Recommendation for empiric use of hydroxy-chloroquine for prophylaxis of SARS-CoV-2 infection
Background:
Hydroxy-chloroquine is found to be effective against coronavirus in laboratory studies and in-vivo studies. Its use in prophylaxis is derived from available evidence of benefit as treatment and supported by pre-clinical data. The following recommendation for the use of hydroxy-chloroquine as a prophylactic agent against SARS-CoV-2 infection is based on these considerations, as well as risk-benefit consideration, under exceptional circumstances that call for the protection of high-risk individuals.
The National Taskforce for COVID-19 recommends the use of hydroxy-chloroquine for prophylaxis of SARS-CoV-2 infection for selected individuals as follows:
Eligible individuals:
- Asymptomatic healthcare workers involved in the care of suspected or confirmed cases of COVID-19
- Asymptomatic household contacts of laboratory confirmed cases Dose:
- Asymptomatic healthcare workers involved in the care of suspected or confirmed cases of COVID-19: 400 mg twice a day on Day 1, followed by 400 mg once weekly for next 7 weeks; to be taken with meals
- Asymptomatic household contacts of laboratory confirmed cases: 400 mg twice a day on Day 1, followed by 400 mg once weekly for next 3 weeks; to be taken with meals
Exclusion/contraindications:
- The drug is not recommended for prophylaxis in children under 15 years of age.
- The drug is contraindicated in persons with known case of retinopathy, known hypersensitivity to
hydroxychloroquine, 4-aminoquinoline compounds Key considerations:
- The drug has to be given only on the prescription of a registered medical practitioner.
- Advised to consult with a physician for any adverse event or potential drug interaction before
initiation of medication
- The prophylactic use of hydroxychloroquine to be coupled with the pharmacovigilance for
adverse drug reactions through self-reporting using the Pharmacovigilance Program of India
(PvPI) helpline/app.
- If anyone becomes symptomatic while on prophylaxis he/she should immediately contact the
health facility, get tested as per national guidelines and follow the standard treatment protocol.
- All asymptomatic contacts of laboratory confirmed cases should remain in home quarantine as
per the national guidelines, even if they are on prophylactic therapy.
- Simultaneously, proof of concept and pharmacokinetics studies be taken up expeditiously. Findings from these studies and other new evidence will guide any change in the
recommendation.
Note - It is reiterated that the intake of above medicine should not in still sense of false secuirity. The hydroxy-chloroquine may not be replaced by any other compound.