Hydroxychloroquine Alternatives – What You Can Use Instead

If you’ve heard a lot about hydroxychloroquine and wonder if there’s a better choice, you’re not alone. The drug made headlines during the pandemic, but doctors often recommend other meds that have clearer benefits and fewer risks. Below we break down the most common alternatives, when they work best, and what you should watch out for.

Top Drug Alternatives

Ivermectin is an anti‑parasitic that some doctors use off‑label for early‑stage COVID‑19. The usual dose is 0.2 mg per kilogram of body weight, taken once or twice a day for a short course. It’s cheap and widely available, but it can cause nausea, dizziness, or skin rash in a small number of people. Make sure you get a prescription and follow the exact dosing schedule.

Doxycycline is an antibiotic that also has anti‑inflammatory properties. For mild COVID‑19 it’s often given at 100 mg twice daily for five days. It can help reduce fever and cough, and it’s also used for Lyme disease and acne. Common side effects include upset stomach and sun sensitivity, so avoid long sun exposure while you’re on it.

Azithromycin is a macrolide antibiotic that doctors sometimes combine with other drugs for respiratory infections. The standard regimen is 500 mg on day 1, followed by 250 mg daily for four more days. It’s generally well‑tolerated, but it can affect heart rhythm in people with existing heart issues. Ask your doctor if you have a history of arrhythmia.

Remdesivir is an antiviral given through an IV. It’s approved for hospitalized COVID‑19 patients who need oxygen support. The treatment lasts five days, with a loading dose of 200 mg on day 1, then 100 mg daily. It’s usually only available in a hospital setting, but it has shown a clear reduction in recovery time for serious cases.

Colchicine is a gout medication that reduces inflammation. Some trials suggest it can lower the risk of severe COVID‑19 when started early. The dose is 0.5 mg twice daily for three days, then once daily for a few more days. Watch for diarrhea and stomach pain, and don’t use it if you have kidney disease.

When to Choose an Alternative

Pick an alternative based on the condition you’re treating. For lupus or rheumatoid arthritis, doctors still rely on hydroxychloroquine because it’s proven to reduce flare‑ups. If you can’t tolerate it or have a specific contraindication, azathioprine or methotrexate are common substitutes that target the immune system differently. Discuss blood‑test monitoring with your provider, as these drugs need regular check‑ups.

For COVID‑19, start any alternative as soon as symptoms appear—ideally within the first 48 hours. Early treatment gives the best chance to cut viral load and avoid hospitalization. Combine the drug with basic home care: rest, hydration, and a balanced diet. If you notice worsening breathing, fever over 101°F, or new confusion, seek medical help right away.

Safety always comes first. Before switching, review your current meds with a pharmacist to avoid dangerous interactions. Some alternatives, like ivermectin and colchicine, can clash with statins or blood thinners. Keep a list of all supplements and over‑the‑counter drugs you take, and share it with your doctor.

Bottom line: hydroxychloroquine isn’t the only game in town. Depending on why you need it, there are at least five well‑studied options that can cut symptoms, lower risk, and fit your lifestyle. Talk to your healthcare provider about the best fit for you, and don’t skip the follow‑up visits—those check‑ins keep you on track and catch side effects early.