Remdesivir is back on the doctor’s table to treat patients infected with COVID-19. The Ministry of health and welfare has included Remdesivir in the list of drugs to be used for the treatment of COVID patients.
The drug had become a point of contention during the second wave when it was sold on the black market. Hoarders made hay after it was considered a wonder drug to treat COVID. After hue and cry, the government took Remdesivir out of the list of drugs used for treating the infection.
A year on, the ministry has issued a slew of new guidelines for the clinical management of Covid treatment in the country.
Who should be administered Ramdesivir?
“Remdesivir (EUA) may be considered only in patients with moderate to severe disease (requiring supplemental oxygen). It can be used in patients who have no renal or hepatic dysfunction, who are within 10 days of onset of symptoms,” the ministry said.
The ministry recommended a dose of 200 mg injection IV on day 1 f/b 100 mg IV OD for the next 4 days.
However, the ministry said it should not be used in patients who are not on oxygen support or in-home settings.
Tocilizumab
Tocilizumab has also been recommended for patients having severe disease. It can be administered preferably within 24 to 48 hours of the onset of severe disease/ICU admission.
It can be used for patients with significantly raised inflammatory markers. It can be used for patients who are not improving despite the use of steroids.
Interestingly, Molnupiravir has not been included in the list of drugs to be used for Covid treatment. Other drugs prescribed in the new treatment norms include Tab Ivermectin (200 mcg/kg once a day for 3 days) and Tab HCQ (400 mg BD for 1 day f/b 400 mg OD for 4 days) etc.
Home isolation
As per the new guidelines, Covid-19 patients undergoing mild symptoms without shortness of breath and hypoxia are required to observe home isolation. Such patients have also been advised to maintain physical distance, hand hygiene, and use of masks indoors. Those suffering from mild Covid should seek medical attention only if they are having difficulty in breathing, high fever, or severe cough lasting for more than 5 days.
Hospitalization
People suffering from moderate Covid symptoms, those undergoing breathlessness or with SP02 levels fluctuating between 90-93 percent, can get admitted to the clinical ward to avail of Covid treatment.
According to the new guidelines, such patients should be given oxygen support. Awake proning should be encouraged in all patients requiring supplemental oxygen therapy (sequential position changes every 2 hours). Other treatments include anti-inflammatory or immunomodulatory therapy. There should be no contraindication or high risk of bleeding.