Even as the National Task Force on Covid of the Indian Council of Medical Research (ICMR) on Wednesday rejected the inclusion of antiviral drug Molnupiravir in the coronavirus treatment. guidelines for the fourth time, the Gujarat government has placed an order for 4.85 lakh tablets. ICMR said the drug’s known and unknown harms far out- weigh its claimed benefit. However, the Gujarat government has decided to go ahead with its January 8 tender.

The Gujarat Medical Services Corporation Limited (GMSCL), on January 8, 2022, floated a tender to buy 4.85 lakh Molnupiravir 200 mg tablets or capsules at expected use during the third Covid wave in the state. The last date to fill the ten- der is January 15.

Prabhav Joshi, the Managing Director (MD) of GMSCL, told Mirror, The tender process will continue as the state has an intent to purchase Molnupiravir. While it hasn’t been included in ICMR’S Covid protocol, the pandemic is a crisis and we want to keep all our options open going ahead.

When asked whether public sector hospitals intended to buy Molnupiravir despite safety concerns raised at the Centre, Joshi said, Earlier, Hydroxychloroquine and Fávipiravir were touted Covid cures and later removed from treatment protocols. Molnupiravir is a new drug and its procurement process takes time. We want to be sure that we have it in hand in case new evidence emerges.

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ICMR Director General Dr Balram Bhargava said,We had extensive deliberation and the final conclusion was that Molnupiravir has certain risks that warrant caution in its use. Experts opined that there is a ram- pant and irrational use of Molnupiravir. Efforts should be made to restrict its use as known and unknown harms far outweigh its claimed benefit.

Dr Maharshi Desai, who is a member of the Gujarat Covid Task Force, said, Till now we have seen only mild symptoms. Mostly the elderly and co-morbid patients need specific treatment. Molnupiravir has got Teratogenicity (causing defects in foetus) and cartilage damage in children. It has side effects as well and cannot be prescribed indiscriminately. Every medicine has a risk-benefit ratio. You need to know when and how to use it. Just because it is available, it need not be consumed.

Another Gujarat Covid Task Force member Dr Tushar Patel, a Critical Care Intensivist, said it should only be used in high-risk patients and that too,only if necessary, since it has side effects. Most people are recovering even without antibiotics this time. Young patients especially should not be given Molnupiravir.

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