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Paper by NJ White et al, PLoS Medicine, in press. Using available pharmacokinetic information from healthy volunteers, the treatment of malaria, the chronic treatment of rheumatological conditions and the toxicokinetics of chloroquine in self-poisoning, the authors predict exposures and safety margins in the high dose chloroquine and hydroxychloroquine COVID-19 prevention and treatment regimens currently under evaluation. These regimens are predicted to have reasonable safety margins. Large, well conducted randomised clinical trials with appropriate monitoring are required to determine if chloroquine and hydroxychloroquine have preventive or treatment efficacy in COVID-19 and acceptable safety. Current recommendations for their use outside of clinical trials are not justified at this time.

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