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Jakarta Post

Public urged not to buy dexamethasone for COVID-19 treatment

  • Moch. Fiqih Prawira Adjie

    The Jakarta Post

Jakarta   /   Thu, June 18, 2020   /   06:33 am
Public urged not to buy dexamethasone for COVID-19 treatment A pharmacist displays an ampoule of dexamethasone at the Erasme Hospital amid the COVID-19 outbreak in Brussels, on Tuesday. (REUTERS/Yves Herman)

A public health expert and a community that monitors pandemic effects in Indonesia have warned the public to avoid rushing to buy dexamethasone, an inexpensive and widely used corticosteroid medication, which has been hailed as a “major breakthrough” in COVID-19 treatment.

The drug has become the latest hope amid the pandemic after researchers, led by a team from the University of Oxford in the United Kingdom, conducted research that yielded promising results and which has received support from the World Health Organization.

The researchers administered dexamethasone, which is used to reduce inflammation in other diseases, to more than 2,000 severely ill COVID-19 patients, reported Among those who could only breathe with the help of a ventilator, the drug reduced deaths by 35 percent, and by one-fifth in other patients receiving oxygen only, according to preliminary results of the Recovery Trial. There was no benefit among patients who did not require respiratory support.

Nevertheless, Pandu Riono, a public health expert from the University of Indonesia that specializes in risk networks for emerging infectious diseases, urged the public not to buy the drug for individual treatment.

“The drug cannot be taken carelessly,” Pandu told The Jakarta Post on Wednesday, adding that it was not intended for regular consumption and had the risk of side effects, which may range from a bloated face to internal organ damage, without medical supervision.

He said that dexamethasone was effective in mitigating the “cytokine storm” -- a severe immune reaction in which the body releases too many cytokines into the blood too quickly -- that might occur in severe cases of COVID-19.

Dexamethasone was also effective in treating inflammations in cases of allergies where it might cause shortness of breath, he added.

Read also: WHO trial suspends hydroxychloroquine treatment for new COVID-19 patients

Several studies have also mentioned shorter hospital stays among pneumonia patients administered with the corticosteroid medication.

“In the [Oxford] study, they used the drug on hospitalized patients who were severe cases already on ventilators for breathing assistance,” Pandu said. “The study showed a significantly reduced mortality rate [...], but it should only be administered to those with severe symptoms.”

Meanwhile, pandemic monitoring community KawalCOVID-19 (Guard against COVID-19) warned the public over possible misperceptions surrounding the drug, especially after it was widely covered by the media.

“The articles [reporting on the drug] provide correct information, such as that dexamethasone was given to hospitalized patients with severe symptoms.

“However, we have a problem with the public’s literacy rate. We’re concerned that the public might mistakenly believe the drug is a cure for COVID-19,” KawalCOVID-19 cofounder Elina Ciptadi told the Post on Wednesday.

“We fear a possible disconnect between media reports and the public’s reaction,” she said, adding that a scarcity of the drug due to rush buying could occur if the public was not properly informed.

Elina’s concern was based on a recent situation when chloroquine received wide endorsement, including from President Joko “Jokowi” Widodo, in treating the coronavirus disease in the country. Such a move prompted a spike in sales of the said drug on e-commerce platforms in March, which then forced the Health Ministry and the Indonesian Doctors Association (IDI) to issue a warning against chloroquine buying by individuals over fears of diminished stock.

Read also: As Jokowi promises millions of chloroquine doses for COVID-19, experts warn against self-medication

As of Wednesday, a search for dexamethasone on e-commerce platforms yielded hundreds of results. The price of the drug ranges from Rp 2,000 (14 US cents) for one strip containing 10 tablets of 0.5-milligrams to Rp 190,000 for one box containing 100 ampoules for injections.

“With the latest reports, we are worried that the availability of the drug will be very limited [if people stockpile], even though dexamethasone is also used to treat people with autoimmune disease,” Elina said.