# Unfortunately, I think the media is setting up Trump for a big win on Hydroxychloroquine.

**URL:** <https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190>\
**Category:** Politics & Elections\
**Created:** [April 6, 2020, 3:21pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190 "2020-04-06T15:21:16Z")\
**Posts on this page:** 20\
**Page:** 9

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**Author:** ![tafinucane](https://avatars.discourse-cdn.com/v4/letter/t/f19dbf/32.png) [@tafinucane](https://boards.straightdope.com/u/tafinucane)\
**Post date:** [April 9, 2020, 5:04pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/161 "2020-04-09T17:04:21Z")

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> [@Ann\_Hedonia](#):
>
> Not the “I was at death’s doorstep and I took this pill and 2 or 6 or 8 hours later I recovered almost completely” anecdotes. That is an extraordinary claim for an anti-viral and it requires a high level of proof.

> **[Why Does the President Keep Pushing a Malaria Drug?](https://www.theatlantic.com/health/archive/2020/04/hydroxychloroquine-trump/609547/?utm_source=pocket-newtab)**
>
> What is actually known about hydroxychloroquine, the medication that Trump is fixated on recommending for COVID-19

The original French “study” doesn’t even rise to the level of anecdotal.

6 patients had no detectable virus after 6 days. 3 were intubated in ICU due to respiratory complications of the infection, 1 died, and 1 quit the pills due to adverse reaction to the drugs. Fox only reported on the healed patients.

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**Author:** ![MattDHat](https://avatars.discourse-cdn.com/v4/letter/m/c89c15/32.png) [@MattDHat](https://boards.straightdope.com/u/MattDHat)\
**Post date:** [April 10, 2020, 9:00pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/162 "2020-04-10T21:00:03Z")

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OK, I am not a Dr. Dr.- just a pharmacist with a Ph.D. in a dept. of pharmacy practice for the past 27 years, so maybe Dr. Oz outguns me. But even though I’m a cripple and 63, I’m fairly sure I can still kick his ass…So I can live with it.🆒

One thing to remember- the FDA is an agency of the executive branch; in other words, the President sets their budget and appoints their people. They are political, because they have to be.  
As to Hydroxychloroquine Sulfate;  
Off-Label Uses: Coronavirus disease 2019 (COVID-19); Level of Evidence [C]  
Level of Evidence Definitions: Level of Evidence Scale (A, B, C & G)  
C=“Evidence from observational studies (eg, retrospective case series/reports providing significant impact on patient care), unsystematic clinical experience, or from potentially flawed randomized, controlled trials (eg, when limited options exist for condition). Any estimate of effect is uncertain.”  
Or, to paraphrase a post, We don’t know.

What we do know is that this isn’t an over the counter (OTC) medication. As I tell my students , drugs are prescription-only for a very simple reason- they can, somehow or someway, kill you. NO drug therapy is risk free- it is always a cost|benefit assessment.

We don’t have diddly, in my humble opinion, of reliable evidence for this molecule as an antiviral. The size of the studies makes them VERY susceptible to all sorts of bias. Most drugs being tested for being allowed on the market are evaluated in 1-5,000 people, depending on animal toxicity studies. So there’s rather wobbly evidence for this molecule doing anything (I’m skipping null hypothesis, Type I & II errors, Statistical significance and statistical _power_ out of kindness).  
But, I know- we don’t KNOW.

Yep, but what we DO know is the drug is not harmless. If you give it to a large enough number of people, some of those people ARE going to die, as a direct result of the drug.  
Retinopathy incidence is 10-40% depending on length of therapy, (years) but renal impairment and being thin (you know, things common in the old) increase odds for early occurrence; going blind isn’t dead, but it’s not fun, either.

Severe hypoglycemia- including life-threatening loss of consciousness, Cardiomyopathy resulting in cardiac failure, sometimes fatal, Suicidal behavior/psychosis, Bone marrow suppression (u stop making blood cells), acute hepatic failure, and renal impairment were all identified in clinical trials- these are labeled “frequency not defined” but ,again, clinical trials are usually 1,000-5,000 people, depending on toxicity seen in animal studies. The rule of thumb is, the inverse of the incidence = the number of people needed to detect an effect. So incidence range is 1/10th of a % to 2/100th of a % detected during clinical trials; post-marketing findings: (meaning, only seen when large # of people were taking it, so lower incidence than range above) Renal insufficiency, extrapyramidal reaction, Neutropenia, pancytopenia, Cardiomyopathy, prolonged QT interval, torsades de pointes, and ventricular arrhythmia.  
Those #'s aren’t great- a drug like this wouldn’t be OK’ed for morning sickness- but malaria kills- again- cost|benefit analysis.

So we don’t KNOW if this molecule could help with COVID-19, but we DO KNOW, that is if we give it to a million people, 200 (on the low end) will suffer acute hepatic failure- and that’s just one of the ADRs.

Hydroxychloroquine is a good drug, used carefully, in the right patients, by clinicians familiar with its use, for disease states with high “costs”. But it’s not candy, and advocating population-wide administration of this agent in the absence of an over-whelming preponderance of evidence for significant therapeutic benefit is simply not justifiable.  
In fact, I’ll be happy to play expert witness in a court of law again, and state that, in my considered opinion, it is more than “not justifiable” - it is criminally actionable. And I’M a stupid conservative!

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**Author:** ![dropzone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dropzone/32/7515_2.png) [@dropzone](https://boards.straightdope.com/u/dropzone)\
**Post date:** [April 11, 2020, 12:16am UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/163 "2020-04-11T00:16:39Z")

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Well, not THAT stupid. 😉

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**Author:** ![MikeF](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@MikeF](https://boards.straightdope.com/u/MikeF)\
**Post date:** [April 11, 2020, 12:56pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/164 "2020-04-11T12:56:18Z")

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That exchange on Fox should be played after every rally, I mean press briefing, where Trump touts the drug.

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**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\
**Post date:** [April 11, 2020, 1:19pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/165 "2020-04-11T13:19:12Z")

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> [@MattDHat](#):
>
> OK, I am not a Dr. Dr.- just a pharmacist with a Ph.D. in a dept. of pharmacy practice for the past 27 years, so maybe Dr. Oz outguns me. But even though I’m a cripple and 63, I’m fairly sure I can still kick his ass…So I can live with it…  
> snip  
> …And I’M a stupid conservative!

This was a very thorough, informative, and entertaining ass-kicking. Thank you for that. You’re not a stupid conservative, you’re one of the good ones.

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**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\
**Post date:** [April 13, 2020, 10:16pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/166 "2020-04-13T22:16:49Z")

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Some studies for (hydroxy)chloroquine have shown increased risks of QT prolongation and ventricular arrhythmia. These can be potentially dangerous side effects. A small study in Brazil was stopped yesterday because of them. But this is hardly a surprise effect, and I presume other studies are still continuing.

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**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\
**Post date:** [April 16, 2020, 12:54am UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/167 "2020-04-16T00:54:19Z")

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One of the studies being made, just came with negative results: French study finds hydroxychloroquine doesn’t help patients with coronavirus.

> **[News](https://www.fox10tv.com/news/)**
>
> FOX10 News Mobile Alabama, your trusted source for news covering the Alabama, Pensacola Florida and Mississippi Gulf Coast

> [@](#):
>
> (CNN) – A drug that’s been touted by President Donald Trump as a “game changer” didn’t help hospitalized patients with coronavirus and was associated with heart complications, according to a new study.
> 
> “This provides evidence that hydroxychloroquine does not apparently treat patients with Covid 19,” said Dr. Paul Offit, an infectious disease specialist at Children’s Hospital of Philadelphia. “Even worse, there were side effects caused by the drug – heart toxicities that required it be discontinued.”

> [@](#):
>
> “I think it’s going to be great,” Trump said at a White House briefing on March 19.
> 
> “What do you have to lose? Take it,” he said on April 4.

How about the lives of many? You Agent Orange! :mad:

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**Author:** ![Mr.Duality](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mr.duality/32/4098_2.png) [@Mr.Duality](https://boards.straightdope.com/u/Mr.Duality)\
**Post date:** [April 16, 2020, 11:56am UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/168 "2020-04-16T11:56:22Z")

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Didn’t read the whole thread. Just want to relate my experience with Chloroquine. Took it for a while 29 years ago as an antimalarial precaution. It seriously interfered with sleep. What sleep I got was punctuated by strange and twisted dreams. Have talked with other people who had similar experience. Would NOT recommend.

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**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\
**Post date:** [April 16, 2020, 1:11pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/169 "2020-04-16T13:11:58Z")

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> [@Mr.Duality](#):
>
> Didn’t read the whole thread. Just want to relate my experience with Chloroquine. Took it for a while 29 years ago as an antimalarial precaution. It seriously interfered with sleep. What sleep I got was punctuated by strange and twisted dreams. Have talked with other people who had similar experience. Would NOT recommend.

It’s also only 60-70% effective as an antimalarial IIRC, and those are apparently not the only side effects: comes with a side order of nausea and other symptoms too from what I remember.

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**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\
**Post date:** [April 16, 2020, 2:06pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/170 "2020-04-16T14:06:12Z")

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> [@Mr.Duality](#):
>
> Didn’t read the whole thread. Just want to relate my experience with Chloroquine. Took it for a while 29 years ago as an antimalarial precaution. It seriously interfered with sleep. What sleep I got was punctuated by strange and twisted dreams. Have talked with other people who had similar experience. Would NOT recommend.

I used to take mefloquine and had very similar experiences. Seems like those quinine compounds do some crazy shit to your brain.

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**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\
**Post date:** [April 21, 2020, 6:21pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/171 "2020-04-21T18:21:39Z")

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[More deaths, no benefit from malaria drug in VA virus study](https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2)

> [@](#):
>
> Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.
> 
> About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.

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**Author:** ![orcenio](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/orcenio/32/1036_2.png) [@orcenio](https://boards.straightdope.com/u/orcenio)\
**Post date:** [April 21, 2020, 6:55pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/172 "2020-04-21T18:55:16Z")

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Trump has toned down trumpeting it as a silver bullet for the past few days, so I was expecting that the trials were not going good. It’s too bad, but highlights how foolishly irresponsible Trump is for his daily misinformation and lying. Why can’t he just shut up and let the professionals deal with this mess?

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**Author:** ![RioRico](https://avatars.discourse-cdn.com/v4/letter/r/f04885/32.png) [@RioRico](https://boards.straightdope.com/u/RioRico)\
**Post date:** [April 22, 2020, 9:01am UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/173 "2020-04-22T09:01:19Z")

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> [@orcenio](#):
>
> Why can’t he just shut up and let the professionals deal with this mess?

His insightful intestines direct him otherwise. And because solipsism, nothing exists outside himself. Nobody else knows anything. He’s lost if not in total control.

Who has lately seen the nation’s top medical officer, the Surgeon General?

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**Author:** ![bobot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bobot/32/21622_2.png) [@bobot](https://boards.straightdope.com/u/bobot)\
**Post date:** [April 24, 2020, 9:25pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/174 "2020-04-24T21:25:44Z")

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“Citing a “primary outcome” of death, researchers cut short a study testing anti-malaria drug chloroquine as a potential treatment for COVID-19 after some patients developed irregular heart rates and nearly two dozen of them died after taking doses of the drug daily.”

> **[Citing a high risk of death, researchers cut chloroquine coronavirus study...](https://www.nbcchicago.com/news/national-international/fda-warns-against-using-hydroxychloroquine-for-coronavirus-outside-of-hospitals/2261289/)**
>
> Scientists say the findings should "serve to curb the exuberant use" of the drug, which has been touted by President Trump as a potential "game changer" in the fight against the coronavirus.

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**Author:** ![CairoCarol](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cairocarol/32/3825_2.png) [@CairoCarol](https://boards.straightdope.com/u/CairoCarol)\
**Post date:** [April 24, 2020, 9:56pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/175 "2020-04-24T21:56:51Z")

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> [@Mr.Duality](#):
>
> Didn’t read the whole thread. Just want to relate my experience with Chloroquine. Took it for a while 29 years ago as an antimalarial precaution. It seriously interfered with sleep. What sleep I got was punctuated by strange and twisted dreams. Have talked with other people who had similar experience. Would NOT recommend.

Are you sure that wasn’t mefloquine? As someone who has lived and traveled in malarial regions a great deal, I’ve been prescribed both, and I’ve never heard of chloroquine messing up your mind.

On the other hand, Mefloquine (brand name Larium) is really bad, psychologically speaking. I know, I came close to having a psychotic break on the stuff while the medical world was still in denial that it had any side effects (they’ve since recanted and even identified the mechanisms by which the side effects occur).

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**Author:** ![susan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/susan/32/17537_2.png) [@susan](https://boards.straightdope.com/u/susan)\
**Post date:** [April 24, 2020, 10:23pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/176 "2020-04-24T22:23:03Z")

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Malarone can cause vivid dreams and psychosis.

ETA: Oh, and: [Psychosis following chloroquine ingestion: a 10-year comparative study from a malaria-hyperendemic district of India](https://www.sciencedirect.com/science/article/abs/pii/S0163834313002089)

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**Author:** ![Riemann](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/riemann/32/3133_2.png) [@Riemann](https://boards.straightdope.com/u/Riemann)\
**Post date:** [April 24, 2020, 10:39pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/177 "2020-04-24T22:39:56Z")

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> [@susan](#):
>
> Malarone can cause vivid dreams and psychosis.

Malarone is the usual anti-malarial of choice now, because any side effects are generally much milder than other drugs. I haven’t seen vivid dreams or psychosis listed even among rare side effects.

> **[Malarone Oral: Uses, Side Effects, Interactions, Pictures, Warnings &...](https://www.webmd.com/drugs/2/drug-19799/malarone-oral/details)**
>
> Find patient medical information for Malarone oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.

I think you may be confusing it with Lariam (Mefloquine):

> **[Lariam Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing...](https://www.webmd.com/drugs/2/drug-1811/lariam-oral/details)**
>
> Find patient medical information for Lariam oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.

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**Author:** ![susan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/susan/32/17537_2.png) [@susan](https://boards.straightdope.com/u/susan)\
**Post date:** [April 24, 2020, 10:46pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/178 "2020-04-24T22:46:43Z")

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No, I’m thinking of Malarone. Yes, it has fewer side effects but can still cause these effects.

> [@](#):
>
> Although one review suggested that atovaquone-proguanil is “the best tolerated of all antimalarial medications”, psychiatric symptoms, particularly sleep disturbance and abnormal dreams, do occur with use of the drug, although again less commonly than with quinoline anti-malarials including mefloquine [Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives - PMC](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918116/)

> [@](#):
>
> Rare cases of seizures and psychotic events (such as hallucinations) have been reported during postmarketing experience. However, a causal relationship has not been established. [Malarone Side Effects: Common, Severe, Long Term](https://www.drugs.com/sfx/malarone-side-effects.html)

> [@](#):
>
> Acute psychosis is found among people who take Malarone, especially for people who are male, 10-19 old , have been taking the drug for \< 1 month, also take medication Armour Thyroid, and have Depression. This study is created by eHealthMe based on reports of 2,440 people who have side effects when taking Malarone from the Food and Drug Administration (FDA), and is updated regularly. [Could Malarone cause Acute psychosis? - eHealthMe](https://www.ehealthme.com/ds/malarone/acute-psychosis/)

Super fun when you’re in loco parentis on an international trip!

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**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\
**Post date:** [April 28, 2020, 2:28am UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/179 "2020-04-28T02:28:58Z")

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Some other studies have apparently shown more harm than benefit. I hope they find something cheap and effective for these things since this is not the last pandemic. And vaccines are tricky.

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**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\
**Post date:** [June 15, 2020, 6:00pm UTC](https://boards.straightdope.com/t/unfortunately-i-think-the-media-is-setting-up-trump-for-a-big-win-on-hydroxychloroquine/851190/180 "2020-06-15T18:00:45Z")

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FDA revokes emergency use of hydroxychloroquine

> **[FDA revokes emergency use of hydroxychloroquine](https://www.cnbc.com/2020/06/15/fda-revokes-emergency-use-of-hydroxychloroquine.html)**
>
> Hydroxychloroquine is unlikely "to be effective in treating COVID-19 for the authorized uses in the EUA," the FDA says.

> [@](#):
>
> The Food and Drug Administration said it is ending its emergency use authorization for chloroquine and hydroxychloroquine, the anti-malaria drugs backed by President Donald Trump to combat Covid-19.
> 
> The agency determined the drugs were “unlikely to be effective in treating COVID-19 for the authorized uses in the EUA.”

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