Antivirals in NZ

[Kiwidi]

Just received this message from my GP after a query about availability of anti virals. Has anyone heard of this inhaler and whether or not it is effective? Omicron is knocking at our door🙄

She has sent me a prescription for it.

There is nothing about the use of anti viral medication on our local health pathways for Drs.

This may be updated soon but I guess I would have to discuss with a specialist if I was thinking this might be useful for a particular patient, eg yourself.

The only other intervention which can be helpful for immunocompromised patients who have covid 19 infection, is using pulmicort inhaler within the first 14 days of infection, for up to 14 days. It has been shown to be safe and reduce the need for oxygen, ventilation, respiratory complications.

[Newdawn Administrator]

It would appear that NICE withdrew this medication as a recommended Covid treatment in Dec ‘21 so it’s not used in the U.K. as a therapeutic.

‘The inhaled corticosteroid budesonide should no longer be offered to patients with COVID-19 unless they are part of a clinical trial, the National Institute for Health and Care Excellence (NICE) has said.’

pharmaceutical-journal.com/...

Unfortunately the article appears to require a subscription.

‘Budesonide, sold under the brand name Pulmicort among others, is a medication of the corticosteroid type. It is available as an inhaler, nebulization solution, pill, nasal spray, and rectal forms. The inhaled form is used in the long-term management of asthma and chronic obstructive pulmonary disease. Wikipedia

It’s not a treatment that I’m familiar with in general usage for Covid and although I’m not qualified to comment with any authority, it does seem to target severe lung dysfunction which isn’t a recognised feature of omicron. Others may have better information but I’d be puzzled to receive this as a precautionary measure unless I had a pre-existing lung problem.

Are you asthmatic?

Newdawn

[Kiwidi in reply to Newdawn]

Thank you. No I am not. My lungs are very strong!

[LeoPa in reply to Newdawn]

There was a prior discussion about this. It helps preventing the cytokine storm. During the alpha wave very few with asthma using budesonide ended up in the hospital. There are better option now. If nothing else was available I'd take it.

[Newdawn Administrator in reply to LeoPa]

I think if there was nothing else available, I’d try most things Leo but it wouldn’t be given here. However, when I had the Omicron variant, I wouldn’t have felt the need for this because like Kiwi, I don’t have asthma and the symptoms were not consistent with the purpose of this inhaler.Just a shame if this is the only thing being offered for the immunocompromised however.

Newdawn

[LeoPa in reply to Newdawn]

It's not the symptoms or asthma. It prevents the cytokine storm (to some extent) that killed many.

[Newdawn Administrator in reply to LeoPa]

Interesting then that NICE here recommended abandoning its use early in the pandemic. I’d actually applaud the doctor who prescribed it however in the absence of more credible, up to date alternatives specifically geared towards Omicron which manifests itself quite differently to previous variants. I think the issue is, ‘why is this the only therapeutic being offered to our immunocompromised friends in NZ’?

I can totally understand why they’d be asking those questions.

Newdawn

[guzzifan]

Well, that's pretty much as expected for us here in NZ.

On the radio this morning they interviewed Dr Bryan Betty, medical director of the RNZCGP, about the antiviral drugs paxlovid and molnupiravir. Although the Govt has agreements to purchase 60K doses of each (wow!), neither is approved for use here yet. Medsafe is still evaluating Paxlovid, and no application has been made for molnupiravir to be evaluated. The paxlovid is expected to arrive in April (pending approval).

So, Kiwis, don't hold your breath waiting for these drugs. Best to just hold your breath to stop Covid getting in!

rnz.co.nz/news/national/460...

rnz.co.nz/national/programm...

[Kiwidi]

Thank you. Probably won’t use it.

[Kiwidi]

Thank you fellow kiwi. Very sad again that we are so far behind the rest of the world in our ‘neck of the backwoods’ - the anti viral Ronapreve was approved on 21/12/21 but my GP knows nothing about it. We have had so much time to get prepared for this but unfortunately the immunocompromised have been forgotten (again!)

[guzzifan in reply to Kiwidi]

Kiwidi, just be aware that ronapreve loses a lot of its effectiveness against the omicron variant of Covid-19.

roche.com/dam/jcr:dfe6dcb4-...

[guzzifan]

Hi Kiwidi, If you're still looking at this thread, take a look at Dr Rob Weinkove's talk today:

youtu.be/wSet-9sB-VM(Not working as expected?)

About 32 minutes into the talk, he discusses drugs for Covid-19 available (and not available) in NZ.

Cheers -Jim.

[Kiwidi in reply to guzzifan]

Thanks Jim

Yes Rob Weinkove gave a good overview of the anti- virals (available and not available) Surprised that he said some could be prescribed without being approved by Medsafe- or did I get that wrong?

[guzzifan in reply to Kiwidi]

Yes, I'm sure he said they can prescribe them without the drug being approved by Medsafe, it's just more complicated (for them).