Punjab govt starts monitoring sale, distribution of COVID-19 drug Dexamethasone

Punjab government has started to monitor and control the sale of  Dexamethasone (injection and tablet) in a bid to prevent the steroid's profiteering and hoarding after the Oxford University confirmed on Tuesday that it can be used to save the life of critically-ill coronavirus patients.  

The scientists believe the drug, which is easily available and cheap, could be of huge benefit in poorer countries with high numbers of Covid-19 patients.

The doctors in Pakistan, however, are already prescribing the medicine to seriously ill coronavirus patients. “We are already prescribing the dexamethasone, both in the public and private sector, to patients with coronavirus having infiltrated into their lungs,” confirmed Prof Dr Irshad Hussain, former head of Department of Medicine at King Edward Medical University (KEMU)/ Mayo Hospital, Lahore.

However, the study reinforces the treatment after a successful trial with a definitive result of considerable reduction in mortality among critically-ill Covid-19 patients.

Prof Irshad Hussain said that the drug improved oxygen saturation of serious COVID-19 patients and also averted their admission to hospitals. “When the body's immune system overreacts to fight off coronavirus, it suppresses the cytokine storm,” he added.

However, he said, the drug does not respond to certain serious patients. “Therefore, replacement medicines such as Actemra (Tucilizumab) are being trial-run,” he added.

Noor Muhammad Mehr, an eminent pharmacist and drug lawyer, said that the successful trial of Dexamethasone on coronavirus patients could turn fortunes of serious COVID-19 patients in countries like Pakistan.

Dexamethasone, he says, is a type of corticosteroid medication, which is used to reduce inflammation in a range of other conditions such as rheumatoid arthritis and asthma, a number of skin diseases, severe allergies, chronic obstructive lung disease, croup, brain swelling, ocular pain following ophthalmic surgery, and along with antibiotics in tuberculosis. 

In adrenocortical insufficiency, he says, it should be used together with a medication that has greater mineralocorticoid effects such as fludrocortisone. In preterm labour, he said, it may be used to improve outcomes in the baby’s health.

Noor Mehr said that the drug, Dexamethasone, was easily available in the market under various brand names, which is being sold between MRP 45 and 300. “It may be taken orally or as an injection into a muscle or intravenously,” he said, adding that the effects of Dexamethasone are frequently seen within a day and last for about three days.

Meanwhile, in reference to recent developments in the treatment of COVID-I9 where Dexamethasone may be effective in the treatment of the infectious disease, the chief drug controller wrote a letter to drug controller/deputy drug controller/drug inspector, Punjab, saying that monitoring and control of the sale of the said drug was of utmost importance in current circumstances, so that sufficient quantities be made available for the treatment of COVID-I9 patients. 

Thus, he directed the officials to monitor the distribution of the drug. The respective drug inspector should obtain the current stock position from the distributors of the relevant brands of injection and tablet and report to the Chief Drug Controller (CDC) office. Furthermore, all the drug inspectors should ensure the sale of the drug strictly on the prescription of the registered medical practitioners.

It is further directed that the drug inspectors should also reveal the brands of Dexamethasone currently available in the market, along with their distribution setups and submit their reports to the CDC office by Wednesday (today) till 12 PM.

The Punjab government is in the process of a trial-run of Actemra (Tucilizumab) on critically-ill coronavirus patients to see its efficacy and further recommendation accordingly.