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What’s in This?: Hydroxychloroquine and Azithromycin

Trump tweeted about these drugs as possible cures for the coronavirus, but his enthusiasm is a bit… premature?

We’re often told that you should never eat anything (or put anything on your body) if you don’t recognize everything on the ingredients list. But since most of us have no idea what xanthan gum or potassium benzoate are — or more importantly, what they’re doing to our bodies — we’re decoding the ingredients in the many things Americans put in (and on, or near) themselves.

This edition: Hydroxychloroquine and azithromycin, a malaria drug and an antibiotic, respectively, that President Trump recently discussed in a press briefing and tweeted about as potential cures for the coronavirus (FOX News spent most of last night carrying this water for him as well).

Before jumping directly into the ingredients, I should note that hydroxychloroquine and azithromycin, both of which are administered in pill form, are generic names for these drugs — hydroxychloroquine is also sold under the brand name Plaquenil, and azithromycin is sold under the brand name Zithromax (and Zithromax Z-Pak). In their name-brand tablet forms, both medications boast a number of commonly used inactive ingredients, like starches and powders that form the bulk of the tablet and help control how the medication is released into your body (many of these inactive ingredients are used across the board in tablet making, so you can take a closer look at some of them here). 

For the purpose of this article, though, the active ingredients — that is, the medications themselves — will be my main focus.

The Ingredients

1) Hydroxychloroquine: Hydroxychloroquine is primarily an antimalarial drug, which means it treats malaria, a disease caused by parasites that invade your red blood cells, by simply killing the parasites. It can also be used to treat lupus erythematosus or rheumatoid arthritis, and while doctors are uncertain about how exactly it does this, they believe that it could be because the drug affects how your immune system works.

As for why Trump has been touting hydroxychloroquine as a potential coronavirus cure, the Centers for Disease Control and Prevention have stated that, in a laboratory environment, hydroxychloroquine and chloroquine (a similar, but more toxic version of hydroxychloroquine, which has also been talked about as a possible coronavirus cure) have shown to be be effective against several forms of the coronavirus.

However, as many, many, many medical professionals have quickly pointed out, the evidence that encouraged all of this is meager at best — there was a small French study of 36 patients, and a reported 100-patient trial from China. Even White House immunologist Anthony Fauci stated, “No,” when asked if hydroxychloroquine could prevent the coronavirus.

Until we see more data about how the drug interacts with the coronavirus, which is currently in progress, Trump’s enthusiasm, as many health officials have warned, seems premature.

Even without the science, these remarks by Trump have had a large impact on Americans, prompting some to start hoarding hydroxychloroquine, presenting a possible shortage for people who actually need it, and encouraging several deaths as a result of people recklessly ingesting chloroquine in an attempt to dodge the coronavirus (on the flip side, there are some people claiming that the drug saved them from the coronavirus). Hydroxychloroquine, I should also note, has some gnarly side effects, including heart failure and suicidal thoughts.

2) Azithromycin: Azithromycin, an antibiotic used to treat many different kinds of infections caused by bacteria, including respiratory infections, might seem less random than hydroxychloroquine for treating the coronavirus, but Trump is still early to the party with this one. 

Again, people are mentioning azithromycin primarily because of that small French study, which showed that patients receiving a combination of hydroxychloroquine and azithromycin experienced a reduction in the amount of virus floating through their blood faster than taking hydroxychloroquine alone, and even faster than taking nothing. But I repeat, this was a small study, not at all randomized and basically ignores any potential side effects that might result from pumping people full of hydroxychloroquine (azithromycin generally has less intense side effects). That said, side effects are, of course, not the biggest concern if someone is literally about to die.

The Takeaway

The biggest takeaway here should be, take medical advice from doctors, not the president (and especially not this president). Nevertheless, these drugs may have some promise — so much so that some coronavirus victims in dire need of help have reportedly been receiving the combination, and some medical centers are recommending these drugs for their serious cases. Moreover, on Sunday, New York Governor Andrew Cuomo said that a more conclusive study of the drugs will start soon, so expect to be hearing more, and keep your fingers crossed. 

But yeah, until we do hear more, assume anything Trump says is bullshit, as per usual.