By Rachna Khaira CHANDIGARH —13 Apr 2020
For the past couple of weeks, Paramjit Kaur, a 48-year-old school teacher in Mohali, Punjab, has been trying desperately to find tablets of hydroxychloroquine (HCQ), the anti-malaria drug that is also prescribed for patients suffering from rheumatoid arthritis.
“The chemists are selling HCQ to only regular customers and not to walk-ins. Also, they provide a single strip every time. Last week, my chemist told me he would get more supply but this time when I visited, it’s out of stock,” Kaur told HuffPost India over the phone.
Kaur is now down to her last two tablets and is dreading the recurrence of swelling and acute pain in her joints if she skips her daily dose. Her mother-in-law, who also suffers from the same disease, has already switched to ayurvedic medicine.
As India prepares to begin exporting HCQ again to some countries after a brief ban, pharmacists and patients say it has almost disappeared from the market. Apart from malaria, the drug is also prescribed to patients (mostly women) suffering from auto-immune diseases such as lupus and rheumatoid arthritis.
While state authorities insist there is no domestic shortage, multiple news reports have quoted panicked patients who are unable to access the drug that keeps their pain in control.
Like many other medicines, the ongoing national lockdown has disrupted the supply of HCQ as well. But the bigger reason for the shortage may be the unproven claim—most famously by US President Donald Trump—that the drug could help COVID-19 patients.
As some states insist on prescriptions and patients resort to panic-buying, worried doctors warn that it’s the chronic sufferers who may need the drug more than potential COVID-19 patients.
Doctors across cities told HuffPost India that they currently see no choice but to give priority to the patients who need the medicine the most.
In Chennai, many hospitals that still have HCQ tablets in their in-house pharmacies are selling them only to patients suffering from severe pain and swelling in joints.
“We are facing acute shortage of HCQ from the last few weeks and are left with no option but to prioritize our patients according to their health condition,” said Dr. Sham Santhanam, a city-based rheumatologist.
Dr. Puja Srivastava, a rheumatologist based in Ahmedabad—one of the manufacturing hubs of the drug— said that her patients too are unable to find the medicine.
“If the supply chain was disrupted in other parts of the country, HCQ should have been available here as the city is a major production hub for the drug. But my patients too are facing scarcity from the last few weeks,” she said.
Not just malaria
According to the American College Of Rheumatology, hydroxychloroquine (Plaquenil), is a “disease-modifying anti-rheumatic drug (DMARD)”, meaning that it helps reduce the pain and swelling that come with arthritis. It may prevent joint damage and reduce the risk of long-term disability.
For lupus patients, there is a more serious threat as there is a possibility of relapse of Systemic Lupus Erythematosus (SLE) if the doses are discontinued. Lupus is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissues in many parts of the body.
“HCQ is used for prophylactic purposes and prevents the relapse of the disease in Lupus patients. It is an immunosuppressant. Relapsing of this disease can cause serious complications in such patients,” said Dr K.L. Gupta, former Professor and Head of the Nephrology Department, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh.
Patients suffering from these diseases are usually put on long-term doses. The daily recommended doses of hydroxychloroquine sulphate for such patents range between 250 mg and 400 mg. ( Huffpost )
