5 ms·

Honestly this is a perfect example of a time when laws are excessively restrictive. I should have the right to purchase this drug and use it as a last resort in

Honestly this is a perfect example of a time when laws are excessively restrictive. I should have the right to purchase this drug and use it as a last resort in the case that I or my family are infected. It's not fair to responsible people who are capable of researching safety and dosages to have to pay for the ignorance of others. Especially when this drug is OTC in most of the world. You don't need a medical degree to safely administer most drugs - and you should have the right to take that risk, even if that means ignorant people getting hurt or dying.

saagarjha 7y ago
What if the drug causes humans to die two weeks after taking it?
- scarejunba 7y ago
  Then you'll know because I volunteered for it. And I know I won't die because it's already safe enough to fight malaria. But maybe you don't know that. That's fine. I do. Let me arbitrage my knowledge.
  - saagarjha 7y ago
    > Then you'll know because I volunteered for it. Clinical trials are already fast-tracked during epidemics; if you're really interested you may even be selected for one. But going out and randomly buying medicine because it seems like it might work (even though it might not, but you're cured without it, which means you're going to go out and tell everyone else to go buy it too) might not necessarily be the best way to deal with this. > But maybe you don't know that. I am aware of chloroquine's use in malaria treatment.
    - scarejunba 7y ago
      > But going out and randomly buying medicine because it seems like it might work (even though it might not, but you're cured without it, which means you're going to go out and tell everyone else to go buy it too) might not necessarily be the best way to deal with this. Hey, that's okay, let me live or die on my own terms. It's my body. Stop trying to rule it. I'm not making you take it. How about you don't make me not take it.
      - DanBC 7y ago
        > It's my body. ...but your body will take up a hospital bed and a team of healthcare professionals to deal with the side effects, thus taking them away from other patients.
        scarejunba 7y ago
        All right, that's a fair complaint about the externalities. I will sign documentation excluding the need for cover in the shared medical system and commit $150k to disposal of my body should I die. The amount is negotiable to release you from your responsibility to me.
- allovernow 7y ago
  The alternative is drowning in your own body fluids after you're turned away by overwhelmed hospitals. Or watching it happen helplessly to your loved ones after they're turned away for being too old, as is happening in Italy. And in any case Chloroquine is a well studied, proven safe drug with minimal side effects and a high therapeutic ratio. Nanny states breed incompetence.
  - internet_user 7y ago
    Therapeutic index of chloroquine isn't very high, and at the doses it's recommended for corona it's rather close to lethal doses, something like within an order of magnitude. Malaria prophylaxis is dosed -once- a weeek. Half-life 60-70 hours. Covid treatment is -twice daily-.
    - sudosysgen 7y ago
      Actually, no. The therapeutic index of chloroquine in the treatment of covid-19 is relatively high. Some people take chloroquine or hydroxychloroquine at about half the acute dosage used for covid-19 (autoimmune disorders) for literal years. Given the half life as you mentioned, once or twice a week with enough lead time would be a sufficient dosage against covid-19 too. It's just that if you want to reach the concentration of chloroquine that you would have to take it over a long time otherwise, you need very high doses. And since you're already infected and have a ton of the virus, you also need higher concentrations than for prophylaxis.
      - tim333 7y ago
        The Chinese use 1g/day for treatment. A single dose of 3g can be fatal so not a massive margin. That said they've used it on hundreds of patients without adverse effects from the drug and probably a lot of lives saved from its effects on the virus.
      - internet_user 7y ago
        chloroquine is not frequently used for autoimmune. At doses used for corona, it is within 50% of margin, or even lower if you are a slow metabolizer of an LD50 dose. plaquenil on the other hand does have a higher therapeutic index. The other major disadvantage is that these drugs can interact with protease inhibitors.
- true_religion 7y ago
  Chloroquine is available without prescription in many West African counties, and is used liberally anytime a child has a fever. At this point, I would label it as dangerous as aspirin.
  - a_imho 7y ago
    I understand there is probably no connection between the two sentences but to be clear as far as I know Aspirin is dangerous for children.
    - true_religion 7y ago
      Yes considering Ryes Syndromes, aspirin can be even more dangerous as a causal treatment.
  - tim333 7y ago
    It's worse than aspirin.
lultimouomo 7y ago
I'm reasonably sure having hospitals run out of it because it was hoarded by preppers is not a desirable outcome.
- allovernow 7y ago
  That's a patently ridiculous reason to make a drug illegal to own without a prescription. Should we also outlaw non Rx toilet paper? Hospitals have supply chains that are separate from pharmacies and grocery stores. This is a non sequitur. What about masks? Should they be preemptively made Rx only when all this is said and done because people hoarded them? What about the fact that evidence of Chloroquine's likely effectiveness has been around in the form of published studies for at least a month and a half and doctors still are barely testing it? What percentage of doctors do you think keep up with literature?
  - saagarjha 7y ago
    Considering that news of coronavirus is so widespread that you're apparently aware of this, I would think that most doctors are probably aware of this too.
    - allovernow 7y ago
      Medical personnel outside of China were still laughing this off as "just another flu" until mid February at the earliest. Unfortunately all I have is anecdote...but it took far too long for people to take this seriously, because doctors are humans too and aren't necessarily trawling internet forums for happenings.
  - lultimouomo 7y ago
    In emergencies it is pretty standard procedures to ration essential stuff in limited supplies. Food is regularly rationed during war times. It would not be ridiculous at all to limit the use of an OTC drug to hospitals during an emergency, if there is limited supply (don't know if that's the case with chloroquine). BTW cloroquine+antivirals is pretty much the first line drug treatment in Italy, at least according to guidelines: http://www.simit.org/medias/1555-covid19-linee-guida-trattamento-01mar.pdf http://www.simit.org/medias/1555-covid19-linee-guida-trattam... I'm pretty sure that doctors dealing with a pandemic have read enough about the treatment options to know the guidelines. But hey, surely that can't know as much as a random guy on the internet.
tim333 7y ago
Well it's hard getting the balance right but you can order it online from mexico if you want eg. https://www.medicinesmexico.com/?keywords=chloroquine https://www.medicinesmexico.com/?keywords=chloroquine

saagarjha 7y ago

What if the drug causes humans to die two weeks after taking it?

scarejunba 7y ago
Then you'll know because I volunteered for it. And I know I won't die because it's already safe enough to fight malaria. But maybe you don't know that. That's fine. I do. Let me arbitrage my knowledge.
- saagarjha 7y ago
  > Then you'll know because I volunteered for it. Clinical trials are already fast-tracked during epidemics; if you're really interested you may even be selected for one. But going out and randomly buying medicine because it seems like it might work (even though it might not, but you're cured without it, which means you're going to go out and tell everyone else to go buy it too) might not necessarily be the best way to deal with this. > But maybe you don't know that. I am aware of chloroquine's use in malaria treatment.
  - scarejunba 7y ago
    > But going out and randomly buying medicine because it seems like it might work (even though it might not, but you're cured without it, which means you're going to go out and tell everyone else to go buy it too) might not necessarily be the best way to deal with this. Hey, that's okay, let me live or die on my own terms. It's my body. Stop trying to rule it. I'm not making you take it. How about you don't make me not take it.
    - DanBC 7y ago
      > It's my body. ...but your body will take up a hospital bed and a team of healthcare professionals to deal with the side effects, thus taking them away from other patients.
      - scarejunba 7y ago
        All right, that's a fair complaint about the externalities. I will sign documentation excluding the need for cover in the shared medical system and commit $150k to disposal of my body should I die. The amount is negotiable to release you from your responsibility to me.
allovernow 7y ago
The alternative is drowning in your own body fluids after you're turned away by overwhelmed hospitals. Or watching it happen helplessly to your loved ones after they're turned away for being too old, as is happening in Italy. And in any case Chloroquine is a well studied, proven safe drug with minimal side effects and a high therapeutic ratio. Nanny states breed incompetence.
- internet_user 7y ago
  Therapeutic index of chloroquine isn't very high, and at the doses it's recommended for corona it's rather close to lethal doses, something like within an order of magnitude. Malaria prophylaxis is dosed -once- a weeek. Half-life 60-70 hours. Covid treatment is -twice daily-.
  - sudosysgen 7y ago
    Actually, no. The therapeutic index of chloroquine in the treatment of covid-19 is relatively high. Some people take chloroquine or hydroxychloroquine at about half the acute dosage used for covid-19 (autoimmune disorders) for literal years. Given the half life as you mentioned, once or twice a week with enough lead time would be a sufficient dosage against covid-19 too. It's just that if you want to reach the concentration of chloroquine that you would have to take it over a long time otherwise, you need very high doses. And since you're already infected and have a ton of the virus, you also need higher concentrations than for prophylaxis.
    - tim333 7y ago
      The Chinese use 1g/day for treatment. A single dose of 3g can be fatal so not a massive margin. That said they've used it on hundreds of patients without adverse effects from the drug and probably a lot of lives saved from its effects on the virus.
    - internet_user 7y ago
      chloroquine is not frequently used for autoimmune. At doses used for corona, it is within 50% of margin, or even lower if you are a slow metabolizer of an LD50 dose. plaquenil on the other hand does have a higher therapeutic index. The other major disadvantage is that these drugs can interact with protease inhibitors.
true_religion 7y ago
Chloroquine is available without prescription in many West African counties, and is used liberally anytime a child has a fever. At this point, I would label it as dangerous as aspirin.
- a_imho 7y ago
  I understand there is probably no connection between the two sentences but to be clear as far as I know Aspirin is dangerous for children.
  - true_religion 7y ago
    Yes considering Ryes Syndromes, aspirin can be even more dangerous as a causal treatment.
- tim333 7y ago
  It's worse than aspirin.

lultimouomo 7y ago

I'm reasonably sure having hospitals run out of it because it was hoarded by preppers is not a desirable outcome.

allovernow 7y ago
That's a patently ridiculous reason to make a drug illegal to own without a prescription. Should we also outlaw non Rx toilet paper? Hospitals have supply chains that are separate from pharmacies and grocery stores. This is a non sequitur. What about masks? Should they be preemptively made Rx only when all this is said and done because people hoarded them? What about the fact that evidence of Chloroquine's likely effectiveness has been around in the form of published studies for at least a month and a half and doctors still are barely testing it? What percentage of doctors do you think keep up with literature?
- saagarjha 7y ago
  Considering that news of coronavirus is so widespread that you're apparently aware of this, I would think that most doctors are probably aware of this too.
  - allovernow 7y ago
    Medical personnel outside of China were still laughing this off as "just another flu" until mid February at the earliest. Unfortunately all I have is anecdote...but it took far too long for people to take this seriously, because doctors are humans too and aren't necessarily trawling internet forums for happenings.
- lultimouomo 7y ago
  In emergencies it is pretty standard procedures to ration essential stuff in limited supplies. Food is regularly rationed during war times. It would not be ridiculous at all to limit the use of an OTC drug to hospitals during an emergency, if there is limited supply (don't know if that's the case with chloroquine). BTW cloroquine+antivirals is pretty much the first line drug treatment in Italy, at least according to guidelines: http://www.simit.org/medias/1555-covid19-linee-guida-trattamento-01mar.pdf http://www.simit.org/medias/1555-covid19-linee-guida-trattam... I'm pretty sure that doctors dealing with a pandemic have read enough about the treatment options to know the guidelines. But hey, surely that can't know as much as a random guy on the internet.

tim333 7y ago

Well it's hard getting the balance right but you can order it online from mexico if you want eg. https://www.medicinesmexico.com/?keywords=chloroquine https://www.medicinesmexico.com/?keywords=chloroquine