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ICMR clears hydroxychloroquine for wider usage, but with some riders

According to the new guidelines — which come with caveats — recommended by the joint monitoring group and the national task force set up by ICMR, hydroxychloroquine can be given as a prophylactic for all asymptomatic healthcare workers involved in treating Covid-19, including those in quarantine centres.

, ET Bureau|
Last Updated: May 23, 2020, 07.29 AM IST
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The experts also found data from India’s pharmacovigilance programme, which showed 214 reported instances of adverse reactions associated with prophylactic HCQ use.
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New Delhi: The Indian Council of Medical Research (ICMR) has recommended a wider use of hydroxychloroquine (HCQ) in the battle against Covid-19, brushing aside ethical concerns over a drug that hasn’t been tested against the coronavirus after finding only mild side-effects in its assessments.

According to the new guidelines — which come with caveats — recommended by the joint monitoring group and the national task force set up by ICMR, hydroxychloroquine can be given as a prophylactic for all asymptomatic healthcare workers involved in treating Covid-19, including those in quarantine centres. Healthcare workers in all hospitals — even those that are not specifically designated as Covid-19 centres — can be given HCQ, they said.

The drug is recommended for asymptomatic frontline workers such as surveillance workers deployed in containment zones and paramilitary and police personnel involved in Covid-19-related activities. HCQ can be given to asymptomatic household contacts of laboratory-confirmed cases. The recommendations come with some caveats — the drug should be discontinued if it causes side-effects such as cardiomyopathy and rhythm (heart rate) disorders.

making-it-clear


The drug is not to be given to people known to have retinopathy, hypersensitivity to HCQ or G6PD deficiency, a condition that causes red blood cells to break down. The drug is not meant for prophylaxis children under 15 years of age and pregnant women. ICMR has made it mandatory for the drug to be given under strict medical supervision, on the prescription of a registered medical practitioner and with informed consent.

The recommendations were based on an assessment of HCQ prophylaxis among 1,323 healthcare workers, which indicated mild adverse effects such as nausea (in 8.9% of the workers), abdominal pain (7.3%), vomiting (1.5%), hypoglycaemia (1.7%) and cardiovascular effects (1.9%).

The experts also found data from India’s pharmacovigilance programme, which showed 214 reported instances of adverse reactions associated with prophylactic HCQ use. Seven were serious cases, of which three had ECG irregularities.

An investigation from three Central government hospitals in New Delhi indicated that healthcare workers involved in Covid-19 care who were on HCQ prophylaxis were less likely to be infected than those who were not on the drug.

An observational prospective study at the AIIMS in New Delhi showed that 248 of 334 healthcare workers who took HCQ prophylaxis had a lower incidence of coronavirus infection than those who didn’t take the drug.
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