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Sitaram Khadka,1 Dhan Bahadur Shrestha,2 Pravash Budhathoki,3 Era Rawal4 1Department of Pharmacy, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu 44600, Nepal; 2Department of Emergency Medicine and General Practice, Mangalbare Hospital, Morang 56600, Nepal; 3Department of Emergency Medicine and General Practice, Dr Iwamura Memorial Hospital, Bhaktapur 44800, Nepal; 4Department of Emergency Medicine and General Practice, Kathmandu Medical College, Kathmandu 44600, NepalCorrespondence: Sitaram KhadkaDepartment of Pharmacy, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu 44600, NepalTel +00977-9851077589Email sitaram.khadka@naihs.edu.npAbstract: Coronavirus disease (COVID-19) pandemic has been a global disease burden. It has affected more than sixteen million people in the world within seven months of its first outbreak in Wuhan. Different treatment modalities, therapeutic and prophylactic agents for its therapy are underway. Until the proven therapy gets available, repurposing of drugs is a better way out. Hydroxychloroquine (HCQ) has been a potential recourse of treatment in this regard for COVID-19 management. As different episodes of cardiac adverse events of HCQ are reported, safety concerns are now a prime objective. The risk-benefit analysis is mandatory to address rational drug therapy even in such a global health crisis. In this article, we want to evaluate the safety and efficacy of HCQ in COVID-19 management.Keywords: cardiac arrhythmia, COVID-19, drug repositioning, hydroxychloroquine, severe acute respiratory syndrome coronavirus-2