While ivermectin was one of the most commonly heard (and used) drugs in the first wave, it was superseded by remdesivir, Fabiflu, azithromycin, and plasma therapy in the second wave. And now as the third wave hits the country, the baton has been handed over to the drugs molnupiravir and the monoclonal antibody cocktail. The former is also not included in the national COVID-19 diagnostic protocol. Considering how many drugs that were previously acclaimed were taken off the drug list for COVID protocol, what exactly to do when they test positive? Well, the most important thing that we all need to understand right now is to stay away from self-administered drugs and allow trusted doctors to prescribe medicines based on our symptoms and severity.
Lancelot Pinto fears that as these names emerge, they will be used indiscriminately by both patients and doctors. “General practitioners often do not update their knowledge, and there is pressure from patients and their families to prescribe anything. They often succumb to such pressures and overdose or incorrectly prescribe certain drugs, which are clearly not needed by the patient.”
“Most cases require symptomatic treatment”
There has been an explosion of cases in the last 72 hours. Dr Sushila Kataria, Senior Director, Internal Medicine, Medanta Gurugram warned, “Most of the cases are from Omicron and it is too early to say that there will be only minor cases. We have an Omicron patient on oxygen support right now at Medanta. Although it may be milder than Delta, we will ascertain its severity in two weeks’ time.” Half of the patients Dr Kataria is treating now are those who tested COVID positive earlier.
Both Dr Pinto and Dr Sushila currently recommend symptomatic treatment of COVID. “Paracetamol, anti-allergic, steam and gargles are enough to initiate treatment for those who do not have any risk factors. Medicines such as mollupiravir and monoclonal antibody cocktail drugs are only for patients who have risk factors such as age, obesity, diabetes, high blood pressure, kidney or liver disease.
“Monoclonal Antibody Cocktail Not Effective Against Omicron”
“Monoclonal antibody cocktail is being advised for COVID patients with mild symptoms but with high risk factors. For others, it is important to stay connected with their doctors through teleconsultation, so if your case progresses, the doctors can decide the next step immediately,” says Dr Kataria. Also, the antibody cocktail drugs currently available in India do not work against the Omicron variant. This is why they have been discontinued in many countries facing the Omicron boom.
“Our past experience has shown that anti-viral drugs like Fabiflu don’t work very well, so they should be used with caution. People shouldn’t be given a 5-day course. Even remdesivir What was earlier a 5 day course has now been reduced to 3 days.
We also need to understand that all these drugs have been tested on illiterate people. So we don’t know yet whether these drugs will work in the vaccine group.
“Molnupiravir has shown limited efficacy and there are risks involved”
Molnupiravir is a drug currently under study. “When used early in the disease, it has limited efficacy when used in non-vaccinated individuals at high risk. In the largest trial to date, those with low viral loads and those with diabetes No significant effect of the drug was found on patients with previous evidence of COVID-19. There are also serious birth defect risks associated with its use. Women were prescribed to remain on contraception during and for 4 days after the last dose of the drug and men are advised to use contraception during the last dose of the drug and for 3 months. Therefore, this drug should not be used indiscriminately,” cautions Dr. Pinto.
Fluvoxamine, an antidepressant, is another drug showing some promise in COVID treatment but recommending it for routine use can be risky.
Bottom-line
For most people with COVID, symptom-based treatment is all that is needed. Paracetamol for fever, decongestants and antihistamines for nasal congestion, and inhaled corticosteroids for cough. There are medicines used for COVID treatment but each has its limits and we all should act responsibly and not panic.
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