Karnataka falls short of two vital Covid drugs recommended by Centre

Out of the six Covid medicines that the Centre asked Karnataka to stock in varying quantities, the state is falling short of two: Dexamethasone and Posaconazole injections.

Against the Government of India’s mandate of 11 lakh, the state has about 50,000 Dexamethasone steroid injections, while it has just 1,200 Posaconazole jabs against the recommended stockpiling of 10,000.

State Health Commissioner D Randeep said Karnataka State Medical Supplies Corporation Limited (KSMSCL) has issued a purchase order to meet the buffer stock requirement of Dexamethasone within a week.

The injection used in the treatment of chronic obstructive lung disease is not fast moving for the time being, the commissioner said, adding: “We don’t expect any immediate shortage.”

Antifungal drug Posaconazole is needed to treat patients with mucormycosis if they are resistant to Liposomal Amphotericin B, the first choice of drug.

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Health Minister Dr K Sudhakar said his department is unable to find Posaconazole in the market.

While Dexamethasone or steroids are the cornerstone of any severe Covid management, Dr Vivek Padegal, director of Pulmonology at Fortis Hospital-Bannerghatta Road, pointed to an alternative drug, Methylprednisolone, which the state has a stock of 2.22 lakh.

“I don’t think there is a shortage of Methylprednisolone, but we ran out of everything in the second wave,” Dr Padegal said.

“The requirement for Posaconazole can be felt only four to 12 weeks after the patient’s recovery from Covid when they get fungal infection. Even if it is just 5% of the hospitalisation, it is significant,” he said.

While hoping that only fewer patients will be on steroids with the Omicron variant, Dr Padegal said Posaconazole is also needed in treating patients with blood infection and cancer. “That may perhaps explain the drug’s shortage in the market,” he said.

Manipal Hospitals pulmonologist Dr Satyanarayana Mysore told DH that Dexamethasone is a lifesaving anti-inflammatory drug.

“Out of the four arms of the recovery trial in the UK, Dexamethasone was the only drug that proved to be a lifesaver,” he said. “Until now, it is the only drug with massive evidence (as a lifesaver).”

He said patients require 6 mg of Dexamethasone per day for 10 days. “It shouldn’t be given until the seventh day of illness, unless there is increasing cough, CRP, fluctuating oxygen levels, and breathlessness,” he said. “We give it if the patient’s cytokines are elevated or find new infiltrates on the X-Ray.”

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