India just dropped not only ivermectin, but also HCQ (hydroxychloroquine) and favipiravir to treat COVID-19!
Find out why they did so, and what it means for COVID-19 treatment in India!
India Drops Ivermectin, HCQ + Favipiravir As COVID-19 Drugs!
India had earlier been criticised for continuing to recommend HCQ (hydroxychloroquine) as prophylaxis since at least May 2020, even though it failed to prevent two massive COVID-19 surges.
Then they recommended the use of ivermectin in mild or asymptomatic cases of COVID-19 that are in home quarantine, even though it has not been proven to work against COVID-19.
On 27 May 2021, the Directorate General of Health Services of the Indian Ministry of Health and Family Welfare released updated Comprehensive Guidelines for Management of COVID-19 patients.
That updated COVID-19 treatment guidelines removed not just ivermectin, hydroxychloroquine and favipiravir, but also other popular off-label treatments like azithromycin, doxycycline, zinc and plasma therapy.
By dropping hydroxycholoroquine, India was finally acknowledging that HCQ simply does not work against COVID-19 – a fact that the world had known since June 2020, when the WHO Solidarity Trial dropped it after determining that it was ineffective against COVID-19.
As we explained before, the verdict on ivermectin is still out, so it simply does not make sense to use it as a mainstream COVID-19 treatment, outside of clinical trials.
The same goes for favipiravir, which is also under investigation as a potential treatment for COVID-19, after lab tests and small pilot studies in humans showed some benefit in reducing symptoms and duration of illness. However, there is still not enough evidence to use it to treat COVID-19 outside of clinical trials.
Indian COVID-19 Treatment w/o Ivermectin, HCQ + Favipiravir
The Indian treatment guidelines for COVID-19 is now much simpler, after removing a whole bunch of off-label drugs.
For example, there is basically no treatment for asymptomatic COVID-19 patients, bringing it in line with the rest of the world.
Oxygen support for mild COVID-19 still seems excessive, but it is a heck of a lot better than the earlier guidelines!
Only two off-label drugs are now authorised for emergency use against COVID-19 – remdesivir and tocilizumab, with the following warnings :
Remdesivir
- Emergency Use Authorisation based on limited scientific evidence globally.
- Only to be used in select moderate / severe hospitalised COVID-19 patients on supplemental oxygen, within 10 days of onset of disease.
- Exercise extreme caution as this is an experimental drug with potential to harm.
Tocilizumab
- Only approved for use in severe and critically-ill COVID-19 patients, that meet these conditions :
a) no signs of improvement in oxygen requirement after 24-48 hours on corticosteroids
b) has significantly raised inflammatory markets (C-Creative Protein ≥ 75 mg/L) - Must only be used with patients who are free of any bacterial / fungal / tuberculous infection.
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