Explained: Is Remdesivir a life-saving drug; what alternatives are available?

At a time when the country is witnessing a massive surge in coronavirus cases and an insurmountable strain on the health infrastructure antiviral drug Remdesivir has become the most sought after drug to treat hospitalised coronavirus patients In fact the centre government has banned the export of Remdesivir from April 11 in order to fight its shortage However the Indian medical fraternity has been claiming that it is not a lifesaving drug and its unnecessary use is unethicalMidday online spoke to DrBipinJibhkate Consultant critical care medicine and ICU director Wockhardt Hospital Mumbai to understand the role of Remdesivir in the battle against coronavirus and if it is really a ldquomagic bulletrdquoWhat is RemdesivirldquoRemdesivir was approved as the first drug to treat COVID19 by the US Food and Drug Administration in 2020 When the entire world was struck by the COVID19 pandemic the drug was said to be useful in dealing with SARSCOV2 and it was given authorization for emergency use It is being used ever since and now that has led to a severe scarcity of the drug in the countryIt is an antiviral drug that is being used in the treatment of COVID19 patients who come in severe and critical conditionIt has to be administered early between 612 daysThis antiviral drug was earlier manufactured in 2014 to fight the Ebola virus and the Middle EastRespiratory Syndrome MERSrdquoWhy is it importantldquoRemdesivir is making headlines as it is thought to be a miracle drug Its demand has gone up in the country amid the second wave of Coronavirus This drug is given in a small subset in terms of shortening the time to recovery by approximately five daysof patients when it comes to Coronavirus Since it has been used indiscriminately in those infected with the virus it has led to a scarcity of the drugrdquoHow can it fight COVID19ldquoRemdesivir was used as we didnrsquot have any antiviral drugs This drug was proven to be beneficial for those who required hospital admission and were on oxygen This antiviral drug can beopted by people who are admitted to the hospital Remdesivir is injected intravenously and it tends to subsume itself into the genetic material of the virus by preventing the replicating enzyme from making new copies of the virusrdquoHow effective is itldquoIt is said to treat and relieve severely ill COVID19 patients But there is no clinical trial or evidence to support this claimIn India the Ministry of Health has also recommended it as an investigational therapy in their COVID19 management protocol document However it is not clarified whether it is a lifesaving drug or a magical bulletThis drug is just used because we do not have any antiviral drugs This drug cannot be taken as a regular antibioticrdquoWho can take RemdesivirldquoThis drug is given to moderately or severely ill COVID19 patients in the hospital and who are on oxygen For administering the drug onersquos liver and renal function tests have to be monitored first It canrsquot be given to those patients who have liver and renal failure It cannot be given to those who are asymptomatic or have a low viral loadrdquoAre there any sideeffectsldquoThe listed sideeffects of this drug can be an infusion reaction with symptoms like low blood pressure nausea allergic reactions and vomiting It can also lead to fatal allergic reactions in peoplerdquoCan it bring down the mortality rateldquoBased on available evidence Remdesivir that is given to hospitalized patients didnrsquot reduce mortality it didnrsquot cut down the duration of hospitalization and it didnrsquot affect the progression of the disease Remdesivir that is authorized for the treatment of coronavirus fails to prevent deaths among patients or reduce the hospital stay revealed a large study named lsquoSolidarity Therapeutics Trialrsquothat isconducted by the World Health Organization WHOrdquoIs there an alternative of RemdesivirldquoTocilizumab injection is widely used to treat critically ill patients infected with Coronavirus This drug can be used when the patient goes into respiratory failure This drug will help your respiratory system by blocking IL6 receptors A single dose of this drug should not exceed more than 800 mg Favipiravir drug is used in the initial stages that is first 78 days and given to moderate to severely ill patients If the patient has gout heshe needs to be careful and the patient will have to be monitored for liver function before giving it Dexamethasone is a steroid for those with hypoxia oxygenation problems It is not to be used in the early phase as it can be dangerous for the patient It has to be started after 10 days and used for the ones with respiratory failure If it is used too late then also it will not be beneficial It should be used with caution in patients with high sugarHydroxychloroquine was also used for the treatment of COVID19 But there is no clinical evidence available about its efficacyrdquoHow to source RemdesivirWith every passing day sourcing this antiviral drug is becoming more difficult However leads can be gathered from the official websites of the producers of Remdesivir Seven Indian companies Mylan Hetero Jubilant Life Sciences Cipla Dr Reddys Zydus Cadila and Sun Pharma produce Remdesivir injectionsBesides social media toolkits and helpline numbers have also proved to be helpful in this critical hourHow much does it costA vial of Remdesivir can range anywhere between Rs 899Rs 3000Are you looking for beds oxygen plasma meals Remdesivir etc in Maharashtra Mumbai Pune and Thane Tap on this link