Use of Hydroxychloroquine (Plaquenil®) in the context of COVID 19 – Risk of QT prolongation and drug/drug interactions

A Dear Healthcare Professional Letter has been issued by Sanofi to highlight to healthcare professionals the known risk of QT prolongation and drug-drug interactions associated with hydroxychloroquine and that prescription of hydroxychloroquine for the management of COVID-19 is off-label. A significant number of serious and life-threatening cases of QT prolongation, torsade de pointe, syncope, cardiac arrest, and sudden death in the context of COVID-19 management has been reported to Sanofi. In most of these cases, hydroxychloroquine was co-administered with other drugs known to induce QT prolongation (e.g., azithromycin). The majority of patients recovered after hydroxychloroquine discontinuation. In view of the seriousness of these cases, healthcare professionals are advised to show caution in using hydroxychloroquine off-label in the management of COVID-19. In particular, in patients with specific risk factors (e.g., co-administration of hydroxychloroquine with other drugs known to prolong the QT interval, such as some anti-infectives, including azithromycin), cardiac ECG monitoring at hospital is advised. A list of drug interactions and corresponding precautions for use is provided with the letter. Please refer to the letter for details. Published: 29 May 2020

Dear Healthcare Professional Letters