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Ivermectin, hydroxychloroquine dropped from ICMR guidelines for COVID-19 treatment; here’s why

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The new guidelines allow the use of Remedesivir and Tocilizumab in specific circumstances.

Ivermectin, hydroxychloroquine dropped from ICMR guidelines for COVID-19 treatment; here’s why
The Indian Council of Medical Research (ICMR)-COVID-19 National Task Force has dropped hydroxychloroquine and Ivermectin from the clinical guidance for adult COVID-19 patients after noticing no mortality benefits and an increased risk of adverse drug effect (ADE) when co-administered with azithromycin. Hydroxychloroquine, which was approved by the US to cure malaria, does not help COVID-19 patients, as per the reports.
In the case of Ivermectin, a prescription medication to treat parasitic infections, studies showed no relation to mortality benefits and clinical recovery.
The WHO had also warned against the use of Ivermectin.
The clinical guidance made jointly by AIIMS, ICMR NTF and Joint Monitoring Group on May 19 was reviewed on August 20 in the context of emerging evidence for both medicines and concluded that both these medications can be used with caution at climax trial settings.
The new guidelines, however, allow the use of Remedesivir and Tocilizumab in specific circumstances.
The guideline suggests the use of Remedesivir in select moderate to severe COVID-19 patients on supplemental oxygen within 10 days of onset of symptoms.
Tocilizumab can be used in severe patients, preferably within 24-48 hours of the onset of severe disease or ICU admission.
The guidelines also say that those with moderate disease with SpO2 levels 92-96 per cent may take anticoagulation medicine and methylprednisolone injection.
People with mild infections must maintain physical distancing, wear masks indoors and have strict hand hygiene, the report cited.
Symptomatic patients may take antipyretics, multivitamins, and antitussives and are asked to seek immediate medical help if they experience difficulty in breathing or have a high-grade fever lasting more than five days.
For those with severe infection and increasing oxygen requirements, the guidance suggests the use of non-invasive ventilation (NIV) -- helmet or face mask interface depending on availability.
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