3 ms·

I wasn't able to find a reliable source on short notice, but the ones I found indicate a therapeutic index of around 4-8 for chloroquine. The therapeutic index

I wasn't able to find a reliable source on short notice, but the ones I found indicate a therapeutic index of around 4-8 for chloroquine. The therapeutic index is the ratio between the dose that is effective and the lethal dose. So in this case if you take 4-8 times the dose that actually works you're in the range where it could kill you. I'd be really interested in more robust sources on this. But from the bits I've seen so far, this drug doesn't have as much distance between the effective dose and the lethal dose as you'd like for something that people are likely to self-administer now.

robocat 7y ago
The therapeutic index for paracetamol (acetaminophen) is ~10 (or less for people with damaged liver etc) Be careful with all medicines or drugs - taking more can easily lead to worse outcomes. Edit: “In a review article on paracetamol toxicity among children, the therapeutic index was 1.7” [Heubi JE, Bien JP. Acetaminophen use in children: more is not better. J Pediatr 1997]
- fabian2k 7y ago
  Paracetamol is probably the most dangerous over the counter medicine available, and might not be approved in this way if it were in the process now. This is really the exception, it's the poster child for dangerous, but still widely available medication.
  - dmix 7y ago
    Fortunately unlike Tylneol, Hydroxychloroquine requires a prescription in the US. In an effort to limit shortages multiple states are already making the criteria for prescription even more limited (anyone who prescribed it for COVID-19 was already making an off-label prescription): https://www.reuters.com/article/us-health-coronavirus-usa-pharmacies/states-work-to-limit-prescriptions-of-potential-coronavirus-drugs-idUSKBN2190XC https://www.reuters.com/article/us-health-coronavirus-usa-ph... Also of note, the couple took `chloroquine phosphate` not `hydroxychloroquine` which was what the government just fast-tracked and is apparently a 3x more effective treatment than the former. According to Wikipedia, HCQ is used for people sensitive to Chloroquine-phospate: > Specifically it is used for chloroquine-sensitive malaria https://en.wikipedia.org/wiki/Hydroxychloroquine https://en.wikipedia.org/wiki/Hydroxychloroquine We don't yet know if the person in the article was prescribed it or even had any symptoms/prior medical history.
    - robocat 7y ago
      > HCQ is used for people sensitive to Chloroquine-phospate: > Specifically it is used for chloroquine-sensitive malaria HCQ is used for Malaria that is chloroquine sensitive, not people. Well that’s how I read it. Looks like it was patented in 2005, which might also help explain why it became more common? But I”m totally guessing that: https://en.wikipedia.org/wiki/4-Aminoquinoline https://en.wikipedia.org/wiki/4-Aminoquinoline
      - dmix 7y ago
        > Malaria that is chloroquine sensitive, not people Yep there's some chloroquine phosphate resistant malaria (Plasmodium) that hydroxychloroquine still works for. It also works for the other non-resistant ones making it a good first option, more here: https://www.drugs.com/monograph/hydroxychloroquine-sulfate.html https://www.drugs.com/monograph/hydroxychloroquine-sulfate.h... There's no current patent on either drugs. But as I said, data was showing HCQ was 3x more effective, which was why the new studies are focusing on that...
deleted 7y ago
[deleted]
stordoff 7y ago
For hydroxychloroquine, Wikipedia has the following summary, with citation (and figures confirmed in the abstract): > The therapeutic, toxic and lethal ranges are usually considered to be 0.03 to 15 mg/l, 3.0 to 26 mg/l and 20 to 104 mg/l, respectively. However, nontoxic cases have been reported up to 39 mg/l, suggesting individual tolerance to this agent may be more variable than previously recognised. For chloroquine, it just says it is "known to be small" (with citation, though I can't see the full PDF to see what "small" means).
tyingq 7y ago
The man and his wife took it in the form of aquarium cleaner. I imagine it's quite hard to translate that form into an actual dose. See http://bannerhealth.mediaroom.com/chloroquinephosphate http://bannerhealth.mediaroom.com/chloroquinephosphate
tim333 7y ago
The lethal dose is about 3-5g in an adult. The amount used for treatment varies. The highest was the Chinese taking 2x500mg per day for coronavirus. They reported no adverse effects but it seems a little close. Others I think have used 500mg once per day. This link has some info http://www.maripoisoncenter.com/wp-content/uploads/2015/03/CTR-Chloroquine.pdf http://www.maripoisoncenter.com/wp-content/uploads/2015/03/C... Says 20mg/kg toxic, 40mg/kg usually fatal without invervention.

robocat 7y ago

The therapeutic index for paracetamol (acetaminophen) is ~10 (or less for people with damaged liver etc) Be careful with all medicines or drugs - taking more can easily lead to worse outcomes. Edit: “In a review article on paracetamol toxicity among children, the therapeutic index was 1.7” [Heubi JE, Bien JP. Acetaminophen use in children: more is not better. J Pediatr 1997]

fabian2k 7y ago
Paracetamol is probably the most dangerous over the counter medicine available, and might not be approved in this way if it were in the process now. This is really the exception, it's the poster child for dangerous, but still widely available medication.
- dmix 7y ago
  Fortunately unlike Tylneol, Hydroxychloroquine requires a prescription in the US. In an effort to limit shortages multiple states are already making the criteria for prescription even more limited (anyone who prescribed it for COVID-19 was already making an off-label prescription): https://www.reuters.com/article/us-health-coronavirus-usa-pharmacies/states-work-to-limit-prescriptions-of-potential-coronavirus-drugs-idUSKBN2190XC https://www.reuters.com/article/us-health-coronavirus-usa-ph... Also of note, the couple took `chloroquine phosphate` not `hydroxychloroquine` which was what the government just fast-tracked and is apparently a 3x more effective treatment than the former. According to Wikipedia, HCQ is used for people sensitive to Chloroquine-phospate: > Specifically it is used for chloroquine-sensitive malaria https://en.wikipedia.org/wiki/Hydroxychloroquine https://en.wikipedia.org/wiki/Hydroxychloroquine We don't yet know if the person in the article was prescribed it or even had any symptoms/prior medical history.
  - robocat 7y ago
    > HCQ is used for people sensitive to Chloroquine-phospate: > Specifically it is used for chloroquine-sensitive malaria HCQ is used for Malaria that is chloroquine sensitive, not people. Well that’s how I read it. Looks like it was patented in 2005, which might also help explain why it became more common? But I”m totally guessing that: https://en.wikipedia.org/wiki/4-Aminoquinoline https://en.wikipedia.org/wiki/4-Aminoquinoline
    - dmix 7y ago
      > Malaria that is chloroquine sensitive, not people Yep there's some chloroquine phosphate resistant malaria (Plasmodium) that hydroxychloroquine still works for. It also works for the other non-resistant ones making it a good first option, more here: https://www.drugs.com/monograph/hydroxychloroquine-sulfate.html https://www.drugs.com/monograph/hydroxychloroquine-sulfate.h... There's no current patent on either drugs. But as I said, data was showing HCQ was 3x more effective, which was why the new studies are focusing on that...

deleted 7y ago

[deleted]

stordoff 7y ago

For hydroxychloroquine, Wikipedia has the following summary, with citation (and figures confirmed in the abstract): > The therapeutic, toxic and lethal ranges are usually considered to be 0.03 to 15 mg/l, 3.0 to 26 mg/l and 20 to 104 mg/l, respectively. However, nontoxic cases have been reported up to 39 mg/l, suggesting individual tolerance to this agent may be more variable than previously recognised. For chloroquine, it just says it is "known to be small" (with citation, though I can't see the full PDF to see what "small" means).

tyingq 7y ago

The man and his wife took it in the form of aquarium cleaner. I imagine it's quite hard to translate that form into an actual dose. See http://bannerhealth.mediaroom.com/chloroquinephosphate http://bannerhealth.mediaroom.com/chloroquinephosphate

tim333 7y ago

The lethal dose is about 3-5g in an adult. The amount used for treatment varies. The highest was the Chinese taking 2x500mg per day for coronavirus. They reported no adverse effects but it seems a little close. Others I think have used 500mg once per day. This link has some info http://www.maripoisoncenter.com/wp-content/uploads/2015/03/CTR-Chloroquine.pdf http://www.maripoisoncenter.com/wp-content/uploads/2015/03/C... Says 20mg/kg toxic, 40mg/kg usually fatal without invervention.