key: cord-0832400-hhj109x5
authors: Carbillon, Lionel; Benbara, Amelie; Boujenah, Jeremy
title: Hydroxychloroquine at usual doses as an option for Covid-19 treatment
date: 2020-08-21
journal: Am J Obstet Gynecol
DOI: 10.1016/j.ajog.2020.08.043
sha: 980c097232d24582c47dd9ac93952fefed6207e4
doc_id: 832400
cord_uid: hhj109x5

nan

Considering the promising chloroquine treatment, the authors focus on side effects of high doses, 21 mainly based on the report of higher volumes of distribution of chloroquine during pregnancy in a small 22 series of women (2). However, their deduction of an assumed need for higher doses against 23

Coronavirus-Disease-19 ("at least 500 mg twice daily") raises the question of the rationale for such 24 doses. 25

In actuality, the authors of this pharmacokinetic study (2) only hypothesized that reduced 26 concentrations of chloroquine in pregnancy "could compromise its curative antimalarial efficacy". 27

Besides, the 90%-effective inhibitor concentration of chloroquine against SARS-CoV-2 in Vero E6 cells is 28 low (3), and easily achievable in vivo. Another pharmacokinetic study confirms that clearance and total 29 drug exposure of the widely used variant hydroxychloroquine does not change during pregnancy (4), 30 which does not support using higher doses during pregnancy (4, 5). 31 32 33

COVID-19) Pandemic and Pregnancy

Pharmacokinetics of 36 chloroquine and monodesethylchloroquine in pregnancy

Remdesivir and chloroquine effectively inhibit 39 the recently emerged novel coronavirus (2019-nCoV) in vitro

42 Pharmacokinetics of Hydroxychloroquine in Pregnancies with Rheumatic Diseases

Hydroxychloroquine and 45 azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial