New weapons – and precautions – as controls are lifted on COVID ‘magic bullets’

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From Thursday (September 1), patients with COVID-19 can buy prescription antiviral drugs from pharmacies as authorities ease access to weapons against the virus.

“Health agencies are providing easier access to these drugs while maintaining patient safety,” said Dr Udom Kachintorn, chairman of Thailand’s committee on public health reform.

Pharmacists will be able to fill prescriptions for Favipiravir, Molnupiravir and Paxlovid. Pharmacies are required to purchase these drugs from importers certified by the Food and Drug Administration (FDA) and to record all sales to customers. The registrations will be monitored by the authorities, just like the sales of steroids.

Approved suppliers can sell antiviral drugs to hospitals, clinics and pharmacies in accordance with regulations. Prices will not be controlled as the government believes that market competition will ensure fairness and affordability.

Use with caution

FDA Secretary General Dr. Paisarn Dunkum said that although the Center for COVID-19 Situation Administration (CCSA) allowed the public to buy antiviral drugs starting September 1, it should understand that everyone doesn’t need it.

“You can only take them if they have been prescribed for you by a doctor,” Paisarn said. “So if you don’t have a prescription, pharmacies won’t sell you antiviral drugs.”

Public Health Ministry Permanent Secretary Dr Kiattibhoom Vongrachit added that antiviral drugs should not be stored in household medicine boxes as they have side effects and expiry dates.

“Like antibiotics, they should not be taken lightly or stored away,” he said.

Side effects of favipiravir, for example, include diarrhea, hyperuricemia (increased uric acid), neutropenia (low white blood cell count), nausea, vomiting, and abdominal pain. Molnupiravir, on the other hand, can cause dizziness, headache, hives, itching, rash, nausea, flushing of the skin, and vomiting. Paxlovid can cause taste changes, diarrhea, high blood pressure, or muscle pain.

Medicines also come with other precautions. For example, Molnupiravir cannot be used in patients under 18 years old.

During this time, most people who contract COVID-19 can recover with only basic fever and decongestion medication.

Beware of black market drugs

Limited access to antiviral drugs has seen demand rise on the black market over the past two years. There are discussions online about how these antiviral drugs can be acquired through outlets that bypass official channels.

An online ad offered boxes of 40 Molnupiravir 200-milligram tablets branded as “Moluzen-200” for 4,590 baht each, including delivery. Meanwhile, a course of the generic Indian version of Paxlovid can be purchased for 9,900 baht.

Such offers trick people into thinking they can keep these pills handy in case a family member gets COVID-19 and doesn’t want to see a doctor.

However, the Department of Public Health this month teamed up with the Consumer Policing Division to crack down on a gang selling antiviral pills. Authorities seized a cache of smuggled pills with a street value of around 10 million baht.

“They were smuggled into Thailand without quality control or FDA review,” Public Health Minister Anutin Charnvirakul said. “How can you trust these drugs? »

He added that the transport of contraband drugs will be destroyed to protect people who might be tempted to buy them.

The FDA said if found guilty in court, the smugglers could face up to five years in prison and a maximum fine of 10,000 baht for selling unlicensed drugs. They also risk up to three years in prison and/or a maximum fine of 5,000 baht for selling unregistered drugs.

Meanwhile, health authorities insist they have organized an adequate supply of antiviral drugs during the country’s ongoing battle with COVID-19.

In the first seven months of this year (January-July), 265.5 million tablets of Favipiravir, 12 million tablets of Molnupiravir and 275,210 vials of Remdisivir were distributed for the treatment of COVID-19.

And now that these drugs can be stocked by private hospitals, clinics and pharmacies, there is no longer a need for people to take risks with contraband antivirals, the government says.

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