Hydroxychloroquine: What are the side effects of Trump’s anti-malaria drug and is it safe?

Donald Trump has claimed he takes a “daily” dosage of hydroxychloroquine as a “preventive” medication against the coronavirus with the approval of a White House doctor, though his own Food and Drug Administration has not approved any medicines to combat or treat Covid-19 following warnings that the drug could trigger lethal heart conditions.

The drug has been approved for some clinical trials for coronavirus treatment, but it is unclear how the president was prescribed the medicine for daily use without showing any symptoms.

Hydroxychloroquine has been approved by the FDA to treat or prevent malaria, as well as some types of lupus and rheumatoid arthritis. But the drug’s efficacy in coronavirus patients has not been proven, and the agency has warned that clinical trials for the drug to treat Covid-19 should only treat hospitalised patients under close heart monitoring.

The FDA says using hydroxychloroquine phosphate and choloroquine phosphate can pose serious risks, including “serious heart rhythm problems” as well as low blood sugar, particularly among people with diabetes, anaemia and other blood problems, worsening of seizures and other neurologic issues, and eye damage.

On 28 March, the FDA issued a emergency use authorisation to allow hydroxychloroquine and chloroquine products in the Strategic National Stockpile to be distributed and used for certain hospitalised Covid-19 patients “as appropriate, when a clinical trial is not available or feasible”.

Last week, the National Institutes of Health began clinical trials to treat Covid-19 patients by using a combination of hydroxychloroquine and the antibiotic azithromycin.

“Repurposing existing drugs is an attractive option because these medications have undergone extensive testing, allowing them to move quickly into clinical trials and accelerating their potential approval for Covid-19 treatment,” Dr Anthony Fauci said in a statement. “Although there is anecdotal evidence that hydroxychloroquine and azithromycin may benefit people with Covid-19, we need solid data from a large randomized, controlled clinical trial to determine whether this experimental treatment is safe and can improve clinical outcomes.”

The FDA has also warned Americans against using chloroquine phosphate, a common aquarium cleaner, which is not the same as medicinal chloroquine phosphate. At least one person in the US has died after ingesting the chemical.

Patients also have reported more than two dozen side effects after taking hydroxychloroquine, according to the American Society of Health-System Pharmacists.

Side effects have included nausea, weight loss, diarrhoea, hair loss, rashes, headaches, mood swings, irritability and nervousness, among others.

Patients are advised to call their doctor if they experience more serious side effects, including muscle weakness, twitching, blurred vision, light sensitivity, pale skin, bruising, confusion or seizures.