Ivermectin, an antiparasitic drug, being touted as a possible treatment for the coronavirus infection will not be included in the Health Ministry's Clinical Management Protocol for COVID-19, sources said on October 22.

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Some states including Uttar Pradesh are already using the drug-off label not only as a treatment option but also as a prophylaxis against COVID-19, a source said. Already widely used against intestinational parasites and scabies, it is relatively a safe and cheap drug. The experts of the ICMR's National Task Force for COVID-19 and the Joint Monitoring Group held its meeting on October 22 to deliberate on whether the drug should be included in the national treatment guidelines. "Following deliberations, experts decided not to include Ivermectin in the national clinical management protocol for COVID-19 because of lack of sufficient evidence on its efficacy based on randomised trials held in India and abroad," a source said.

The Health Ministry has allowed the use of remdesivir for restricted emergency use purposes in moderate cases under investigational therapies" in the Clinical Management Protocol for COVID-19. The ministry has also okayed off-label application of tocilizumab, a drug that modifies the immune system or its functioning, and convalescent plasma for treating COVID-19 patients in moderate stage of the illness as investigational therapies".

It also recommended hydroxychloroquine in patients during the early course of the disease and not on critically ill patients. The centre has also included an inexpensive, widely used steroid dexamethasone in treatment protocols for COVID-19 patients in the moderate to severe stages of their illness among other therapeutic measures. The ministry advised use of dexamethasone, which is already used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects, as an alternative choice to methylprednisolone for managing moderate to severe cases of coronavirus infection.