As a patient, I don’t know what to believe!!
Commonly Asked COVID-19 Questions
We asked Clinical Pharmacist, Paul Fleming (PharmD) and Primary Care Physicians to put together a list of the most commonly asked questions about the Novel Coronavirus (COVID-19) and Medications.
Does my blood pressure medicine increase my risk of getting coronavirus?
Not likely. The coronavirus uses a protein on the surface of your body’s cells to infect those cells. Scientists working with cells in a laboratory found that ACE inhibitors (eg, lisinopril, benazepril) and ARBs (eg, losartan, valsartan) – the same medicines that you take to lower your blood pressure or protect your kidneys if you have diabetes – caused those cells to have more of this type of protein on their surfaces. These scientists were not working with the coronavirus. Because the coronavirus uses this protein to infect your cells and because these medicines caused cells to make more of this protein, scientists questioned whether these medicines might increase the risk of getting the coronavirus.
BOTTOM LINE: While the results of their studies are interesting, we have no proof that being on one of these medicines increases your risk of getting the coronavirus so you should not stop your medicine. What we do know is that patients with high blood pressure, high sugar, or kidney disease are at a higher risk of being infected and stopping your medicines might put you at a higher risk.
Does my diabetes medicine increase my risk of getting coronavirus?
No, and the only diabetes medicine that has been mentioned by the media is Actos (pioglitazone). The coronavirus uses a specific protein on the surface of your body’s cells to infect those cells. We know that Actos can cause certain cells in your body to make more of these proteins. Because the coronavirus uses this protein to infect your cells and because Actos causes cells to make more of this protein, scientists questioned whether taking Actos might increase the risk of getting the coronavirus.
BOTTOM LINE: Diabetes itself puts you at a higher risk of infection especially if your sugar is high. We have no proof that taking Actos puts you at a higher risk of getting the coronavirus so you should not stop your medicine because it helps keep your sugar controlled.
I heard you cannot use ibuprofen (Advil, Motrin) if I have the coronavirus because you will get worse.
There were a couple of people infected with the coronavirus in France that took ibuprofen and said that their symptoms got worse. Based on these few reports, the French Minister of Health recommended taking Tylenol (acetaminophen) instead of ibuprofen for pain and fever if you have the coronavirus.
BOTTOM LINE: We cannot assume based on a hand full of cases in France that all people will have this reaction to ibuprofen. In fact, except for France, other countries including the US still recommend ibuprofen as a good choice for controlling pain and fever with the coronavirus because no other patients have reported having a bad reaction to the medicine. However, if you have high blood pressure, a history of heart attack, kidney or liver disease, ask your primary care provider which medicine you should use to control pain or fever. Ibuprofen may not be the best choice for you.
My medicine comes from China. Should I take it?
Yes, there is no reason not to take a medicine because it was made in China. You are not at a higher risk of getting the coronavirus because your medicine was made in China.
I heard about a medicine on TV that might prevent me from getting coronavirus. Should I ask my primary care provider for a prescription?
No. Chloroquine and Plaquenil (hydroxychloroquine) are medicines that are used to prevent people from getting malaria. Neither medicine is FDA approved to prevent coronavirus infection or treat coronavirus patients though the FDA did just authorize the emergency use of both medicines for hospitalized patients with COVID-19. Both chloroquine and Plaquenil can have major drug interactions and cause severe side effects so they are not for every patient. Studies from China show that chloroquine might keep patients from getting coronavirus and suggest that it works to treat patients with coronavirus. Plaquenil, the safer of the 2 medicines, works the same way as chloroquine and in a small study of patients hospitalized with coronavirus infections, seemed to work well for treating those patients. Plaquenil is also used to treat patients with lupus and rheumatoid arthritis and these patients depend on this medicine to control their conditions.
BOTTOM LINE: We do not have good studies showing that Plaquenil can prevent coronavirus infection. While it seems to be effective at treating hospitalized patients with coronavirus, we need larger studies to show that it works to prevent and treat coronavirus. At this time, because patients using the medicine to treat lupus and rheumatoid arthritis really need this medicine and because Plaquenil is on backorder (not available) due to increased prescribing by providers, PPCP providers are not prescribing Plaquenil to prevent coronavirus infections so that hospitalized patients with severe coronavirus infections have a better chance of getting the treatment that they need now.