for any difference in progression and outcome between people with high BP on beta blockers compared to those on ACE inhibitors?

ACE and ACE2 do completely opposite things, raise and lower BP respectively. ACEi haven't been shown to have any effect on ACE2 in humans afaik.

sadie1502 · 01-04-2020 11:16pm

SARS 1 did they not develop a vaccine? I thought they had a lot of research of developing a vaccine. How did they treat SARS?

Jurgen Klopp · 02-04-2020 12:42am

iguana wrote: »

Wouldn't anything wrapped around your mouth and nose help avoid spreading the virus? I had been wrapping a scarf a few times around my mouth and nose, sometimes with a dust mask under it for the last week that I was out. I've had a respiratory illness of some sort since the 18th and was last shopping a few hours before my symptoms started. If I do have Covid I'm hoping that having the scarf around my face will have protected anyone who was around me that day and the days before.

Ah yes iguana as long as it's not one that's full of holes design wise wrapping it a couple times will greatly reduce the viral load you would shed. I am using a penny's snood one of the fleece ones it will gather as much as any non PPE will and at least I can toss it in at 90c too

I'd love to make some homemade ones but I've no elastic, but plenty of cotton

I can sow by hand but trying to see what is use in place of sewn on elastic

I don't want to use any cord like material as I don't know if the tightly twisted fibres will cleanse correctly even at 90c

I'm looking into using some light gardening wire instead but that entails having to cut 4 holes form the front of the mask to run them through so I'd probably be defeating the purpose of containing the viral load

RoYoBo · 02-04-2020 10:53am

Jurgen Klopp wrote: »

I'd love to make some homemade ones but I've no elastic, but plenty of cotton I can sow by hand but trying to see what is use in place of sewn on elastic

Big rubber bands? Or ... ahem ... some knicker elastic from an old pair.

02-04-2020 11:26am

sadie1502 wrote: »

SARS 1 did they not develop a vaccine? I thought they had a lot of research of developing a vaccine. How did they treat SARS?

They said: phew, dodged a bullet there, thankfully nothing like that can ever happen again so no need to research coronavirus vaccines, treatment options etc.

sadie1502 · 02-04-2020 11:28am

[Deleted User] wrote: »

They said: phew, dodged a bullet there, thankfully nothing like that can ever happen again so no need to research coronavirus vaccines, treatment options etc.

Really. Surly they knew it could happen again.

CIARAN_BOYLE · 02-04-2020 11:34am

sadie1502 wrote: »

Really. Surly they knew it could happen again.

They made the determination that anything they developed for sars would be of academic value only and would not be effective the next time a coronavirus emerged.

Wibbs · 02-04-2020 11:37am

There wasn't any money behind it essentially so the preliminary work didn't get far. And though SARS(and MERS) was a bit of a panic it was an easier virus to control as it wasn't as infectious and most of all you were really only infectious when you had clear symptoms. Covid is a bastard because it's both fairly infectious(though nothing like measles for example) and is infectious before you come down with symptoms. Though Hollywood loves an ebola type virus in disaster films it's not ever likely to go pandemic. Again because you're clearly horribly unwell when you become infectious and it isn't as easy to transmit, so it tends to be spread among close family members, health workers and funeral practices rather than wider community spread.

Hydroxychloroquine + azithromycin combination being touted as a Corona treatment

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