Call to halt hydroxychloroquine prescribing, dispensing for COVID-19

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PSA strongly advises pharmacists to refuse dispensing of hydroxychloroquine outside of approved indications, and urges prescribers to stop writing prescriptions as a ‘just in case’ measure

Following President Trump’s announcement last week that hydroxychloroquine will be fast-tracked by the US Food and Drug Administration as a treatment for COVID-19 infection after showing “very encouraging early results”, Australian community pharmacies have seen unprecedented demand for the drug.

His announcement seems to be based on in-vitro evidence of activity against SARS coronavirus and, subsequent to that, the preliminary results from a small French study showing that the combination of hydroxychloroquine and azithromycin reduced viral load in people with COVID-19 infection, pharmacy academics have pointed out.

The study upon which the US President’s announcement was made has received criticism, not because the treatment is, or might be, ineffective,  but because there is no way to draw solid conclusions about the clinical benefits of this agent, based on this early data, they say, adding that a rigorous and sufficiently large randomised clinical trial is needed. 

The Pharmaceutical Society of Australia (PSA) has since heard from Australian pharmacies that they have been receiving prescriptions from doctors prescribing for other doctors and their families, as well as dentists prescribing to the community and their families, and non-medical prescribers prescribing bulk amounts of the drug.

PSA national president Chris Freeman has provided “strong advice” to pharmacists “to refuse the dispensing of hydroxychloroquine if there is not a genuine need” at this point in time, until further advice is available.

“That need is for those indications for what it is approved for – inflammatory conditions or the suppression and treatment of malaria,” says Associate Professor Freeman.

The stock of this medication needs to be managed effectively and utilised for those who many genuinely need it.

A/Prof Freeman adds that if the medication does indeed have efficacy against COVID-19, then the medication needs to be prescribed and used judiciously.

“The current stock of hydroxychloroquine needs to be managed sensibly, it needs to be available for those who are currently being prescribed this medicine, and it may also be needed for treatment of COVID-19 in the future,” he says.

A/Prof Freeman urges pharmacists to manage their existing stock of hydroxychloroquine sensibly, ensuring those who are currently prescribed the medicine have an existing supply.

PSA also urges prescribers not to write prescriptions for this medicine as a ‘just in case’ measure, and reiterates that pharmacists should refuse supply of hydroxychloroquine outside of the indications at this point in time.

“While the data may not yet be clear, if hydroxychloroquine is shown to be effective for COVID-19, we want every dose available to treat those who may require it,” A/Prof Freeman says.

PSA is currently working with the TGA and the Minister for Health regarding appropriate management of national stockpiles and medicines stock.

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