Source: Mumbai Mirror
After much back and forth, the Maharashtra government on Monday made Hydroxychloroquine (HCQ) a part of its Covid-19 treatment protocol. Hydroxychloroquine is widely used around the world to prevent and treat malaria, but it now has a new role in the current pandemic, which is that of a prophylactic, as it builds immunity against viral infections.
While many frontline health workers, including top doctors, have been taking HCQ and prescribing it too, the medication, also used to treat rheumatoid arthritis and lupus, will now be given to all asymptomatic and mildly symptomatic patients who are under 55 and have no other underlying health complications. This follows the state government accepting its Covid-19 Task Force’s recommendation to make HCQ more widely available across the state at all government-run Covid care centres.
HCQ’s efficacy in battling Covid-19 infection in all scenarios is still under review. An American retrospective study published recently in the Lancet said that they could not confirm benefits of HCQ for Covid-19 patients and the drug has the already known rare side effects. They went as far as to say that those side effects could cause death, though cited no data of that actually happening.
A Task Force member, who did not wish to be identified, said: “There are different opinions on the use of HCQ, but we have seen that the advantages outweigh the disadvantages. We are recommending a dosage of 200 mg along with Doxycycline.”
The Indian Council of Medical Research (ICMR), whose clearance was secured by the Task Force for including HCQ in the state’s treatment protocol, issued a new advisory on the drug last Saturday, saying it should be used only under medical supervision and should not instill a sense of false security. In March, the ICMR had recommended the drug as a prophylaxis against Covid-19 for healthcare workers across the country.
Dr Sanjay Oak, who heads the Task Force, confirmed that the use of HCQ has been recommended. “In regular hospitals, doctors can take a call, but we have recommended it in our new advisory for all field hospitals after a thorough check up, ECG and under close observation,” he said.
While earlier HCQ was being combined with Azithromycin, but the latter has now been replaced with Doxycycline. “There are reports of more cardiac toxicity with both these drugs used together (Azithromycin and HCQ). So, the change has been made. Doxycycline is a very safe drug,” Dr Oak said.
Additional Municipal Commissioner (health) Suresh Kakani said there was no reason to doubt HCQS’s usefulness at the moment.
“All BMC healthcare workers are taking HCQ. They seem to have lower Covid infection rates than healthcare workers in private,” Kakani said.Additional Municipal Commissioner (health) Suresh Kakani
On Saturday, ICMR said that assessment of HCQ among 1,323 healthcare workers indicated mild adverse effects such as nausea (8.9%), abdominal pain (7.3%), vomiting (1.5%) and cardiovascular effects (1.9%).
“The data from the pharmacovigilance programme of India, there have been 214 reported instances of mild adverse drug reactions associated with prophylactic HCQ use,” it said.