Hydroxychloroquine is a synthetic drug. Social media posts claiming that hydroxychloroquine can be made at home using citrus peels are false.

Hydroxychloroquine is a drug mainly used to 1) prevent and treat malaria, and 2) treat inflammatory diseases like rheumatoid arthritis. It is derived from an older antimalarial called chloroquine. Both drugs are manufactured by companies that develop speciality chemical products. Both drugs are also only available by medical prescription. 

Chloroquine and hydroxychloroquine are complex, man-made forms of quinine sulfate. Quinine sulfate is a naturally occurring compound in cinchona bark that has been used to treat malaria for centuries. It is also an ingredient in tonic water. However, the concentration present per liter is five to ten times less than doses in pharmaceutical drugs like chloroquine and hydroxychloroquine. 

While tonic water can be made at home using citrus and store bought cinchona powder, chloroquine and hydroxychloroquine can only be produced by highly trained chemists and then prescribed.

Public interest in chloroquine and hydroxychloroquine developed early in the pandemic. Given the urgency to identify potential COVID-19 treatments, some countries, including the U.S., gave special authorization to use chloroquine and hydroxychloroquine for treatment of hospitalized COVID-19 patients. 

However, results from randomized clinical trials (which study causality) and large retrospective observational studies have indicated that these drugs had safety concerns and showed no benefits in increasing COVID-19 survival and other clinical outcomes. As a result, the U.S. Food and Drug Administration revoked its emergency use authorization in June 2020. The U.S. National Institutes of Health’s COVID-19 Treatment Guidelines Panel recommends against the use of chloroquine or hydroxychloroquine to treat COVID-19 patients. Quinine sulfate is also not a proven or approved treatment for COVID-19.