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Hello, I Have Several Questions About The Novel Covid 19
Question: Hello, I have several questions about the novel covid 19 virus that seem to not be addressed. It seems that any and everything negative or deadly is known immediately and is an absolute, but anything hopeful or possibly a positive, gets shot down , or deleted or simply not even asked , for instance, about hydrchloroquine. Since the drug is currently being taken by millions of people for RA or lupus has there been any studies of these people? Have any of them been diagnosed with covid? I know someone from XXXXXXX who says that they take it over there and that it is sold over the counter, so why is it considered so dangerous in the U.S.? Also, are any blood types more susceptible to the virus? And how many people have gotten the virus who DID NOT get a flu shot?
Hello, I have several questions about the novel covid 19 virus that seem to not be addressed. It seems that any and everything negative or deadly is known immediately and is an absolute, but anything hopeful or possibly a positive, gets shot down , or deleted or simply not even asked , for instance, about hydrchloroquine. Since the drug is currently being taken by millions of people for RA or lupus has there been any studies of these people? Have any of them been diagnosed with covid? I know someone from XXXXXXX who says that they take it over there and that it is sold over the counter, so why is it considered so dangerous in the U.S.? Also, are any blood types more susceptible to the virus? And how many people have gotten the virus who DID NOT get a flu shot?
Brief Answer:
please read the detailed answer below
Detailed Answer:
Hello,
I do not agree with your opinion. Positive news has been spread more than ever - and even before confirmation... Take chloroquine for example. Scientists found some in vitro evidence that chloroquine may have a positive effect on COVID-19. Before any proper trial had been completed everybody was trying to find the miracle-drug. After in vivo studies have been conducted, it seems that chloroquine is useless for a mild or moderate disease but it may have some positive effects on certain patients with advanced disease. CDC does not support the routine use of chloroquine for COVID-19.
Regarding the patients with RA or lupus; they seem to be equally burdened by COVID-19 as everybody else. Chloroquine did not seem to protect them, although this assumption is based on the percentage of diseased patients and not a proper study.
Chloroquine has many side effects. Arrhythmias is a great concern, particularly in patients who already use other drugs or have comorbidities. There are eye problems, liver problems, etc. It's not the most dangerous drug that ever existed but no drug should be used unless really needed. Please keep in mind that diseases like lupus and RA are not very prevalent and although many patients take chloroquine for RA or lupus, there will be many more with COVID-19. When you give the drug to many individuals, more side effects will occur. If - for example - a drug causes liver problems in 1 out of 1000 patients who use it and only 100 patients take it in total then it's very likely that nobody will have liver problems. If 100000 patients take it then we'll probably have 100 patients with liver problems. This is something to take into account when considering the utility of any drug.
Although there were some reports suggesting a role for the various blood types, it seems that they're not important in determining either the severity of the susceptibility to the virus.
I do not have numbers regarding the unvaccinated people who got COVID-19. There seems to be some interference between influenza vaccination and COVID-19 susceptibility but the existing data is not strong enough to make infectious diseases experts advise against influenza vaccination. On the contrary, influenza vaccination may help to reduce the burden of influenza and avoid confusion between influenza and COVID-19.
I hope I've answered all of your questions! Please let me know if you need any clarification.
Kind Regards,
Dr. Panagiotis Zografakis,
Internal Medicine Specialist
please read the detailed answer below
Detailed Answer:
Hello,
I do not agree with your opinion. Positive news has been spread more than ever - and even before confirmation... Take chloroquine for example. Scientists found some in vitro evidence that chloroquine may have a positive effect on COVID-19. Before any proper trial had been completed everybody was trying to find the miracle-drug. After in vivo studies have been conducted, it seems that chloroquine is useless for a mild or moderate disease but it may have some positive effects on certain patients with advanced disease. CDC does not support the routine use of chloroquine for COVID-19.
Regarding the patients with RA or lupus; they seem to be equally burdened by COVID-19 as everybody else. Chloroquine did not seem to protect them, although this assumption is based on the percentage of diseased patients and not a proper study.
Chloroquine has many side effects. Arrhythmias is a great concern, particularly in patients who already use other drugs or have comorbidities. There are eye problems, liver problems, etc. It's not the most dangerous drug that ever existed but no drug should be used unless really needed. Please keep in mind that diseases like lupus and RA are not very prevalent and although many patients take chloroquine for RA or lupus, there will be many more with COVID-19. When you give the drug to many individuals, more side effects will occur. If - for example - a drug causes liver problems in 1 out of 1000 patients who use it and only 100 patients take it in total then it's very likely that nobody will have liver problems. If 100000 patients take it then we'll probably have 100 patients with liver problems. This is something to take into account when considering the utility of any drug.
Although there were some reports suggesting a role for the various blood types, it seems that they're not important in determining either the severity of the susceptibility to the virus.
I do not have numbers regarding the unvaccinated people who got COVID-19. There seems to be some interference between influenza vaccination and COVID-19 susceptibility but the existing data is not strong enough to make infectious diseases experts advise against influenza vaccination. On the contrary, influenza vaccination may help to reduce the burden of influenza and avoid confusion between influenza and COVID-19.
I hope I've answered all of your questions! Please let me know if you need any clarification.
Kind Regards,
Dr. Panagiotis Zografakis,
Internal Medicine Specialist
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
please read the detailed answer below
Detailed Answer:
Hello,
I do not agree with your opinion. Positive news has been spread more than ever - and even before confirmation... Take chloroquine for example. Scientists found some in vitro evidence that chloroquine may have a positive effect on COVID-19. Before any proper trial had been completed everybody was trying to find the miracle-drug. After in vivo studies have been conducted, it seems that chloroquine is useless for a mild or moderate disease but it may have some positive effects on certain patients with advanced disease. CDC does not support the routine use of chloroquine for COVID-19.
Regarding the patients with RA or lupus; they seem to be equally burdened by COVID-19 as everybody else. Chloroquine did not seem to protect them, although this assumption is based on the percentage of diseased patients and not a proper study.
Chloroquine has many side effects. Arrhythmias is a great concern, particularly in patients who already use other drugs or have comorbidities. There are eye problems, liver problems, etc. It's not the most dangerous drug that ever existed but no drug should be used unless really needed. Please keep in mind that diseases like lupus and RA are not very prevalent and although many patients take chloroquine for RA or lupus, there will be many more with COVID-19. When you give the drug to many individuals, more side effects will occur. If - for example - a drug causes liver problems in 1 out of 1000 patients who use it and only 100 patients take it in total then it's very likely that nobody will have liver problems. If 100000 patients take it then we'll probably have 100 patients with liver problems. This is something to take into account when considering the utility of any drug.
Although there were some reports suggesting a role for the various blood types, it seems that they're not important in determining either the severity of the susceptibility to the virus.
I do not have numbers regarding the unvaccinated people who got COVID-19. There seems to be some interference between influenza vaccination and COVID-19 susceptibility but the existing data is not strong enough to make infectious diseases experts advise against influenza vaccination. On the contrary, influenza vaccination may help to reduce the burden of influenza and avoid confusion between influenza and COVID-19.
I hope I've answered all of your questions! Please let me know if you need any clarification.
Kind Regards,
Dr. Panagiotis Zografakis,
Internal Medicine Specialist
please read the detailed answer below
Detailed Answer:
Hello,
I do not agree with your opinion. Positive news has been spread more than ever - and even before confirmation... Take chloroquine for example. Scientists found some in vitro evidence that chloroquine may have a positive effect on COVID-19. Before any proper trial had been completed everybody was trying to find the miracle-drug. After in vivo studies have been conducted, it seems that chloroquine is useless for a mild or moderate disease but it may have some positive effects on certain patients with advanced disease. CDC does not support the routine use of chloroquine for COVID-19.
Regarding the patients with RA or lupus; they seem to be equally burdened by COVID-19 as everybody else. Chloroquine did not seem to protect them, although this assumption is based on the percentage of diseased patients and not a proper study.
Chloroquine has many side effects. Arrhythmias is a great concern, particularly in patients who already use other drugs or have comorbidities. There are eye problems, liver problems, etc. It's not the most dangerous drug that ever existed but no drug should be used unless really needed. Please keep in mind that diseases like lupus and RA are not very prevalent and although many patients take chloroquine for RA or lupus, there will be many more with COVID-19. When you give the drug to many individuals, more side effects will occur. If - for example - a drug causes liver problems in 1 out of 1000 patients who use it and only 100 patients take it in total then it's very likely that nobody will have liver problems. If 100000 patients take it then we'll probably have 100 patients with liver problems. This is something to take into account when considering the utility of any drug.
Although there were some reports suggesting a role for the various blood types, it seems that they're not important in determining either the severity of the susceptibility to the virus.
I do not have numbers regarding the unvaccinated people who got COVID-19. There seems to be some interference between influenza vaccination and COVID-19 susceptibility but the existing data is not strong enough to make infectious diseases experts advise against influenza vaccination. On the contrary, influenza vaccination may help to reduce the burden of influenza and avoid confusion between influenza and COVID-19.
I hope I've answered all of your questions! Please let me know if you need any clarification.
Kind Regards,
Dr. Panagiotis Zografakis,
Internal Medicine Specialist
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
I would like to know How it's possible that millions of people take HCQ and suddenly it's a big problem. It makes no sense and I feel that your answers are less than completely accurate, for instance, you cited eye problems. Fromwhat my doctor told me, eye problems are very rare and usually after being on the medication for several years, and usually with an already existing eye problem. So how can you make it seem like a "common" side effect? I am more confused than ever. Also, you said everyone is trying to find a miracle drug , did this one just get pulled out of thin air , or was there a reason why it would even be considered as a possibility? I would also like you to expand on the information about people already on HCQ who are getting the virus also.
I would like to know How it's possible that millions of people take HCQ and suddenly it's a big problem. It makes no sense and I feel that your answers are less than completely accurate, for instance, you cited eye problems. Fromwhat my doctor told me, eye problems are very rare and usually after being on the medication for several years, and usually with an already existing eye problem. So how can you make it seem like a "common" side effect? I am more confused than ever. Also, you said everyone is trying to find a miracle drug , did this one just get pulled out of thin air , or was there a reason why it would even be considered as a possibility? I would also like you to expand on the information about people already on HCQ who are getting the virus also.
Brief Answer:
it is a problem...
Detailed Answer:
Hello again,
permanent eye problems (retinopathy) may occur in 0.1-1.0% of patients taking HCQ. Let's say it's 0.5%. So if 200 patients take HCQ, only 1 of them will get retinopathy. If 200 millions take it then it's gonna be 1 million new patients with retinopathy. So 1 million people are going to get a very serious eye problem. Is this 1 million going to save their lives with HCQ? That's very doubtful - at least the current data do not support this view. HCQ seems to provide some benefit to carefully selected patients but not to the crowd. Please keep in mind that COVID-19 has a mortality rate of less than 1%. The problem with COVID-19 is not it's severity for any particular individual. It's the infectivity that may cause everybody to get diseased and if everybody get diseased at the same time, the healthcare system will become overwhelmed and people with heart attacks, strokes and other serious disorders will be lost because of the healthcare system inability to cope with the increased load.
HCQ has certainly shown some potential in in-vitro studies (lab data that is) but less potential in in-vivo data (inside the body). It has shown effectiveness for selected individuals with advanced disease and it IS used in some cases (at least in my country - Greece). It's not for everyone though...
Regarding the patients who already use HCQ, I don't have anything more than what I've already mentioned. Data from rheumatological registries indicated that patients with lupus, RA, etc get COVID-19 at the same rate as everyone else.
I hope things are more clear now!
Best Regards!
it is a problem...
Detailed Answer:
Hello again,
permanent eye problems (retinopathy) may occur in 0.1-1.0% of patients taking HCQ. Let's say it's 0.5%. So if 200 patients take HCQ, only 1 of them will get retinopathy. If 200 millions take it then it's gonna be 1 million new patients with retinopathy. So 1 million people are going to get a very serious eye problem. Is this 1 million going to save their lives with HCQ? That's very doubtful - at least the current data do not support this view. HCQ seems to provide some benefit to carefully selected patients but not to the crowd. Please keep in mind that COVID-19 has a mortality rate of less than 1%. The problem with COVID-19 is not it's severity for any particular individual. It's the infectivity that may cause everybody to get diseased and if everybody get diseased at the same time, the healthcare system will become overwhelmed and people with heart attacks, strokes and other serious disorders will be lost because of the healthcare system inability to cope with the increased load.
HCQ has certainly shown some potential in in-vitro studies (lab data that is) but less potential in in-vivo data (inside the body). It has shown effectiveness for selected individuals with advanced disease and it IS used in some cases (at least in my country - Greece). It's not for everyone though...
Regarding the patients who already use HCQ, I don't have anything more than what I've already mentioned. Data from rheumatological registries indicated that patients with lupus, RA, etc get COVID-19 at the same rate as everyone else.
I hope things are more clear now!
Best Regards!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
it is a problem...
Detailed Answer:
Hello again,
permanent eye problems (retinopathy) may occur in 0.1-1.0% of patients taking HCQ. Let's say it's 0.5%. So if 200 patients take HCQ, only 1 of them will get retinopathy. If 200 millions take it then it's gonna be 1 million new patients with retinopathy. So 1 million people are going to get a very serious eye problem. Is this 1 million going to save their lives with HCQ? That's very doubtful - at least the current data do not support this view. HCQ seems to provide some benefit to carefully selected patients but not to the crowd. Please keep in mind that COVID-19 has a mortality rate of less than 1%. The problem with COVID-19 is not it's severity for any particular individual. It's the infectivity that may cause everybody to get diseased and if everybody get diseased at the same time, the healthcare system will become overwhelmed and people with heart attacks, strokes and other serious disorders will be lost because of the healthcare system inability to cope with the increased load.
HCQ has certainly shown some potential in in-vitro studies (lab data that is) but less potential in in-vivo data (inside the body). It has shown effectiveness for selected individuals with advanced disease and it IS used in some cases (at least in my country - Greece). It's not for everyone though...
Regarding the patients who already use HCQ, I don't have anything more than what I've already mentioned. Data from rheumatological registries indicated that patients with lupus, RA, etc get COVID-19 at the same rate as everyone else.
I hope things are more clear now!
Best Regards!
it is a problem...
Detailed Answer:
Hello again,
permanent eye problems (retinopathy) may occur in 0.1-1.0% of patients taking HCQ. Let's say it's 0.5%. So if 200 patients take HCQ, only 1 of them will get retinopathy. If 200 millions take it then it's gonna be 1 million new patients with retinopathy. So 1 million people are going to get a very serious eye problem. Is this 1 million going to save their lives with HCQ? That's very doubtful - at least the current data do not support this view. HCQ seems to provide some benefit to carefully selected patients but not to the crowd. Please keep in mind that COVID-19 has a mortality rate of less than 1%. The problem with COVID-19 is not it's severity for any particular individual. It's the infectivity that may cause everybody to get diseased and if everybody get diseased at the same time, the healthcare system will become overwhelmed and people with heart attacks, strokes and other serious disorders will be lost because of the healthcare system inability to cope with the increased load.
HCQ has certainly shown some potential in in-vitro studies (lab data that is) but less potential in in-vivo data (inside the body). It has shown effectiveness for selected individuals with advanced disease and it IS used in some cases (at least in my country - Greece). It's not for everyone though...
Regarding the patients who already use HCQ, I don't have anything more than what I've already mentioned. Data from rheumatological registries indicated that patients with lupus, RA, etc get COVID-19 at the same rate as everyone else.
I hope things are more clear now!
Best Regards!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello, being Greek myself, I appreciate the dialogue, so let's go on. Please include more variables in your statistics . For instance, the age and pre existing health issues of those who got heart problems and arrythmia, AND, more importantly, their AGE, the health of people on continents where HCQ is taken as a prophylactic, and our US service members who take it when they are overseas. Why are we only being told of a select few who allegedly had these side effects when there are a lot of other people to look at. And so why does the package insert not specify any of these possible side effects? I ask these questions because I have RA and it has been to asked of me by my rheumatologist to take HCQ for several years now and I keep refusing it. So since it has recently becomef front and center, I guess I'm now trying to find out as much as I can about it, with it being used for covid. Before this virus existed, I was continually told how safe it is, for LONG TERM USE. So you can understand my questioning it now, Also we still have not discussed any dosage amounts. Please specify that with your response. I want to know the doses these patients were getting. And since it was originally for malaria, what is the dosage and duration of use for that purpose?
Hello, being Greek myself, I appreciate the dialogue, so let's go on. Please include more variables in your statistics . For instance, the age and pre existing health issues of those who got heart problems and arrythmia, AND, more importantly, their AGE, the health of people on continents where HCQ is taken as a prophylactic, and our US service members who take it when they are overseas. Why are we only being told of a select few who allegedly had these side effects when there are a lot of other people to look at. And so why does the package insert not specify any of these possible side effects? I ask these questions because I have RA and it has been to asked of me by my rheumatologist to take HCQ for several years now and I keep refusing it. So since it has recently becomef front and center, I guess I'm now trying to find out as much as I can about it, with it being used for covid. Before this virus existed, I was continually told how safe it is, for LONG TERM USE. So you can understand my questioning it now, Also we still have not discussed any dosage amounts. Please specify that with your response. I want to know the doses these patients were getting. And since it was originally for malaria, what is the dosage and duration of use for that purpose?
Brief Answer:
please read the full answer
Detailed Answer:
Hi,
Your explanation made me understand your doubts.
I don't have detailed data from clinical studies but the arrhythmias warning is definitely in the summary of product characteristics (SPC) of the drug. It is a well-known side effect. Chloroquine may cause prolongation of the QT interval in the ECG which (usually in combination with other drugs like azithromycin) may cause a potentially fatal arrhythmia. It's not a common side effect obviously and it's less prevalent with HCQ compared to chloroquine-phosphate. Besides the QT prolongation, it may cause other - uncommon as well - forms of cardiac toxicity.
The retinopathy is another well-known side effect and you'll find warnings about it in the SPC of the drug. Patients are usually advised to visit an ophthalmologist before initiating treatment and at least once a year thereafter.
It is considered a relatively safe drug provided that it's used under medical supervision. You've got to consider the number of patients taking it though - I'm repeating myself now but I feel I have to. If a limited number of patients take any drug - even the drug with the worst side effects - for a good reason then the side effects issues will be limited as well. If everybody takes it, the side effects will probably be more than the complications of COVID-19. That's the reasoning behind the CDC and the rest of the experts' guidance.
The initial dosage is 800mg and it's the same in the Greek protocol for COVID-19. For malaria, the total dose is 2000mg. For COVID-19 the patient will receive 200mg twice a day after day 1.
We are moving into uncharted waters with COVID-19 and it's normal that scientists may change their mind after new data come up. Some treatments may show promise at first and scientists are always thrilled to 'discover' new treatments. What matters most is whether these promising treatments prove their utility or not.
Regards
please read the full answer
Detailed Answer:
Hi,
Your explanation made me understand your doubts.
I don't have detailed data from clinical studies but the arrhythmias warning is definitely in the summary of product characteristics (SPC) of the drug. It is a well-known side effect. Chloroquine may cause prolongation of the QT interval in the ECG which (usually in combination with other drugs like azithromycin) may cause a potentially fatal arrhythmia. It's not a common side effect obviously and it's less prevalent with HCQ compared to chloroquine-phosphate. Besides the QT prolongation, it may cause other - uncommon as well - forms of cardiac toxicity.
The retinopathy is another well-known side effect and you'll find warnings about it in the SPC of the drug. Patients are usually advised to visit an ophthalmologist before initiating treatment and at least once a year thereafter.
It is considered a relatively safe drug provided that it's used under medical supervision. You've got to consider the number of patients taking it though - I'm repeating myself now but I feel I have to. If a limited number of patients take any drug - even the drug with the worst side effects - for a good reason then the side effects issues will be limited as well. If everybody takes it, the side effects will probably be more than the complications of COVID-19. That's the reasoning behind the CDC and the rest of the experts' guidance.
The initial dosage is 800mg and it's the same in the Greek protocol for COVID-19. For malaria, the total dose is 2000mg. For COVID-19 the patient will receive 200mg twice a day after day 1.
We are moving into uncharted waters with COVID-19 and it's normal that scientists may change their mind after new data come up. Some treatments may show promise at first and scientists are always thrilled to 'discover' new treatments. What matters most is whether these promising treatments prove their utility or not.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
please read the full answer
Detailed Answer:
Hi,
Your explanation made me understand your doubts.
I don't have detailed data from clinical studies but the arrhythmias warning is definitely in the summary of product characteristics (SPC) of the drug. It is a well-known side effect. Chloroquine may cause prolongation of the QT interval in the ECG which (usually in combination with other drugs like azithromycin) may cause a potentially fatal arrhythmia. It's not a common side effect obviously and it's less prevalent with HCQ compared to chloroquine-phosphate. Besides the QT prolongation, it may cause other - uncommon as well - forms of cardiac toxicity.
The retinopathy is another well-known side effect and you'll find warnings about it in the SPC of the drug. Patients are usually advised to visit an ophthalmologist before initiating treatment and at least once a year thereafter.
It is considered a relatively safe drug provided that it's used under medical supervision. You've got to consider the number of patients taking it though - I'm repeating myself now but I feel I have to. If a limited number of patients take any drug - even the drug with the worst side effects - for a good reason then the side effects issues will be limited as well. If everybody takes it, the side effects will probably be more than the complications of COVID-19. That's the reasoning behind the CDC and the rest of the experts' guidance.
The initial dosage is 800mg and it's the same in the Greek protocol for COVID-19. For malaria, the total dose is 2000mg. For COVID-19 the patient will receive 200mg twice a day after day 1.
We are moving into uncharted waters with COVID-19 and it's normal that scientists may change their mind after new data come up. Some treatments may show promise at first and scientists are always thrilled to 'discover' new treatments. What matters most is whether these promising treatments prove their utility or not.
Regards
please read the full answer
Detailed Answer:
Hi,
Your explanation made me understand your doubts.
I don't have detailed data from clinical studies but the arrhythmias warning is definitely in the summary of product characteristics (SPC) of the drug. It is a well-known side effect. Chloroquine may cause prolongation of the QT interval in the ECG which (usually in combination with other drugs like azithromycin) may cause a potentially fatal arrhythmia. It's not a common side effect obviously and it's less prevalent with HCQ compared to chloroquine-phosphate. Besides the QT prolongation, it may cause other - uncommon as well - forms of cardiac toxicity.
The retinopathy is another well-known side effect and you'll find warnings about it in the SPC of the drug. Patients are usually advised to visit an ophthalmologist before initiating treatment and at least once a year thereafter.
It is considered a relatively safe drug provided that it's used under medical supervision. You've got to consider the number of patients taking it though - I'm repeating myself now but I feel I have to. If a limited number of patients take any drug - even the drug with the worst side effects - for a good reason then the side effects issues will be limited as well. If everybody takes it, the side effects will probably be more than the complications of COVID-19. That's the reasoning behind the CDC and the rest of the experts' guidance.
The initial dosage is 800mg and it's the same in the Greek protocol for COVID-19. For malaria, the total dose is 2000mg. For COVID-19 the patient will receive 200mg twice a day after day 1.
We are moving into uncharted waters with COVID-19 and it's normal that scientists may change their mind after new data come up. Some treatments may show promise at first and scientists are always thrilled to 'discover' new treatments. What matters most is whether these promising treatments prove their utility or not.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
So if I go any deeper , I feel that this will have to turn political, in so far as risk versus benefit. The trade-off of how many will benefit from the drug, compared to fatalities from side effects, does not seem to sync with the use of other drugs with potentially bad side effects. Warfarin and coumadin for example. How many people die each year from the effects of blood thinners alone, including aspirin, yet they're used all the time. And what about xarelto? And I see that you said it's being used in Greece for the virus? how are patients faring there? Ok , now I would like to know if I should take it for my RA. What are the risks for me? I'm 62, no diabetes or heart issues, no cancers, weight has always been low until recently, !45lbs. 5'3". But it's not without reason, I eat a lot, I love food and have always had a tremendous appetite and never got fat, so I have no discipline. Anyway, in the last few years, my RA has gotten bad, it's getting disfiguring in my hands and I have lost a lot of dexterity due to stiffness, pain and the turning of my fingers. so my main question is , will it bring down any swelling, relieve pain and halt the disfiguration? Does the benefit outweigh the risk? and how long can I stay on it?
So if I go any deeper , I feel that this will have to turn political, in so far as risk versus benefit. The trade-off of how many will benefit from the drug, compared to fatalities from side effects, does not seem to sync with the use of other drugs with potentially bad side effects. Warfarin and coumadin for example. How many people die each year from the effects of blood thinners alone, including aspirin, yet they're used all the time. And what about xarelto? And I see that you said it's being used in Greece for the virus? how are patients faring there? Ok , now I would like to know if I should take it for my RA. What are the risks for me? I'm 62, no diabetes or heart issues, no cancers, weight has always been low until recently, !45lbs. 5'3". But it's not without reason, I eat a lot, I love food and have always had a tremendous appetite and never got fat, so I have no discipline. Anyway, in the last few years, my RA has gotten bad, it's getting disfiguring in my hands and I have lost a lot of dexterity due to stiffness, pain and the turning of my fingers. so my main question is , will it bring down any swelling, relieve pain and halt the disfiguration? Does the benefit outweigh the risk? and how long can I stay on it?
Brief Answer:
it's not political...
Detailed Answer:
It's a public health issue. I wouldn't say it's political. The politicians love to make the public happy. If the people ask for something, the politicians are always happy to provide it. Their reluctance to do so is in itself a good indication that something's wrong with this treatment.
The drugs you've mentioned (warfarin, coumadin, aspirin, xarelto) and the likes are only given to patients that fulfill certain criteria. The bleeding risk and expected benefit are estimated before prescribing such drugs. For example, a patient with atrial fibrillation who "has" to take warfarin or the newer anticoagulants may not be found eligible for either treatment if the bleeding risk outweighs the expected benefit (risk of stroke). I can tell you about drugs with a side effect rate of 50% or more but such medications are given for serious disorders and the expected benefit surely outweighs the risks.
There's always a risk with medical treatments, even with the simplest ones. Doing nothing also carries a risk because you may be deprived of a useful treatment!
Regarding your case with RA, I'm not the right person to decide about your treatment. Your rheumatologist should do so and discuss treatment options with you. HCQ is one of the various options. There are newer drugs as well (perhaps with higher side effects rate than HCQ) but this analysis is better left for your rheumatologist.
Drugs do help with RA and if you're having symptoms you should consider conforming with your doctor's treatment suggestions.
HCQ can be given for as long as it's needed if there's a good reason to do so but only under medical supervision (monitoring liver enzyme levels, checking the eyes at least once a year, etc).
it's not political...
Detailed Answer:
It's a public health issue. I wouldn't say it's political. The politicians love to make the public happy. If the people ask for something, the politicians are always happy to provide it. Their reluctance to do so is in itself a good indication that something's wrong with this treatment.
The drugs you've mentioned (warfarin, coumadin, aspirin, xarelto) and the likes are only given to patients that fulfill certain criteria. The bleeding risk and expected benefit are estimated before prescribing such drugs. For example, a patient with atrial fibrillation who "has" to take warfarin or the newer anticoagulants may not be found eligible for either treatment if the bleeding risk outweighs the expected benefit (risk of stroke). I can tell you about drugs with a side effect rate of 50% or more but such medications are given for serious disorders and the expected benefit surely outweighs the risks.
There's always a risk with medical treatments, even with the simplest ones. Doing nothing also carries a risk because you may be deprived of a useful treatment!
Regarding your case with RA, I'm not the right person to decide about your treatment. Your rheumatologist should do so and discuss treatment options with you. HCQ is one of the various options. There are newer drugs as well (perhaps with higher side effects rate than HCQ) but this analysis is better left for your rheumatologist.
Drugs do help with RA and if you're having symptoms you should consider conforming with your doctor's treatment suggestions.
HCQ can be given for as long as it's needed if there's a good reason to do so but only under medical supervision (monitoring liver enzyme levels, checking the eyes at least once a year, etc).
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
it's not political...
Detailed Answer:
It's a public health issue. I wouldn't say it's political. The politicians love to make the public happy. If the people ask for something, the politicians are always happy to provide it. Their reluctance to do so is in itself a good indication that something's wrong with this treatment.
The drugs you've mentioned (warfarin, coumadin, aspirin, xarelto) and the likes are only given to patients that fulfill certain criteria. The bleeding risk and expected benefit are estimated before prescribing such drugs. For example, a patient with atrial fibrillation who "has" to take warfarin or the newer anticoagulants may not be found eligible for either treatment if the bleeding risk outweighs the expected benefit (risk of stroke). I can tell you about drugs with a side effect rate of 50% or more but such medications are given for serious disorders and the expected benefit surely outweighs the risks.
There's always a risk with medical treatments, even with the simplest ones. Doing nothing also carries a risk because you may be deprived of a useful treatment!
Regarding your case with RA, I'm not the right person to decide about your treatment. Your rheumatologist should do so and discuss treatment options with you. HCQ is one of the various options. There are newer drugs as well (perhaps with higher side effects rate than HCQ) but this analysis is better left for your rheumatologist.
Drugs do help with RA and if you're having symptoms you should consider conforming with your doctor's treatment suggestions.
HCQ can be given for as long as it's needed if there's a good reason to do so but only under medical supervision (monitoring liver enzyme levels, checking the eyes at least once a year, etc).
it's not political...
Detailed Answer:
It's a public health issue. I wouldn't say it's political. The politicians love to make the public happy. If the people ask for something, the politicians are always happy to provide it. Their reluctance to do so is in itself a good indication that something's wrong with this treatment.
The drugs you've mentioned (warfarin, coumadin, aspirin, xarelto) and the likes are only given to patients that fulfill certain criteria. The bleeding risk and expected benefit are estimated before prescribing such drugs. For example, a patient with atrial fibrillation who "has" to take warfarin or the newer anticoagulants may not be found eligible for either treatment if the bleeding risk outweighs the expected benefit (risk of stroke). I can tell you about drugs with a side effect rate of 50% or more but such medications are given for serious disorders and the expected benefit surely outweighs the risks.
There's always a risk with medical treatments, even with the simplest ones. Doing nothing also carries a risk because you may be deprived of a useful treatment!
Regarding your case with RA, I'm not the right person to decide about your treatment. Your rheumatologist should do so and discuss treatment options with you. HCQ is one of the various options. There are newer drugs as well (perhaps with higher side effects rate than HCQ) but this analysis is better left for your rheumatologist.
Drugs do help with RA and if you're having symptoms you should consider conforming with your doctor's treatment suggestions.
HCQ can be given for as long as it's needed if there's a good reason to do so but only under medical supervision (monitoring liver enzyme levels, checking the eyes at least once a year, etc).
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you for the information about HCQ, I just want to know if it relieves pain and reduces swelling in the fingers, which are my main complaints, or is it just to halt the joint disfiguration in my fingers. Because to me, if I'm going to take it, I at least want pain relief and less swelling, not just stopping the progression of the disfiguration. Thanks
Thank you for the information about HCQ, I just want to know if it relieves pain and reduces swelling in the fingers, which are my main complaints, or is it just to halt the joint disfiguration in my fingers. Because to me, if I'm going to take it, I at least want pain relief and less swelling, not just stopping the progression of the disfiguration. Thanks
Brief Answer:
yes
Detailed Answer:
You're welcome!
HCQ may induce remission and help with the symptoms. It's not a painkiller though. It is going to help by reducing RA activity. Permanent (established) disfiguration and the problems associated with it, won't get better. Swelling and pain caused by inflammation may improve.
yes
Detailed Answer:
You're welcome!
HCQ may induce remission and help with the symptoms. It's not a painkiller though. It is going to help by reducing RA activity. Permanent (established) disfiguration and the problems associated with it, won't get better. Swelling and pain caused by inflammation may improve.
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
yes
Detailed Answer:
You're welcome!
HCQ may induce remission and help with the symptoms. It's not a painkiller though. It is going to help by reducing RA activity. Permanent (established) disfiguration and the problems associated with it, won't get better. Swelling and pain caused by inflammation may improve.
yes
Detailed Answer:
You're welcome!
HCQ may induce remission and help with the symptoms. It's not a painkiller though. It is going to help by reducing RA activity. Permanent (established) disfiguration and the problems associated with it, won't get better. Swelling and pain caused by inflammation may improve.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi, I have one more question about HCQ. Of the possible side effects, especially the eye problems and liver problems, are they permanent? Do they go away or does the body revert back to what it was prior to starting the medication if it is stopped? Because if the potential side effects reverse after ceasing treatment , then I am willing to take the risk, especially with the eyes. That one is my main concern. Sight is a gift I treasure and am grateful for, and would not be willing to risk losing it over relief of RA pain and swelling.
Hi, I have one more question about HCQ. Of the possible side effects, especially the eye problems and liver problems, are they permanent? Do they go away or does the body revert back to what it was prior to starting the medication if it is stopped? Because if the potential side effects reverse after ceasing treatment , then I am willing to take the risk, especially with the eyes. That one is my main concern. Sight is a gift I treasure and am grateful for, and would not be willing to risk losing it over relief of RA pain and swelling.
Brief Answer:
some are reversible, some not
Detailed Answer:
Hello,
HCQ may cause various problems in the eyes. The most important one is retinopathy. Retinopathy is not reversible. The good thing is that it's asymptomatic at first and the ophthalmologist can detect it (in time, hopefully, if you visit one once every year). Stopping the drug before it makes too much damage will save your sight.
The liver problems are usually reversible although serious permanent damage cannot be excluded.
If your doctor believes that HCQ is the right treatment for you and you should rely on him/her.
Best Regards!
some are reversible, some not
Detailed Answer:
Hello,
HCQ may cause various problems in the eyes. The most important one is retinopathy. Retinopathy is not reversible. The good thing is that it's asymptomatic at first and the ophthalmologist can detect it (in time, hopefully, if you visit one once every year). Stopping the drug before it makes too much damage will save your sight.
The liver problems are usually reversible although serious permanent damage cannot be excluded.
If your doctor believes that HCQ is the right treatment for you and you should rely on him/her.
Best Regards!
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
some are reversible, some not
Detailed Answer:
Hello,
HCQ may cause various problems in the eyes. The most important one is retinopathy. Retinopathy is not reversible. The good thing is that it's asymptomatic at first and the ophthalmologist can detect it (in time, hopefully, if you visit one once every year). Stopping the drug before it makes too much damage will save your sight.
The liver problems are usually reversible although serious permanent damage cannot be excluded.
If your doctor believes that HCQ is the right treatment for you and you should rely on him/her.
Best Regards!
some are reversible, some not
Detailed Answer:
Hello,
HCQ may cause various problems in the eyes. The most important one is retinopathy. Retinopathy is not reversible. The good thing is that it's asymptomatic at first and the ophthalmologist can detect it (in time, hopefully, if you visit one once every year). Stopping the drug before it makes too much damage will save your sight.
The liver problems are usually reversible although serious permanent damage cannot be excluded.
If your doctor believes that HCQ is the right treatment for you and you should rely on him/her.
Best Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Prasad
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