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Comment by saagarjha | Hacker News Reader

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

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.

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.

Yes considering Ryes Syndromes, aspirin can be even more dangerous as a causal treatment.

It's worse than aspirin.

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.

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-.

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.

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.

> The other major disadvantage is that these drugs can interact with protease inhibitors

What are the possible consequences of this?

Death.

Kaletra, a protease inhibitor, is a combination of two drugs, one of which is a CYP3A4 inhibitor. It is used with some success on coronavirus patients.

Co-administering this with chloroquine 500mg/BID could easily result in chloroquine concentrations well above LD50.

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.

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.

> 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.

> 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.

> 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.

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.

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