Two years into the Covid19 pandemic, Canadian provincial health authorities have begun repurposing inexpensive, widely available medicines for early outpatient treatment. Ontario is listing fluvoxamine, while Quebec is allowing the OTC sale of paxlovid to Covid-positive patients.
Ontario first in Canada to list fluvoxamine as COVID treatment | The Suburban - Joel Goldenberg:
December 23, 2021 - "Ontario is the first province in Canada to officially declare that the inexpensive anti-depressant fluvoxamine should be under consideration as a way to prevent people with mild cases of COVID-19 from having to be hospitalized.
Ontario's Science Table says of fluvoxamine, '50 mg PO daily titrated up to 100 mg PO TID for 15 days may be considered for mildly ill patients presenting within seven days of symptom onset. This recommendation is based on very low certainty evidence of reduction in hospitalization, and the need for outpatient treatment options with a reasonable safety profile during an anticipated spike in COVID-19 cases due to the Omicron variant. Pharmacist consultation and outpatient provider follow-up is important to avoid any significant adverse drug interactions with fluvoxamine.'
"Fluvoxamine is sold in pharmacies as Luvox, and has been found in a study to cut COVID hospitalization significantly and can potentially reduce serious illness and deaths if prescribed early enough. As previously reported, the study was published in the medical journal Lancet Global Health, and took a look at results from 1,500 people in Brazil who were diagnosed early with COVID.... Those given fluvoxamine took it 100 mg twice a day for 10 days, and the result was that COVID hospitalization decreased by a third. As well, of those who took the medication, one died, compared to 12 who took the placebo.
"This past January, researchers at McGill University were also looking into fluvoxamine as a way to lessen COVID symptoms. Other universities have studied the drug as well, and it has been endorsed as a treatment by Johns Hopkins University."
Pharmacists can provide antiviral | The Suburban - Joel Ceasu:
April 1, 2022 - "Quebec pharmacists can now provide the antiviral Paxlovid ™ without a prescription to symptomatic patients who are at risk of developing complications and who present a positive screening test result for COVID-19.Access to a pharmacist from one of the 1,900 community pharmacies in Quebec will make it possible to offer residents local care and promote faster launch of treatment both for the individual and for the health care system.
"This can reduce the probability of hospitalization by up to 89% for vulnerable patients.... [I]nitiating treatment with Paxlovid ™ must be done within five days of the onset of symptoms. The drug was approved by Health Canada in January. Note that if, two days after the start of treatment, the patient's condition changes unfavorably, the pharmacist must refer them to a doctor or a specialized nurse practitioner. 'It is essential that people who have a condition potentially relevant to the use of Paxlovid TM make sure to quickly undergo a screening test for COVID-19 as soon as the first symptoms appear' reads a Health ministry statement. 'If the result is positive, they should promptly consult a pharmacist, a doctor or a specialized nurse practitioner.'
"If other COVID-19 treatments become available and recommended by the National Institute of Excellence in Health and Social Services (INESSS), pharmacists may also prescribe them. The drug will be available following the positive test or with a prescription from a doctor or a nurse practitioner."
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