A jump in prescriptions being issued for drugs touted as possible treatments for COVID-19 has prompted two Missouri health agencies to issue guidelines concerning their use.
In a joint statement, the Missouri Board of Pharmacy and the Missouri State Board of Registration for the Healing Arts said concerns had been raised that “this activity may lead to stockpiling of medication, inappropriate use and potential drug shortages for patients with a legitimate need.”
The drugs in question are hydroxychloroquine, chloroquine and azithromycin. Hydroxychloroquine and chloroquine are commonly used to treat malaria, rheumatoid arthritis and other conditions. Azithromycin is an antibiotic commonly used to treat skin infections, ear and eye infections, and sexually transmitted diseases.
At a news conference last week, President Trump falsely stated the Food and Drug Administration had just approved the use of chloroquine to treat patients infected with the coronavirus. Although China, where the novel coronavirus first emerged in December, initially recommended chloroquine to treat infected patients, it backtracked days later and cautioned doctors and health officials about its potentially lethal side effects, according to Bloomberg News.
An Arizona man died on Monday and his wife was in critical condition after both ingested chloroquine phosphate, an additive used to clean fish tanks, in an apparent effort to ward off COVID-19, the disease caused by the coronavirus. The woman said the couple had seen Trump touting it on television as a possible treatment.
The New York Times reported on Tuesday that doctors have been stockpiling drugs touted as a possible treatment for the coronavirus, which has prompted the pharmacy boards of seven states to issue emergency guidelines on how the drugs should be dispensed at pharmacies.
In its joint statement, the Missouri boards instructed health providers that prescribing the drugs for COVID-19 was discouraged and that doing so for family, friends and co-workers could significantly affect drug supplies and “may lead to improper use.”
“Prescribers should consider limiting the amount prescribed, unless otherwise deemed medically appropriate by the prescriber. [e.g., 14-day supply, etc.],” the statement said.
While the pharmacy board is not recommending that pharmacists refuse to fill prescriptions for the drugs, it’s urging them to use their professional judgment “and take appropriate steps to verify that newly issued prescriptions for hydroxychloroquine, chloroquine and azithromycin are issued for a legitimate medical purpose.”
Some states have adopted a 14-day limit. While Missouri has not done so, it instructed pharmacists to limit the dispensation of the drugs during the COVID-19 state of emergency “without a supporting diagnosis.”
“While both Boards are recommending caution, licensees should avoid interruptions in care for patients previously established on these medications with an appropriate medical diagnosis,” the statement read. “The Boards recognize this may be a difficult balance, however, licensees should make a good faith effort to ensure appropriate prescribing, dispensing and patient care.”
Members of neither board could be reached for comment Tuesday afternoon.
Meanwhile, the Kansas Board of Pharmacy is encouraging “vigilance” and “caution” in dispensing chloroquine and hydroxychloroquine.
“The FDA has not approved use of chloroquine and hydroxychloroquine for COVID19 prophylaxis,” it said. “If used, medications should be restricted to patients who are admitted to hospitals with COVID-19 infections and individual patient care should be discussed with an infectious diseases provider at the healthcare facility.”
KCUR reporter Sam Zeff contributed to this story.
Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.