COVID-19 and your medicines

With the current COVID-19 pandemic, many New Zealanders have questions about their medicines and treatments for the COVID-19 virus.

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Aotearoa e te toa! COVID-19 and your medicines

(Health Navigator NZ, in partnership with Northland DHB & Ministry of Health, 2022)

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COVID-19 and your medicines – do’s and don’ts

Do's Don'ts 
 Do have enough medicine to last a few weeks. Phone or email your GP to get any new prescriptions you may need.

✔ Do set reminders to take your medicine on time if staying at home is a change to your usual routine.

 Do get your flu vaccine it is free if you are 65 years or older or are pregnant – being protected against the flu helps reduce hospital admissions. If there are fewer people in the community ill with the seasonal flu, this puts less pressure on health resources to care for people with COVID-19. 

✔ Do use valid medicine information sources or contact your pharmacist if you have any questions about your medicines.

 Don’t stockpile your medicines or get a larger supply than usual – this could lead to unnecessary shortages for other people.

✘ Don’t stop or reduce your dose of your regular medicines unless advised to by your doctor. There are no clinical studies showing harm from any medicine use in relation to COVID-19.

 Don’t take herbal, homeopathic or natural remedies, including Chinese medicines without checking with your pharmacist – There are none that are effective against COVID-19.

Should I be worried if I take an ACE inhibitor or an ARB?

With the recent outbreak of the COVID-19 virus, there have been reports that people taking medicines called ACE inhibitors or ARBs might be at higher risk of harm, but there is no clinical data to support this. These medicines are used to treat a variety of medical conditions such as high blood pressure, heart failure, diabetic kidney disease and to protect your heart after an heart attack.

ACE inhibitors available in New Zealand ARBs available in New Zealand
  • captopril (Capoten)
  • cilazapril (Zapril)
  • enalapril (Acetec®)
  • lisinopril
  • perindopril
  • quinapril 
candesartan (Candestar®)
losartan

To date these are only theoretical concerns and there is no clinical data to support these reports.1 It is important that you keep taking your medicines. Do not stop taking any of your regular medicines without checking with your doctor. Read more about ACE inhibitors and ARBs.

Should I be worried if I am taking arthritis medicines?

Many people with arthritis are concerned about taking their medicines during the COVID-19 pandemic because some arthritis medicines affect your immune system and may lower your immunity. However, it is important to keep taking your arthritis medicines, including biologic injections, DMARDs like methotrexate, and anti-inflammatory drugs (NSAIDs). Do not stop or reduce your dose unless advised by your rheumatologist. If you have any questions about your arthritis medicines, you should discuss this with your doctor. Read more about medicines to treat rheumatoid arthritis.

People with inflammatory and autoimmune conditions are at increased risk of infections. This is mainly due to the condition itself, rather than treatment, but studies that look at risk of infection in patients taking DMARDs and immunomodulators for rheumatic disease show that different medicines have a different risk of infection.

If you develop an infection while you are taking these medicines, your doctor may discontinue them during the infection and restart treatment once the infection has cleared. People with arthritis can continue to use NSAIDs (such as ibuprofen, naproxen or diclofenac) during the current COVID-19 pandemic.

In summary, during the COVID-19 pandemic, people with rheumatic diseases should do the following:

  • Continue treatment with conventional and biological DMARDs. 
  • Continue to use NSAIDs if required. Read more about NSAIDs.
  • Have the seasonal flu vaccine as early as possible, and consider having the pneumococcal vaccine (especially if you are elderly). 
  • Pay particular attention to hand washing and follow the guidance recommended for your age group and health condition to minimise your risk of exposure to COVID-19.
  • Ask about telephone consultations instead of attending your rheumatology appointments in person.
  • Discuss any changes in your treatment with the rheumatology service if you develop COVID-19 infection.

Should I be worried if I have COPD?

People with COPD are usually at risk of getting chest infections and COPD is a common cause of hospital admissions. Likewise, with COVID-19, they are at a higher risk of having a more severe infection than others, so it is important to keep well. If you have COPD, continue to take your COPD medicines as normal. Do not stop or reduce your dose. Make sure you have enough medicine to last a few weeks and get the flu vaccine as soon as possible. The influenza immunisation programme has been started earlier this year to ensure that vulnerable members of the community get their flu vaccine as soon as possible.

If your COPD symptoms get worse, and you think you are having a flare-up, use your medicines in your COPD action plan, and also phone your doctor about your symptoms. The symptoms of COVID-19 may be mistaken for a flare-up of COPD.  If you are unwell, always call ahead before visiting your doctor or the hospital. This way, they can take necessary steps to prevent the spread of the infection.

Should I be worried if I have asthma?

Currently there is no evidence of increased infection rates in people with asthma but it is very important to keep your asthma under control, by taking your asthma medicines as normal. Stopping your medicines can put you at risk for getting an asthma flare-up. If you do have a flare-up, please follow your usual asthma action plan and phone your doctor for advice if you need it. The emergency department or urgent care may be much busier than usual, but if you are advised to go please do so.

References

  1. Medicines and COVID-19 Christchurch Medicines Information Service
  2. Continue ACE inhibitors and ARBs amid COVID-19 outbreak Goodfellow Unit, NZ, 2020
  3. Information for clinicians on therapeutic options for COVID-19 patients CDC, USA
  4. New Zealand Rheumatology Association NZ, 2020
  5. GOLD COVID-19 guidance Global Initiative for Chronic Obstructive Lung Disease, 2020
  6. COVID-19 and asthma – what patients need to know American Academy of Allergy, Asthma and Immunology 
  7. A rush to judgment? Rapid reporting and dissemination of results and its consequences regarding the use of hydroxychloroquine for COVID-19. Annals of Internal Medicine, 2020 

Reviewed by

Angela is a pharmacist in the Quality Use of Medicines Team at Waitematā District Health Board. She has experience in hospital pharmacy in New Zealand and in the UK, and was previously a medical writer for Elsevier in The Netherlands. Angela is interested in promoting the safe use of medicines, particularly high-risk medicines.

 

Credits: Health Navigator Editorial Team. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 23 Mar 2020