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Can You Take the COVID Cocktail Drug? All Your Questions Answered

Dr Bharat Gopal, Pulmonologist and Dr Mansi Bajaj, General Physician, help us understand how this new form of treatment works.

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This article is a part of a series by The Better India to share verified information about COVID-19 care. While several posts on various aspects of fighting COVID-19 are being circulated on social media and messaging services like WhatsApp, we urge you not to trust unverified content. To separate fact from fiction, we will be sharing the videos and content with doctors and experts and bring you their responses with scientific research-backed information.

On 24 May 2021, pharmaceutical companies Cipla and Roche launched a coronavirus antibody cocktail drug, which they claim is for non-hospitalised patients who face high risk of their infection turning severe.

Having been granted emergency use authorisation in India by the Central Drugs Standard Control Organisation (CDSCO) on 3 May, the cocktail drug was first administered to an 84-year-old Haryana man on 25 May. The first batch of the medication will be available through Cipla’s distribution network across India.

Priced at Rs 59,750 for one dose, and Rs 1,19,500 for the multi-dose pack—each pack can treat two patients—inclusive of all taxes, this is an expensive treatment option.

To understand how this medication will work, who can be administered the medicine, and its efficacy, The Better India caught up with Dr Mansi Bajaj Malik, a Consultant Physician at Vista Eye Care in West Delhi, and Dr Bharat Gopal, Senior Consultant Pulmonology, Fortis Hospital, Delhi.

1. How will this drug help patients who test positive for COVID-19?

Dr Gopal: Casirivimab and Imdevimab, the two neutralising antibody drugs that the treatment contains work similarly to the antibodies produced naturally by the immune system when one gets infected by COVID-19 virus.

The antibodies attach themselves to the spike protein of the virus and prevent it from attaching to the human cells. This in turn prevents the symptoms and the progression of the disease.

COVID cocktail
Dr Bharat Gopal

Dr Mansi: The two antibodies block the ability of the virus to bind and infect the healthy human cell, hence limiting progression of disease from mild to severe, provided they are given this treatment within the first 10 days of infection. They provide passive immunity and mimic the natural defences and pathways of the immune system.

2. Can this drug be administered to high risk patients?

Dr Gopal: Yes, it helps high-risk patients to not let their condition worsen, reducing the risk of hospitalisation and fatality by 70 per cent and shortens the duration of symptoms by four days.

3. With this drug, will the COVID-19 vaccine become redundant?

Dr Mansi: No, not at all.

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Vaccines induce the body’s active immune response in order to protect one from an infectious disease in the future. It tricks the immune system into thinking the body is infected and generates a response.

Developing active immunity takes time but usually lasts longer. Hence, vaccines are not intended to treat patients with active infection.

COVID cocktail
Dr Mansi Bajaj Malik

Antiviral monoclonal antibodies, like this drug, provide passive immunity which can be achieved faster. They may have utility in certain patients who are immunocompromised, those with active infections and those who do not respond to a vaccine.

Both the approaches are important to address the COVID-19 pandemic.

4. Which patients will be administered this form of treatment?

Dr Gopal: This treatment is not meant to be used in those patients who are hospitalised due to COVID-19, or who require oxygen therapy, or those who require an increase in baseline oxygen flow rate due to COVID-19.

Dr Mansi: This therapy is authorised for the treatment of mild to moderate COVID-19 in adults and pediatric patients, 12 years of age and older, with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progressing to severe COVID-19 and/or hospitalisation.

It is not authorised for use in patients who are hospitalised or who require oxygen therapy due to COVID-19.

5. Who can administer this treatment? Can it be purchased as an Over The Counter (OTC) drug?

Dr Mansi: This therapy should only be administered by a qualified healthcare professional in settings where they have immediate access to medications to treat a severe infusion reaction, such as anaphylaxis, if any.

Hence, this is unlikely to be available as an OTC drug.

Dr Gopal: People must be warned against its indiscriminate usage, which will result in a shortage of the drug for those patients who may benefit from it.

(Edited by Yoshita Rao)

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