Black fungus drug in shortage in Noida, Ghaziabad

Noida/Ghaziabad: Patients suffering from Mucormycosis or black fungus, as it is commonly dubbed, are having a hard time fetching drugs for its treatment in Noida and Ghaziabad

Noida/Ghaziabad: Patients suffering from Mucormycosis or black fungus, as it is commonly dubbed, are having a hard time fetching drugs for its treatment in Noida and Ghaziabad. Doctors are prescribing the drug Liposomal Amphotericin B to such patients. However, SOS (save our souls) calls looking for the same have increased on social media since the last week.

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Sector 61 resident Sukhpal Singh Toor said he was unable to find the injection for an acquaintance of his in Noida for two days.

“I made several calls all over the city looking for the injection but it is not available anywhere. We ultimately had to source the injection from Delhi,” he said.

Doctors also said that patients are getting frustrated over the unavailability of the drug. “Number of black fungus patients has increased in our OPD since last week. However, patients are unable to procure the drug, Liposomal Amphotericin B, used to treat it. The shortage is not just in Noida but seems like the problem persists all over the National Capital Region,” said Dr Sudhir Gupta, chest physician and bronchoscopist at Kailash Hospital, Sector 27, Noida.

The drug is being prescribed in large quantities, which makes it further difficult to procure, say kin of patients. “My sister-in-law was prescribed 30 vials of Liposomal Amphotericin B as the fungus has almost reached the eyes. We could only buy around 10 such vials from Delhi,” said Diwarkar Varshney, a resident of Vaishali, Ghaziabad.

According to doctors, earlier the drug used to be available at pharmacies and hospitals. “This drug was very low in demand earlier but due to the sudden spike in cases, it has gone out of stock. However, it is available at our hospitals,” said Dr DK Gupta, chairman and managing director, Felix Hospital, Sector 137, Noida.

Dr Savyasachi Saxena, an ENT surgeon at Fortis Hospital, Noida added that while OPD patients are unable to find the drug in Noida, “the injections are available at the hospital as of now and are being given to IPD patients. However, OPD patients are unable to find the drug anywhere else,” he said.

Doctors said that black marketing of the drug seems to have begun as well. “I had prescribed Amphotericin B Deoxycholate to a patient on Tuesday that is generally available for ₹300 per vial. However, he told me that he could not find it in Ghaziabad and had to procure it for ₹3,000 from a seller in Delhi,” said Dr Nripen Vishnoi, senior ENT and cochlear implant surgeon, Yashoda Super Speciality Hospital Ghaziabad.

The Gautam Budh Nagar administration has requested the Uttar Pradesh Medical Supply Corporation Limited to provide the drug to the district. “We have sent a request to the UPSMC to procure Liposomal Amphotericin B. We hope that the district will not have a shortage of this drug,” said Suhas LY, district magistrate, GB Nagar, adding that the total tally of black fungus cases in the district has not been documented officially.

Meanwhile, Ghaziabad district magistrate Ajay Shankar Pandey said: “We are aware that there is a shortage of the drug for black fungus in the district. For this, we have created a list of verified distributors of Liposomal Amphotericin which will be issued to the public soon.”

As per doctors, there are generally three types of Amphotericin B available in the market and patients who have been prescribed Liposomal Amphotericin B should not confuse it with the other two variants.

“The first variant is the Amphotericin B (conventional) or Deoxycholate, which is available for ₹300 per vial in the market. However, this one is not prescribed to patients of black fungus because it can result in kidney damage, as most patients of Mucormycosis are diabetic. However if the patient is taken care of properly by the physician and if they do not have a history of kidney issues, they can be administered this drug,” said Dr Vishnoi.

“The second variant is lipid complex Amphotericin B, which is also rarely used because of its toxicity. The most commonly used is the third variant, Liposomal Amphotericin B, which is renal safe and is being commonly prescribed by doctors to treat black fungus patients,” he added.

One 50 mg vial of Liposomal Amphotericin B is generally available in the market for ₹6,000. However, since its dose is high, patients are prescribed multiple vials at once.

“The dosage of Liposomal Amphotericin B is prescribed at five-seven milligram per kilogram of the patient’s weight per day. As a result, if a person weighs 60 kg, they will need 300 mg of the drug; so a patient has to buy six vials a day which comes to around ₹30,000,” said Dr Vishnoi.

For mild cases of Mucormycosis or patients who have completed one course of Amphotericin B, Posaconazole tablets or Noxafil (posaconazole) syrups are prescribed.