To the Editor: Quinacrine, a compounded antimalarial, has been used for patients intolerant or unresponsive to hydroxychloroquine. In March 2016, the Pharmacy Compounding Advisory Committee raised safety concerns about quinacrine-associated aplastic anemia. In addition, the Office of New Drugs advised that although quinacrine might be safe at the 100 mg/day dose prescribed for rheumatic skin diseases, generalists might prescribe this drug at higher doses and for alternative indications that have yet to be formally studied.
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