“From several weeks to a month”
According to the website of the largest pharmaceutical distributor Katren apteka.ru, at the moment the drugs Eliquis and Ksarelto have disappeared from pharmacies in Moscow, St. Petersburg and the regions – the most common anticoagulants that are vital for patients after a stroke, with coronary heart disease and other conditions. A similar picture can be seen in the online pharmacy zdravcity.ru of the Protek company, another major player in the Russian pharmaceutical market, as well as on the website of the Ozerki pharmacy network. Anticoagulants can be purchased at some Moscow 36.6 pharmacies, but they are also in short supply in other regions, including St. Petersburg.
“This does not mean that these drugs are not available at all, but in order to acquire them, you will have to spend some time,” Nikolay Bespalov, Development Director of the analytical company RNC Pharma, told MedPortal.
According to the expert, most pharmacies do not have their own inventory, or its volume is very limited, and without supplies from a wholesaler, in conditions of excitement, the goods end very quickly. Distributors can restrict the ability to ship drugs to specific networks by redistributing balances between retail partners so that everyone gets even smaller volumes, but at least something.
“Pharmacies, if they are network structures, can also distribute goods between their outlets based on the current volume of stocks and the location of specific outlets. For example, in a residential area and near a medical facility, the demand for drugs will be different a priori, ”Bespalov said.
It is not yet known when this deficit will be eliminated. If we are talking about a delay in delivery, then the issue can be resolved in a few days. But if there is a problem with the production of drugs, you will have to wait from several weeks to a month.
Should you buy anticoagulants “just in case”?
The Russian temporary guidelines for the treatment of COVID-19 have similar guidelines for the use of anticoagulants: these drugs can be prescribed to prevent deep vein thrombosis and pulmonary embolism in patients with moderate COVID-19 at high risk of thrombosis. Risk factors include malignant tumors, thrombophilia, age over 70, respiratory failure, hormone replacement therapy, etc. Since anticoagulants can have dangerous side effects, in most guidelines, including WHO, they are not recommended for outpatient treatment without supervision doctor.
In addition to the official recommendations, there are also numerous unofficial “treatment protocols” that are published in social networks according to doctors and patients they know and are very popular. Some specialists conduct paid online consultations and suggest taking anticoagulants at the first symptoms of COVID-19 to prevent thrombosis.
“You have to understand that anticoagulants have no prophylactic effect. They reduce the likelihood of thrombosis as a result of rupture of atherosclerotic plaque, which can form against the background of coronavirus. These drugs are indicated for moderate to severe, severe and critical COVID-19, especially if there is no access to low molecular weight heparins. In mild cases, they are not needed, and uncontrolled admission greatly increases the risk of bleeding, “- said the Chief Researcher of the National Medical Research Center of Cardiology, Doctor of Medical Sciences, Professor Igor Sergienko to MedPortal.
Rampant demand for anticoagulants deprives those people who need them, the doctor said. For example, the “top-end” direct-acting anticoagulant rivaroxaban (“Xarelto”) is prescribed for the prevention of stroke and heart attack in people at high risk and those who have previously suffered from these cardiovascular accidents. It is also necessary for patients after joint replacement operations, for peripheral arterial diseases, for the treatment and prevention of venous thrombosis and pulmonary embolism.
“Without timely administration of anticoagulants in such patients, the risk of thrombosis increases dramatically. You shouldn’t deprive these people of normal treatment for unnecessary reasons, ”concluded Igor Sergienko.