State running out of drug to treat mucormycosis

Many families, hospitals finding it difficult to source them

The supply of the anti-fungal drugs Liposomal Amphotericin B or Amphotericin B, which are vital for treating mucormycosis, is drying up in Tamil Nadu with many patients’ families and hospitals finding it difficult to source them.

Mucormycosis, a serious fungal infection now predominantly affecting people post-COVID-19 with uncontrolled diabetes, has been on the rise in several parts of the country. With cases gradually increasing in Tamil Nadu as well, the demand for the drug has shot up.

An ENT specialist from a leading private hospital in Chennai said that Liposomal Amphotericin B or, in its absence, Amphotericin B was the first line of drug for mucormycosis and there were no effective alternatives. “Though Tamil Nadu is not yet seeing as many cases compared to other States, the drug shortage is already being felt,” he said.

While requests seeking help for procuring the drug were plenty on social media from many other States, they had now increased in Tamil Nadu as well.

Two people from Chennai The Hindu spoke to, said they found it extremely difficult to source the drug. One of them said that after desperate parallel attempts by the family failed, the private hospital where his father was admitted managed to source it at the last moment.

A woman from Madurai said that her father-in-law, who recovered from COVID-19 recently, was diagnosed with mucormycosis and had already lost sight in one eye. “The doctors at the private hospital have now administered first dose of the drug and are in need of more doses. We are trying to source but not finding it anywhere,” she said.

A doctor at Rajiv Gandhi Government General Hospital in Chennai said there was adequate supply of the drug at the moment although it was treating only one case of mucormycosis at present.

S.A. Ramesh of Lifecare Pharma Private Ltd., a pharmaceutical distributor and the president of Chennai Chemists and Druggists’ Association, said that there were four or five Indian companies manufacturing the drug. “However, the active pharmaceutical ingredients (API) needed for the manufacturing were largely imported, particularly from China,” he added.

He said as the demand for the drug was not high earlier, most companies possibly stocked up APIs only in limited quantities. “A number of factors like expiry time and the need for cold chain storage may influence how much of APIs companies generally stock up. Because of such factors, it is becoming difficult for these companies to meet the demand,” he added. He said he was hearing about difficulties in importing APIs from China due to certain restrictions, but was not sure how far it was accurate.

Likely to be imported

A few senior ENT specialists said China had stopped sending certain raw materials needed for the drug for the past few months due to the policies of the Indian government. The option of importing from them other countries must be explored.

Mansukh Mandaviya, Union Minister of State for Chemicals and Fertilisers, tweeted on Tuesday that a strategy had been chalked out to ramp up domestic production and also to import the drug from “all over the world”.

Meanwhile, a senior official from Tamil Nadu’s Medical and Family Welfare Department, said that an order for 5,000 vials of Liposomal Amphotericin B had been placed through Tamil Nadu Medical Services Corporation to meet the demand.

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