Conv. Plasma
Nigella Sativa

All HCQ studies
Meta analysis
study COVID-19 treatment researchHCQHCQ (more..)
Melatonin Meta
Azvudine Meta Metformin Meta
Bromhexine Meta
Budesonide Meta Molnupiravir Meta
Colchicine Meta
Conv. Plasma Meta
Curcumin Meta Nigella Sativa Meta
Famotidine Meta Nitazoxanide Meta
Favipiravir Meta Paxlovid Meta
Fluvoxamine Meta Quercetin Meta
Hydroxychlor.. Meta Remdesivir Meta
Ivermectin Meta
Lactoferrin Meta

All Studies   Meta Analysis   Recent:  

Drug Repositioning in Intensive Care Patients and Pharmacokinetic Variability: The Illustration of Hydroxychloroquine

Ragonnet et al., Future Pharmacology, doi:10.3390/futurepharmacol2010007
Mar 2022  
  Source   PDF   All Studies   Meta AnalysisMeta
Comparison of two HCQ dosing regimens, showing high inter-individual variability of HCQ concentrations (as in Ruiz), and significantly better plasma concentrations for the dosing regimen including a loading dose.
Ragonnet et al., 19 Mar 2022, peer-reviewed, 9 authors.
All Studies   Meta Analysis   Submit Updates or Corrections
This PaperHCQAll
Drug Repositioning in Intensive Care Patients and Pharmacokinetic Variability: The Illustration of Hydroxychloroquine
Gwendoline Ragonnet, Elisabeth Jouve, Lionel Velly, Marc Leone, Gary Duclos, Jeremy Bourenne, Karim Harti Souab, Caroline Solas, Romain Guilhaumou
Future Pharmacology, doi:10.3390/futurepharmacol2010007
During the SARS-CoV-2 pandemic, hydroxychloroquine (HCQ), was among the first drugs to be tested due to demonstrated in vitro antiviral activity against SARS-CoV-2. Pharmacokinetic variability was expected due to the frequent comorbidities and pathophysiological modifications observed in severe COVID-19 patients hospitalized in intensive care units (ICUs). The aim of this study was to describe HCQ plasmatic concentrations in ICUs and assess variability factors. A multicentric retrospective study was carried in four ICUs in Marseille from March to April 2020. There were two dosing regimens: 400 mg after a 400 mg loading dose (DR1); and 600 mg without a loading dose (DR2). HCQ concentrations were determined every 2 or 3 days. The impacts of demo-graphic, biological, and clinical covariates were investigated. The median HCQ concentration was: 0.096 mg/L on day (D) 2, 0.129 mg/L on D3 to D5, 0.140 mg/L on D6 to D10 for DR1 versus 0.116 mg/L, 0.261 mg/L, and 0.30 mg/L, respectively, for DR2. At D2, 53.9% and 46.2% of patients with DR1 and DR2, respectively, presented HCQP concentrations <0.1 µg/mL and 48.2% versus 10.7% at D3 to D5. Time post-initiation, dosing regimen, nasogastric administration, and weight showed significant association with HCQ variability. The high proportion of suboptimal HCQ concentrations can be explained by a lack of optimized dosing regimen and numerous pathophysiological changes in the COVID-19/ICU population.
Abdul-Aziz, Alffenaar, Bassetti, Bracht, Dimopoulos et al., Antimicrobial therapeutic drug monitoring in critically ill adult patients: A Position Paper, Intensive Care Med, doi:10.1007/s00134-020-06050-1
Abdulaziz, Shah, Mccune, Hydroxychloroquine: Balancing the need to maintain therapeutic levels with ocular safety: An update, Curr. Opin. Rheumatol, doi:10.1097/BOR.0000000000000500
Alarcón, Mcgwin, Bertoli, Fessler, Calvo-Alén et al., Effect of hydroxychloroquine on the survival of patients with systemic lupus erythematosus: Data from LUMINA, a multiethnic US cohort (LUMINA L), Ann. Rheum. Dis, doi:10.1136/ard.2006.068676
Arabi, Murthy, Webb, COVID-19: A novel coronavirus and a novel challenge for critical care, Intensive Care Med, doi:10.1007/s00134-020-05955-1
Carmichael, Charles, Tett, Population pharmacokinetics of hydroxychloroquine in patients with rheumatoid arthritis, Ther. Drug Monit, doi:10.1097/00007691-200312000-00005
Cunha, Alexander, Ashby, Lee, Chusney et al., Hydroxycloroquine blood concentration in lupus nephritis: A determinant of disease outcome?, Nephrol. Dial. Transplant, doi:10.1093/ndt/gfx318
Doudka, Giocanti, Basso, Ugdonne, Barthelemy et al., Development and validation of a simple and rapid UHPLC-MS/MS method for the quantification of hydroxychloroquine in plasma and blood samples in the emergency context of SARS-CoV-2 pandemic, Ther. Drug Monit, doi:10.1097/FTD.0000000000000836
Fan, Ma, Chen, Yang, Cheng et al., Pharmacokinetics and Bioequivalence Study of Hydroxychloroquine Sulfate Tablets in Chinese Healthy Volunteers by LC-MS/MS, Rheumatol. Ther, doi:10.1007/s40744-015-0012-0
Gagnieu, Garraffo, Solas, Peytavin, Guilhaumou et al., Recommandations pour le Suivi Thérapeutique Pharmacologique du lopinavir/r et de l'hydroxychloroquine chez les patients traités pour une infection à SARS-CoV-2 (COVID-19
Gautier-Veyret, Truffot, Bailly, Fonrose, Thiebaut-Bertrand et al., Inflammation is a potential risk factor of voriconazole overdose in hematological patients, Fundam. Clin. Pharm, doi:10.1111/fcp.12422
Giaime, Guenoun, Pedinielli, Narbonne, Bergounioux et al., Hydroxychloroquine and azithromycin tolerance in haemodialysis patients during COVID-19 infection, Nephrol. Dial. Transplant, doi:10.1093/ndt/gfaa191
Kivity, Landevitz, Shoenfeld, Ben-Zvi, Hydroxychloroquine: From malaria to autoimmunity, Clin. Rev. Allergy Immunol, doi:10.1007/s12016-010-8243-x
Lagier, Million, Gautret, Colsona, Cortaredonaa et al., Outcomes of 3737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis, Travel Med. Infect. Dis, doi:10.1016/j.tmaid.2020.101791
Lê, Peiffer-Smadja, Guedj, Néant, Mentré et al., Rationale of a loading dose initiation for hydroxychloroquine treatment in COVID-19 infection in the DisCoVeRy trial, J. Antimicrob. Chemotherpy, doi:10.1093/jac/dkaa191
Mahévas, Tran, Roumier, Chabrol, Paule et al., Clinical efficacy of hydroxychloroquine in patients with COVID-19 pneumonia who require oxygen: Observational comparative study using routine care data, Br. Med. J, doi:10.1136/bmj.m1844
Marzolini, Stader, Stoeckle, Franzeck, Egli et al., Effect of Systemic Inflammatory Response to SARS-CoV-2 on Lopinavir and Hydroxychloroquine Plasma Concentrations, Antimicrob. Agents Chemother, doi:10.1128/AAC.01177-20
Morita, Takahashi, Yoshida, Yokota, Population Pharmacokinetics of Hydroxychloroquine in Japanese Patients With Cutaneous or Systemic Lupus Erythematosus, Ther. Drug Monit, doi:10.1097/FTD.0000000000000261
Oberoi, Zhao, Sidhu, Viani, Trinh et al., A Phase 1 Study to Evaluate the Effect of Crushing, Cutting Into Half, or Grinding of Glecaprevir/Pibrentasvir Tablets on Exposures in Healthy Subjects, J. Pharm. Sci
Petri, Use of hydroxychloroquine to prevent thrombosis in systemic lupus erythematosus and in antiphospholipid antibodypositive patients, Curr. Rheumatol. Rep, doi:10.1007/s11926-010-0141-y
Rainsford, Parke, Clifford-Rashotte, Kean, Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases, Inflammopharmacology, doi:10.1007/s10787-015-0239-y
Roustit, Guilhaumou, Molimard, Drici, Laporte et al., Chloroquine and hydroxychloroquine in the management of COVID-19: Much kerfuffle but little evidence, Therapies, doi:10.1016/j.therap.2020.05.010
Smit, Peeters, Van Den Anker, Knibbe, Chloroquine for SARS-CoV-2: Implications of Its Unique Pharmacokinetic and Safety Properties, Clin. Pharmacokinet, doi:10.1007/s40262-020-00891-1
Thémans, Belkhir, Dauby, Yombi, De Greef et al., Population Pharmacokinetics of Hydroxychloroquine in COVID-19 Patients: Implications for Dose Optimization, Eur. J. Drug Metab. Pharmacokinet, doi:10.1007/s13318-020-00648-y
Venisse, Peytavin, Bouchet, Gagnieu, Garrafo et al., Concerns about pharmacokinetic (PK) and pharmacokinetic-pharmacodynamic (PK-PD) studies in the new therapeutic area of COVID-19 infection, Antivir. Res, doi:10.1016/j.antiviral.2020.104866
Wu, Chen, Cai, Xia, Xing et al., Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China, JAMA Intern. Med, doi:10.1001/jamainternmed.2020.0994
Yao, Ye, Zhang, Cui, Huang et al., Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am, doi:10.1093/cid/ciaa237
Yasu, Konuma, Kato, Kurokawa, Takahashi et al., Serum C-reactive protein levels affect the plasma voriconazole trough levels in allogeneic hematopoietic cell transplant recipients, Leuk. Lymphoma, doi:10.1080/10428194.2017.1300897
Zhou, Yu, Du, Fan, Liu et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study, Lancet
Please send us corrections, updates, or comments. c19early involves the extraction of over 100,000 datapoints from thousands of papers. Community updates help ensure high accuracy. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop