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Food and Drug Administration allowed an Indian company previously restricted from importing drug products into the US to now start manufacturing one of the drugs. And U. But in those few days, a few people who began self medicating with the drugs in an effort to prevent COVID have died, and others have been hospitalized. These tragedies have raised questions about the safety of the drug combo, and how valid they are as a possible solution to treating COVID The combination Trump mentioned includes two drugs: azithromycin and hydroxychloroquine.

Azithromycin is an antibiotic, usually prescribed for a range of bacterial infections, including bacterial pneumonia. Hydroxychloroquine is a slightly different version of chloroquine, a drug discovered to fight malaria during a massive war-time drug discovery effort in the s.

Since then, resistance to chloroquine has made it unusable in many parts of the world, so scientists developed hydroxychloroquine as its next generation replacement, and designed it with slightly fewer side effects. In another study of about patients in China , doctors also reported some success in using the drug duo to reduce the viral load in patients.

The studies from China and France were not randomized clinical trials—the gold standard in medical research, in which people with similar characteristics are randomly assigned to receive the drug or a placebo. Public anxiety also contributed to a run on the drugs in pharmacies, and pharmacists turned to social media to beg patients not to stock up on the medications, and doctors not to inappropriately prescribe them because people with rheumatoid arthritis and lupus need them.

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While health officials are not condoning that people with mild symptoms start self-medicating with hydroxychloroquine, doctors are starting to use it on their sickest patients in the hospital. Off label use means drugs, like hydroxychloroquine, that are already approved for one use can be prescribed for another use, as long as the doctor is comfortable with the unknown risks and side effects.

David Boulware, a University of Minnesota professor of medicine. Especially as hospitals start getting concerned about dwindling supplies of equipment such as ventilators, anything that can prevent patients declining from mild to severe disease is worth a try. If the drug can prevent severe disease, then that may spare the hospital and the health care system from the most expensive and invasive types of care such as days spent in the ICU with expensive mechanical breathing support.

There have been lab studies of hydroxychloroquine suggesting that in people, cells in the respiratory tract, for example, engulf coronaviruses within a tiny pouch.

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The virus needs to puncture this pouch in order to release its genetic material into the cell and turn it into a viral copying machine to pump out more virus. Hydroxychloroquine is an alkaline compound, so it raises the pH levels of the host environment, preventing the virus from releasing its genes for copying. In lab studies done over the last few years, when researchers infected human cells with different viruses and then bathed them in hydroxychloroquine, they could generally stop viruses like influenza, SARS-CoV-2, and the original SARS virus another type of coronavirus from infecting the cells.

In fact, hydroxychloroquine turned out not to be as successful in stopping infection in animals and people. More rigorous studies will hopefully shed additional light on if, and when, hydroxychloroquine could treat COVID, as well as provide important information about what side effects it may cause. Boulware, for example, is leading a study to test first, whether hydroxychloroquine can be used to prevent healthy people from getting infected if they are exposed, and second, whether it can treat people who are already infected, but early in their disease, from getting worse and needing to be hospitalized.

She's ensured that patients who otherwise need the drugs have access as well.

She also said that local pharmacies are prepared to sell to hospitals should the therapy prove effective following the New York trials. Like Butterfield, Abbott is refusing to fill orders except from doctors for patients with a positive test.

Already, he said, he's provided a modest supply at cost for a major Pensacola area hospital in neighboring Escambia County. In states with no guidelines, we are limiting the dispensing for COVID treatment to a day supply with no refills. Some states are beginning to clamp down. Texas, Idaho and Nevada have taken similar steps. Contact him at , or asassoon floridatoday.