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Taking hydroxychloroquine and Zithromax together for treatment of COVID-19 may lead to rapid and erratic heart rates that can cause other serious side effects, according to the findings of new research.
In a study published in the medical journal JAMA Cardiology on May 1, researchers indicate that patients who took hydroxychloroquine alone and those who took it in combination with the antibiotic azithromycin, sold under the names Zithromax, Z-Pak and Zmax, experienced rapid heart rates that can cause stroke, heart attack, seizure and death.
Amid the COVID-19 pandemic President Donald Trump has frequently suggested hydroxychloroquine could be an effective treatment, despite a lack of evidence indicating the drug can help patients recover. This led to studies focusing on the potential effectiveness of hydroxychloroquine to treat COVID-19 patients.
Researchers studied 90 hospitalized patients with COVID-19 who had clinical findings consistent with pneumonia. The study was performed at an academic tertiary care center in Boston, Massachusetts, from March 1 to April 7, 2020.
Nearly 90% of patients taking hydroxychloroquine either alone or with the antibiotic Zithromax experienced prolonged QT, or more simply, rapid erratic heartbeats.
Overall, 21% of patients who received both hydroxychloroquine and Zithromax experienced dangerous heart arrhythmias of 500 milliseconds or more. A total of 13% of patients experienced a change to their heartbeat by 60 milliseconds or more.
Patients taking only hydroxychloroquine also experienced erratic heartbeats, although patients taking both drugs had greater changes to their heart rhythm.
A study published in 2015 linked Zithromax and other macrolide antibiotics to increased risk of life-threatening heart problems. As both drugs carry a warning of heart side effects, the risks to patients is even greater.
Experiencing irregular and rapid heartbeats can lead to seizures, fainting, and in some cases, sudden death. If a person has irregular heart rhythms for too long it can trigger a heart attack or stroke.
Ten patients had to stop taking hydroxychloroquine because of side effects, including nausea, hypoglycemia and one patient suffered a case of torsades de pointes, a specific type of abnormal heart rhythm that can cause sudden cardiac death.
Hydroxychloroquine is a drug approved by the FDA to treat lupus, rheumatoid arthritis, and malaria. The FDA issued an emergency authorization for doctors to use the drug on some coronavirus patients after a French study showed promising results. However, the study was later found to have problems with research standards.
A study conducted on Veterans with COVID-19 indicated a higher rate of death among patients who used the drug. Some people have taken it upon themselves to use nonprescription versions of the drug used for aquarium treatments, resulting in serious and fatal side effects.
The FDA issued a warning last month, calling on consumers not to take the drug outside of hospital settings and only under a doctor’s care.
“Clinicians should carefully weigh risks and benefits if considering hydroxychloroquine and azithromycin, with close monitoring of QTc and concomitant medication usage,” wrote study authors.