The Indian Council of Medical Research (ICMR) on Friday issued a revised advisory recommending the usage of anti-malarial drug Hydroxychloroquine (HCQ) as a preventive medication for healthcare and other front line workers deployed in non-COVID and COVID areas respectively.
The recommendation was made by the Joint Monitoring Group under the Chairmanship of Directorate General of Health Services (DGHS) including representatives from AIIMS, ICMR, NCDC, NDMA, WHO and experts drawn from Central Government hospitals.
According to the team, three new categories have now been recommended the prophylactic use of HCQ-all asymptomatic healthcare workers involved in containment and treatment of COVID-19 or working in non-COVID hospitals/areas of COVID hospitals/blocks, asymptomatic frontline workers such as surveillance workers deployed in containment zones and paramilitary/police personnel involved in COVID-19 related activities and asymptomatic household contacts of laboratory-confirmed cases.
However, the team barred the usage of HCQ as a preventive medication among persons with known cases of retinopathy, hypersensitivity to HCQ or 4-aminoquinoline compounds, G6PD deficiency and pre-existing cardiomyopathy and cardiac rhythm disorders.
The drug is also not recommended for prophylaxis in children under 15 years of age and in pregnancy and lactation, the advisory said.
“Rarely the drug causes cardiovascular side effects such as cardiomyopathy and rhythm (heart rate) disorders. In that situation, the drug needs to be discontinued,” it added.
“The drug can rarely cause visual disturbance including blurring of vision which is usually self-limiting and improves on discontinuation of the drug,” it further said.
The ICMR has also mentioned some key considerations on the usage of HCQ.
According to the advisory, the drug has to be given only on the prescription of a registered medical practitioner and it is advised to consult with a physician for any adverse event or potential drug interaction before initiation of medication, it said.
Healthcare or front line workers should use PPEs in accordance with the guidelines issued by the health ministry and they should be advised to consult their physician (within their hospital/surveillance team/security organisation) for any adverse event or potential drug interaction before initiation of medication, the advisory said.
If anyone becomes symptomatic while on prophylaxis, he/she should immediately contact the health facility, get tested as per national guidelines and follow the standard treatment protocol, it said.
Apart from the symptoms of COVID-19 (fever, cough, breathing difficulty), if the person on chemoprophylaxis develops any other symptoms, he should immediately seek medical treatment from the prescribing medical practitioner, the advisory said.
All asymptomatic contacts of laboratory-confirmed cases should remain in home quarantine as per the National guidelines, even if they are on prophylactic therapy, it added.