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Other medicines that have been mentioned on the internet in relation to COVID-19

ACE-inhibitors and ARBs1,2 (such as cilazapril or losartan) [updated 22 Apr 14:00]

If you take an ACE-inhibitor (cilazapril or a medicine ending in ‘pril’) or an ARB (losartan or a medicine ending in ‘artan’) for a long-term condition, keep taking it as normal.

  • These medicines are used in New Zealand to control blood pressure, for heart failure, and for some kidney problems.
  • There have been reports that these medicines might be a problem with COVID-19 but there is no definite evidence for this. These medicines may help prevent lung damage during viral infections, but more evidence is needed for this too. There is more detailed explanation below.

The detail:

COVID-19 gets into cells in your body using a substance that is already in your body (an enzyme called ACE2). The way that ACE-inhibitors and ARBs work means they could in theory increase ACE2 in the body but in studies in humans this hasn’t always happened.

ACE2 also plays a part in preventing damage to the lungs during infections. ACE-inhibitors and ARBs have been studied to see if they could help people with lung infections caused by viruses. Studies so far showed a better outcome if people with lung infections caused by a virus stayed on an ACE-inhibitor, including one in patients with COVID-19. More work is needed to confirm this.

Ibuprofen and other NSAIDs3, 4 (Non-Steroidal Anti-Inflammatory Drugs) [updated 21 Apr 15:00]

If you take ibuprofen (or another NSAID), keep taking it as normal.

  • Ibuprofen and other NSAIDs (such as diclofenac) are used to treat pain, fever and inflammation.
  • There was a theory published by researchers that ibuprofen might make COVID-19 infections worse because it might increase ACE2 (like ACE-inhibitors). This wasn’t a study, it was a suggestion by the researchers for scientists to look into. There are also theories that ibuprofen might help.
  • Another concern about using NSAIDs with COVID-19 is past studies suggest they may make lung infections worse. The way the studies collected information means there may have been other reasons for the results, and it might not be the NSAIDs. The current guidelines are that NSAIDs are okay to use to treat symptoms such as pain and fever if needed.

Steroids5-9 [updated 21 Apr 15:00]

If you take a steroid for a long-term condition, keep taking it as normal.

  • Steroids are used for a variety of conditions, usually to reduce inflammation. They come in many different formulations including:
  • Steroids can suppress your immune system, which can make you more likely to pick up infections. How likely this is depends on the dose that you are taking and the way you take them. People taking higher doses of tablets will have more of a risk than people taking lower doses (such as 5 mg of prednisone). If you are using a steroid cream, nasal spray or inhaler, then you have a much lower risk because your body is usually exposed to less steroid.
  • Stopping a steroid suddenly can cause serious health problems, as well as risking a flare-up of your condition. A flare-up could mean you need to go to your GP or hospital, which increases your risk of coming into contact with COVID-19.
  • If you are taking a steroid for a long-term condition like a skin problem, asthma, inflammatory bowel disease or rheumatoid arthritis, keep taking it as normal, and don’t stop it suddenly. If you are concerned about continuing it, talk with your GP or specialist.
  • Physical distancing and good handwashing technique are the best ways to prevent you getting COVID-19.

Medicines that affect the immune system (immunosuppressants)7-9 [updated 22 Apr 14:00]

If you take an immunosuppressant for a long-term condition, keep taking it as normal.

  • Immunosuppressants are used for a variety of conditions, such as transplants, rheumatoid arthritis, inflammatory bowel disease and psoriasis.
  • Immunosuppressants used in New Zealand include adalimumab, azathioprine, ciclosporin, cyclophosphamide, etanercept, infliximab, mercaptopurine, methotrexate, mycophenolate mofetil, rituximab, sirolimus and tacrolimus. (See also the steroids section)
  • If you take an immunosuppressant you may be more likely to pick up infections. Your underlying condition can also make you more susceptible.
  • However, stopping your immunosuppressant can risk a flare-up of your condition. A flare-up could mean you need to go to your GP or hospital, or be treated with stronger immunosuppressants. These all increase your risk of getting COVID-19.
  • If you are taking an immunosuppressant, keep taking it as normal, and don’t stop it suddenly.
  • If you are concerned about continuing it, talk with your GP or specialist.
  • Physical distancing and good handwashing technique are the best ways to prevent you getting COVID-19.

References

About My Medicines

My Medicines Patient Information Leaflets (PILs) contain important, but not all, information about the medicines they describe.

For more information about the sheets, see: What does a My Medicines sheet cover?

My Medicines is developed by a team at the Canterbury District Health Board. Our team is made up of doctors, pharmacists, and a non-medical person to help us keep to plain language. We also discuss our information with specialist health professionals or groups when needed