Why You Should Not Try To Make Hydroxychloroquine at Home

During the COVID-19 pandemic, the antimalarial drug hydroxychloroquine made headlines for several months. Many people revealed that they had been taking hydroxychloroquine in the hope to fight the virus. In these days of the pandemic, many people were fearful and information was in constant flux.

Emergency Approval and Revocation

At that time, there were a lot of questions about the efficacy and safety of using hydroxychloroquine against COVID-19. There was also a lot of hope that it would be the magic pill that could help people fight off the virus. And while the Food and Drug Administration (FDA) had granted emergency use authorization (EAU) to use hydroxychloroquine and chloroquine with patients who didn't otherwise qualify for a clinical trial early on in the pandemic, they also issued a warning. On an April 30, 2020 news release the FDA said that hydroxychloroquine and chloroquine were not to be used outside of a hospital setting or clinical trial due to a risk of "heart rhythm problems" like ventricular tachycardia and ventricular fibrillation and, in some cases, death.

By June 2020, the FDA revoked its EAU for hydroxychloroquine and chloroquine, due to safety issues, including blood and lymph disorders, kidney injuries, and liver problems, in addition to serious heart rhythm problems.

The arguments against taking hydroxychloroquine outside of a specific medical setting were clear, and yet, it seemed individuals were still trying to get the drug—even, apparently, through a very dangerous DIY approach.

In spring 2020, Google Trends data showed that searches for "how to make your own hydroxychloroquine" and "homemade hydroxychloroquine" were on the rise, and Twitter took down posts from a user who shared a homemade recipe for the drug, as captured in this video from Inside Edition.

Dangers of Attempting To DIY Hydroxychloroquine

There are, of course, the most obvious reasons for that: "A person would need specialized knowledge in organic and medicinal chemistry to understand how to create compounds," Bethanne Carpenter, PharmD, an infectious diseases pharmacy specialist at Santa Clara Valley Medical Center in San Jose, California, told Health. "Additionally, depending on what needs to be compounded, they may need specific equipment to purify compounds, and know how to safely mix reagents together to synthesize new compounds."

And that's just the drug-making part. Drugs have to go through rigorous testing (often on animals first, before human testing) to determine their efficacy and safety. "All medications need quality assurance testing for accurate dosage and more," board-certified pharmacotherapy specialist Sally Rafie, PharmD, told Health. And the whole process to get a drug to market usually takes several years.

Carpenter said she's heard of recipes being shared on social media on how to make hydroxychloroquine and chloroquine or posts advocating ingesting other similar marketed foods and drinks as substitutes because they are similar in molecular structure (quinine, small amounts of which are found in tonic water, is one of them).

"While these molecular compounds may be similar, they are still different and may be dangerous to ingest because dosages are not regulated, leading to accidental overdose or ingestion of another toxic compound made during the mixing process," warned Carpenter. Plus, there's no proof these similar molecular compounds are actually effective in treating or preventing COVID-19—they haven't undergone lab testing to show antiviral activity.

The list of things that can go wrong from making drugs at home is a long one—from toxic gas to overdosing from not knowing proper weight measurements.

The Importance of Scientific Evidence

Manufactured substances can be extremely harmful if they're not intended for medicinal use in humans. "A good example is a story from Arizona when a couple took chloroquine that was designed as antiparasitic therapy for their koi fish," said Carpenter. "It may be a similar compound by name, but the product likely had higher doses than what is typically used for humans." The outcome in this instance was tragic: The husband didn't make it to the hospital, and the wife was in critical condition.

Carpenter stressed the importance of scientific evidence in determining whether a drug is safe and effective to treat or prevent a particular disease. "Drugs should be closely observed in a controlled setting such as a randomized, controlled trial to ensure effectiveness and identify potential harms to the patients," explained Carpenter. "It is only from these trials that we can evaluate if the benefits outweigh the risks in using the drug to treat a disease."

Research is stacking up against the use of hydroxychloroquine to prevent and treat COVID-19. For example, a randomized trial published in August 2020 in The New England Journal of Medicine found hydroxychloroquine did not prevent COVID-19 in people after high-risk and moderate-risk exposure to the virus.

In a 2021 study published on JAMA Open Network, COVID-19 patients who received hydroxychloroquine had about the same rates of hospitalization as those patients who received a placebo. And in a Lancet systematic review and meta-analysis of studies, researchers determined that there was no clinical benefit of hydroxychloroquine as a pre-and post-exposure prophylaxis and treatment of patients with COVID-19, including those who were in the hospital and those who were at home.

While many experts agree that we need more treatments aside from vaccines for COVID-19—and it's understandable to want to safeguard your health—this isn't the way to do it. The message from health agencies and those in the medical field is crystal clear: Under absolutely no circumstances should you try to make hydroxychloroquine—or any other medication—at home, ever.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.