Chloroquine and hydroxychloroquine, both 4-aminoquinolines, have been suggested as potential treatments for covid-19. Currently, at least 80 trials of chloroquine, hydroxychloroquine, or both, sometimes in combination with other drugs, are registered worldwide. Though there have been no large-scale clinical trials of the drug's efficacy in treating coronavirus, chemists all over say they are facing a shortage of the medicine.

What is Hydroxychloroquine?

Hydroxychloroquine is in a class of drugs called antimalarials. It is used to prevent and treat acute attacks of malaria. Hydroxychloroquine is very similar to chloroquine, one of the oldest and best-known anti-malarial drugs, but with lesser side-effects. It can be bought over the counter and fairly inexpensive.

It is also used to treat discoid or systemic lupus erythematosus and rheumatoid arthritis in patients whose symptoms have not improved with other treatments.

Role in fight against COVID-19:

The anti-malarial drug that is being touted as 'game-changer' in the fight against COVID-19 and is being aggressively sought by US President Donald Trump. Doctors in several countries, including the United States, France, China, and South Korea, have reported success in treating Covid-19 patients with hydroxychloroquine, sometimes paired with the antibiotic azithromycin. Reports from China suggested that chloroquine could inhibit SARS-CoV-2 in vitro, and showed apparent efficacy in treating COVID-19 in humans. A small non-randomised trial in France also found hydroxychloroquine to be a promising potential treatment. Hydroxychloroquine is an appealing prospect because it’s already been tested in humans and is available in a low-cost generic form.

Side-effects:

Common side effects include vomiting, headache, blurry-vision, and muscle weakness, according to health experts. Severe side effects may include allergic reactions.

ICMR Recommendation for usage:

Despite the fact trials are yet to conclude, people have begun to self-medicate - with sometimes disastrous consequences. The drug is not to be used by everyone. Indian Council of Medical Research (ICMR) recommended HCQ be used as a preventive medication for COVID-19 high-risk group. It has also recommended the use of the drug for those involved in the care of 'suspected or confirmed cases of the coronavirus and for asymptomatic household contacts of laboratory-confirmed patients, apart from healthcare workers who are involved in the treatment of COVID-19'.

After the ICMR issued the advisory, several patients and healthcare professionals stocked up on the drug. However, the government then moved the drug to Schedule H1, meaning that anyone who needs the drug, would have to get a fresh prescription whenever they need to buy the drug.

Why drug is not available in developed country like USA?

The drug is not manufactured in developed nations such as the US because of non-existent malaria.

India’s role in production of HCQ:

India is the biggest manufacturer of hydroxychloroquine. India manufactures 70% of the world's supply of hydroxychloroquine. The country has a production capacity of 40 tonnes of hydroxychloroquine (HCQ) every month, implying 20 crore tablets of 200 mg each. And since the drug is also used to auto-immune diseases like rheumatoid arthritis and lupus, manufacturers have good production capacities that can also be ramped up.

India is the largest exporter of the drug. India would export the drug on a case-by-case basis after meeting all the domestic requirements. The objective is to minimize speculative buying and hoarding in these trying times and ensure balance in the distribution for patients and segments who need them.