The All India Institute of Medical Sciences (AIIMS) and the Indian Council of Medical Research (ICMR) Covid-19 national task force has made the recommendation to drop the use of these two drugs in its revised guidelines.

 

The clinical guidance version dated May 19, 2021, prepared jointly by the AIIMS and ICMR -- national task force for Covid-19 and the Joint Monitoring Group was reviewed on August 20, in the context of emerging evidence of Ivermactine and hydroxychloroquine. After review, the medicines were removed from the guidance document.

 

The reasons behind dropping Hydroxychloroquine also included no mortality benefit, increases the risk of address drug effect (ADE) when co-administered with Azithromycin.

 

"HCQ may be considered for removal from guideline, with recommendation to use with caution only in clinical trial setting (since there is some genuine uncertainty regarding the possible benefit for severe cases and in low dose). Many studies showing increased mortality risk (10/13) and low mortality benefit of HCQ(2/13). Considering evidence for increased ADE(6/13) , especially with azithromycin and only one study showed no increase in ADE(1/13)," said the revised guidelines for Covid management.

 

In the case of Ivermectin, it said, " Ivermectin may be considered for removal from guideline, with recommendation to use only in clinical trial setting until warranted by more conclusive large-scale randomized controlled trials due to the reason that many studies show mortality benefit, and no evidence for increased mortality. High risk of bias in many studies (especially with the ones showing benefit), level of certainty for mortality benefit is low."