COVID-19 treatment: Experts worry excessive usage of Tocilizumab, Remdesivir can do "more harm than good"

As the number of coronavirus cases continue to surge in India, doctors are experimenting with a lot of medicines and therapies to boost recovery. Till date, there is no one approved medicine or treatment plan fully approved for use. However, usage of medicines like Tocillizab and Remdesivir, which have been praised for their efficacy have been in use, with the drugs showing some promise.

However, some experts are now warning that while these medicines aren't true COVID-19 medicines, unintentional use of the same can lead to hazardous side-effects, including bloodstream infections and other immune problems, particularly with Tocilizumab.

Tocilizumab is an immunosuppressant, which has been given the green light by the government authorities to be used as an "investigational therapy". In the same way, another anti-viral medicine, Remdesivir was okayed for use in emergency cases only. HCQ is another medicine which has been used (even as controversies marr its feasibility in fighting COVID-19).

Medicines like remdesivir have been found to fasten recovery time and lessen the viral load in the body. Tocilizumab, meanwhile, works as an immunosuppressant to fight respiratory distress immune complications, which can happen when the virus begins to attack the body's immune system. If used correctly, a medicine like tocilizumab can help fight cytokine storm in moderate and severe cases of COVID-19.

However, it's important to know that all drugs primarily being used right now are being used "off-label", i.e, based on clinical discretion and a lot of studies are needed before we conclude their usage as safe. Tocilizumab, as experts say are immuno-suppressants. If the dosage is not monitored, it can lead to an array of complications like blood infections, health issues, weight fluctuations, digestion issues and in many cases, also weaken the immune system. Hence, even in non-COVID-19 cases, the dosage and administration of the drug need to be closely monitored.

One of the most feared complications of a COVID-19 diagnosis is cytokines, which can happen in severe cases when the virus lodged in the body complicates immune response and makes the body attack itself, instead of the virus. This, in turn, could lead to major problems, including severe organ damage as well as fatality. Medically, this response has been referred to as a cytokine storm.

Interestingly, the workability of these medicines has also fueled a price hike. This has been particularly seen with medicine like Tocilizumab. Not only has the demand for the "life-saving" drug led to an apparent inflammation of prices (fluctuating between Rs. 45,000 to even 1,00,000 per injection dosage), in many places, the drug is also being black marketed.

The monopoly of drug production has also become a cause of concern. Tocilizumab is currently only manufactured by pharma major Roche. In India, it is imported and marketed by Cipla, which is adding to the demand factor. As the need for the drug in severe cases flare-up, several stories of patients families running from one place to another (or even crossing cities) have added to the apathy.

Until and unless scientists find a cure or vaccine (which is being worked on urgently), there is no reliability that any medicine would work 100%. However, anti-inflammatory drug, Dexamethasone, which is considered to be a low-cost steroid drug used to treat inflammation is being vouched as a good alternative to other mediicnes in use. It also has lesser known side-effects and has been found to cut down mortality rates in severe cases of COVID-19. A single dosage of dexamethasone, which is readily available in India costs less than Rs. 10. However, again, it's an experimental medicine and more studies are needed to conclude the benefits of the same.