COVID-19 and medicines – frequently asked questions

Answers to your questions about medicines and COVID-19

Please note: Information, evidence and advice relating to COVID-19 is constantly changing. The information in this article was correct at the time of writing.

 

Is ivermectin a cure for COVID-19?

Update 27 October 2021

The Australian National COVID-19 Clinical Evidence Taskforce has issued a strong recommendation against the use of ivermectin outside of randomised clinical trials.

The Taskforce found that there is a current lack of available evidence for or against the use of ivermectin, and more robust, well-designed randomised controlled trials are needed to demonstrate whether or not ivermectin is effective.

Ivermectin is currently being investigated in the UK as part of the Platform Randomised Trial of Treatments in the Community for Epidemic and Pandemic Illnesses (PRINCIPLE) study, led by the University of Oxford. PRINCIPLE is investigating treatments that can speed up recovery, reduce the severity of symptoms and prevent the need for hospital admission in people at risk of serious illness from COVID-19. The study has so far recruited more than 7000 volunteers.

On 10 September 2021 the Therapeutic Goods Administration (TGA) placed new restrictions on the prescribing of oral ivermectin. With the introduction of these restrictions, GPs can only prescribe ivermectin for TGA-approved conditions, scabies and certain parasitic infections. Specialists including infectious disease physicians, dermatologists, gastroenterologists and hepatologists (liver disease specialists) will be permitted to prescribe ivermectin for other unapproved indications if they believe it is appropriate for a particular patient.

Read our article looking at the current research for this medicine

 

Where can I find out more about masks or face coverings?

Last updated: 27 October 2021

Wearing a face mask is now recommended by Australian health experts in areas where community transmission of COVID-19 is high, if physical distancing is not possible.

State government updates on mask wearing can be found on the Australian Government Department of Health website.

The Australian Commission on Safety and Quality in Health Care has good information about face masks, and frequently asked questions about how to use them safely and effectively:

 

I take blood pressure-lowering medicine. What does COVID-19 mean for me?

Last updated: 20 July 2020

Keeping your blood pressure under control through medicines (if you’re taking any) and lifestyle measures is a top priority during the COVID-19 pandemic. It’s important to continue taking your regular blood pressure-lowering medicines as prescribed by your doctor or nurse practitioner.

If you haven’t already made an easily accessible list of the medicines that you are taking regularly, it is a good idea to do so now. 

In addition, it is important to continue eating a good diet with plenty of fresh food, limiting alcohol intake, and reducing or stopping smoking if possible. People are also encouraged to keep exercising regularly, while following the Department of Health’s physical distancing guidelines, throughout the COVID-19 pandemic

Practicing good hygiene and physical distancing is crucial for people with high blood pressure, to avoid the risk of infection with COVID-19, as they are more likely to become seriously ill. It’s important for people with chronic heart disease to have a flu vaccine, as they are at increased risk of complication from seasonal influenza.

Do blood pressure-lowering medicines make COVID-19 more severe?

No, the opposite is true. Having uncontrolled, high blood pressure is a risk factor that increases the likelihood of serious illness if you do become infected with SARS-CoV-2 (the virus that causes COVID-19).

Studies have found that cardiovascular disease is one of the most common underlying conditions in people with COVID-19 who had poor outcomes from the infection. This is why leading Australian and international heart-health experts recommend you take your medicines, including those used to manage your blood pressure, as prescribed by your doctor during the coronavirus pandemic.

Why have I seen news articles saying that some blood pressure-lowering medicines might be harmful if I am infected with SARS-CoV-2?

Currently, researchers are trying to find out why some people who are infected with SARS-CoV-2 are sicker than others and progress to more serious COVID-19 disease. To understand why more people with cardiovascular disease, including high blood pressure, experience serious illness, researchers began to investigate whether there were any links between SARS-CoV-2 and their medicines.

Based on some early research into coronavirus, it was suggested that blood pressure-lowering medicines called angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) might make it easier for a person to be infected with COVID-19 or increase the likelihood of them becoming seriously ill if they do get sick with the virus.  However, leading Australian and international experts in heart health have been looking at the scientific information available. They all agree that there is no direct clinical evidence to suggest that taking these medicines is harmful during the COVID-19 pandemic. In fact, available evidence shows that stopping your blood pressure-lowering medicines is more likely to lead to health problems. 

The Australian National COVID-19 Clinical Evidence Taskforce supports these conclusions and recommends people with COVID-19 who take ACE inhibitors or ARBs should continue to do so, unless there is another clinical reason not to.  They note that 'Stopping these medications abruptly can lead to acute heart failure or unstable blood pressure'.

There is a lot of information in the media about the effects of different medicines on risk of infection or treatment during the COVID-19 pandemic.

If anything you see or read raises questions about your condition or your prescribed medicines, speak with a health professional. Preferably your regular doctor, nurse or pharmacist, but if they are unavailable you can also get trusted, accurate information from NPS Medicines Line (1300 MEDICINE).

Do not change or stop your medicines unless a medical professional familiar with your situation advises you to.

What are ACE inhibitors and ARBs?

ACE inhibitors and ARBs are blood pressure-lowering medicines that lower blood pressure through their effects on a hormone called angiotensin-II. This hormone causes blood vessels to become narrow, so the heart has to work harder to push blood around your body, leading to higher blood pressure. When this hormone is inhibited or blocked by medicines, the blood vessels relax and blood pressure lowers.

These medicines are often prescribed to reduce the risks associated with high blood pressure, especially in patients with coexisting heart disease, kidney disease or type 2 diabetes, or who have had a stroke or are at a high risk of having a heart problem (including stroke).

ACE inhibitors and ARBs have been around for a long time and their benefits are well known, which is why they are recommended in the treatment of high blood pressure by Australian and international heart-health experts.

Research and commentary about blood pressure-lowering medicine and COVID-19

 

Should I use ibuprofen to treat a fever?

Last updated: 27 October 2021

If you have taken ibuprofen to treat a fever before and it has provided relief, then the current advice is that you can use it if you experience another fever.

Ibuprofen cannot be used by everybody. It is generally not recommended for people:

  • with asthma
  • who are pregnant (particularly in the third trimester)
  • with chronic heart disease, impaired kidney or liver function
  • with stomach ulcers or gastrointestinal bleeding.

Early in the pandemic it was suggested that pre-existing use of non-steroidal anti-inflammatory medicines such as ibuprofen could lead to increased disease severity in patients with COVID-19, however recent studies, such as Drake et al.'s study in The Lancet,  suggest that this is not the case.

Remember that fever is a normal response to many illnesses, and medicines are not always needed to relieve a fever. Most people, including many infants and children, can tolerate low-grade fever (eg, 38 °C – 38.5 °C) without medicine.

What else can I use?

If you cannot take ibuprofen, or prefer not to, then you may be able to manage a fever using medicines containing the single active ingredient paracetamol.

Paracetamol is the preferred first choice to treat a fever in most cases, provided you have no chronic liver disease and it is available for you to use. People with chronic liver disease should speak with their doctor before using paracetamol.

For any medicine (prescription, over-the-counter, herbal or complementary), always use the correct dose for your age as described on the original packaging or given as instructions by your prescriber, and do not take the medicine for longer than directed.

If you have a fever and think it could be related to COVID-19, please read and follow the advice provided on the Australian Government COVID-19 website.

About ibuprofen

Ibuprofen is the active ingredient in a number of medicines commonly used to relieve pain (including muscle and joint pain, period pain, headaches and teething pain) and also fever.

Ibuprofen is available in different strengths and formulations and can be taken by adults, children and babies older than 3 months.

Find out more about ibuprofen and how to use it safely to manage different symptoms on the NPS MedicineWise website:

Research and commentary about ibuprofen, NSAIDS and COVID-19 outcomes

 

I have asthma, what does COVID-19 mean for me?

Last updated 27 October 2021

If you have asthma, the most important action you can take during the COVID-19 pandemic is to stay healthy and keep your asthma well controlled. If this means taking medicines regularly, then keep doing so.

There is no evidence that using a low-dose inhaled corticosteroid (one of a number of medicines known as preventer medicines) increases the risk of SARS-COV-2 infection.

NPS MedicineWise also recommends that people with asthma:

  • get vaccinated for COVID-19 if they meet eligibility criteria
  • know how to use their reliever and preventer medicines (if required)
  • have an up-to-date asthma action plan
  • have sufficient supply of their asthma medicines (please see Limits to salbutamol below)
  • practice good hygiene and distancing to avoid infection
  • contact their usual health professional if they begin to feel unwell or call the National Coronavirus Helpline on 1800 020 080.

People with asthma are encouraged to take precautions whenever there are infectious diseases in the community that can affect their breathing. Talk to your health professional about the potential benefits of having the flu vaccination in preparation for winter.

Limits to salbutamol

Medicines containing salbutamol (also known under the brand names Ventolin, Asmol or Airomir) are an important part of treatment for people with breathing conditions such as asthma. They are available as prescription medicines, but can also be purchased over the counter at pharmacies.

To make sure that stocks of this important medicine remain available for people who need them, over-the-counter sales will be limited to one unit per person per purchase.

In addition, pharmacists have been asked to only sell these medicines to people who have a medically diagnosed breathing condition or who have bought these medicines from them before.

About asthma

You can learn more about asthma, action plans and medicines used to treat this condition on these web pages:

Severe asthma and COVID-19

Asthma Australia and the National Asthma Council have provided guides for people with severe asthma and their health professionals:

 

Can hydroxychloroquine be used to treat or prevent COVID-19?

Last updated: 27 October 2021

Early in the pandemic, hydroxychloroquine was put forward as a potential medicine for the treatment of COVID-19, but recent studies have shown that hydroxychloroquine is not an effective treatment for COVID-19.

A 2021 Cochrane Review assessing current evidence, found that hydroxychloroquine is not beneficial for patients with COVID-19 requiring hospital care.

Use of this medicine for the prevention or treatment of COVID-19 outside of clinical trial research is off-label and not recommended. In Australia, legislation has been created to limit the prescription of hydroxychloroquine, so that supply is available for people who need it to manage chronic health conditions not related to COVID-19.

About hydroxychloroquine

Hydroxychloroquine is the active ingredient in medicines that for many years have been used to prevent and treat malaria, and treat certain autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematous (SLE). Another similar medicine, called chloroquine, is also used overseas but is not marketed in Australia.

Like all medicines, hydroxychloroquine and chloroquine come with risk of side effects. These side effects are well understood and manageable when used to prevent or treat malaria and autoimmune conditions, because of the long-term experience in these settings.

However, these medicines can have serious side effects if used incorrectly, at the wrong dose, if combined with other medicines, or used in people with other health conditions. Taking more than 5 g of hydroxychloroquine or chloroquine is associated with severe poisoning.

At the moment, very little is understood regarding how to use these medicines in the treatment or prevention of COVID-19.

Can I still get hydroxychloroquine for my chronic condition?

If you are currently taking hydroxychloroquine for a chronic condition and you are worried about being able to access this medicine, please speak to your health professional.

The TGA is working with the pharmaceutical industry to help ensure the supply of hydroxychloroquine is maintained for patients who need it to treat their chronic conditions.

People can learn more about their medicines by using our Medicine Finder or calling our Medicine Line (1300 MEDICINE).

Find out more

 

Can medicines be used to treat COVID-19?

Last updated: 2 November 2021

Three medicines are currently available in Australia to treat people with severe COVID-19.

  • Remdesivir – an antiviral medicine for patients with severe COVID-19 symptoms who have been hospitalised. 
  • Sotrovimab – a monoclonal antibody treatment approved for people with COVID-19 at high risk of progressing to severe disease who do not require supplemental oxygen.
  • Casirivimab + imdevimab (Ronapreve) – a combination monoclonal antibody treatment for treating hospitalised people with COVID-19 who do not require supplemental oxygen and are at increased risk of progressing to severe disease. 
    Ronapreve has also received provisional approval for the prevention of COVID-19 in patients exposed to SARS-CoV-2 who either have a medical condition making them unlikely to respond to or be protected by vaccination, or who have not been vaccinated against COVID-19.

Trials are being conducted around the world to investigate the potential of various medicines as treatments for COVID-19. These trials will help to better understand when to use medicines, and for how long, in people with COVID-19, as well as possible side effects or risks that might be associated with their use.

What about antiviral medicines used to treat the flu?

You may know of an antiviral medicine called oseltamivir (Tamiflu). It is sometimes given to treat severe cases of influenza or to protect someone at high risk of complications if they were to get sick with influenza.

To date, trials have not shown oseltamivir to be effective in treating COVID-19 or preventing a person from getting sick with COVID-19. However, it may be used in treatment if the person has influenza at the same time as COVID-19.

How do antiviral medicines work?

Antiviral medicines are medicines that can treat some infections by targeting the viruses that cause them.

Viruses are small infectious agents that survive by making copies of themselves inside living cells. Antiviral medicines work in different ways to stop the copying process. Some medicines can stop the virus entering a cell in the first place. Other medicines affect a step in the copying process causing it to stop or produce damaged virus particles that cannot infect other cells.

What medicines can be used for COVID-19?

Fever is a common symptom of COVID-19, and paracetamol or ibuprofen may be taken for symptom relief, if needed.

In Australia, people with serious COVID-19 symptoms will be treated in hospital with supportive care. This might include oxygen treatment or mechanical ventilation to help the person breathe.

More information

Research and commentary about antiviral medicines and COVID-19

Payne M. What is the effectiveness and safety of antiviral or antibody treatments for coronavirus? – a lay summary. HealthWatch. March 2020. (accessed 13 April 2020).

Rios P, Radhakrishnan A, Antony J, et al. What is the effectiveness and safety of antiviral or antibody treatments for coronavirus? CEBM Research. 26 March 2020.

Norrie JD. Remdesivir for COVID-19: challenges of underpowered studies. 29 April 2020.

National Institutes of Health News release NIH clinical trial shows Remdesivir accelerates recovery from advanced COVID-19. 29 April 2020.

Beigel J, Tomashek K, Dodd L, et al. Remdesivir for the treatment of Covid-19 – Final Report. N Engl J Med 2020; 383:1813-1826.