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Medicines & Treatments

Last Updated: 4/2/21
 

Medicines Australia assures supply of medicines:

Medicines manufacturers are committed to ensuring supply of the medicines that Australians need when they need them.  There are adequate medicines supply in Australia to meet community needs, please do not stock pile.  Medicines Australia is assisting the Department of Health to identify any potential issues relating to supply of essential medicines and to ensure measures are in place to mitigate any shortages or impacts relating to supply concerns if they arise.  (read full statement here)
 

Electronic prescriptions:

This fact sheet outlines how you can get your medicine if you are confined to home due to coronavirus (COVID-19). Changes to electronic prescribing are underway, but you can already have a telehealth consultation with your doctor and get medicines sent directly to you at home.

 

The Home Medicines Service:

Home Medicines Service will enable vulnerable people and people in self-isolation to order their PBS and RPBS prescriptions remotely and have their medicines home delivered at no cost to reduce their potential exposure to COVID-19.  Pharmacies will be able to offer customers free monthly delivery of under 500 grams of medication and other essential supplies using the Australia Post Express Post network, and will be able to claim the cost through a government rebate. Contact your local pharmacist and they will be able to advise you on this or visit: https://www.findapharmacy.com.au/home
 

What should I do about my medication?

If you are on a regular medication for MS or a related condition, then it is recommended that you should continue to take this medication because of the very real risk of relapse when medication is ceased.

This is in view of the very low risk of contracting COVID-19 in Australia, the lack of evidence for any increased risk of COVID-19 infection or its complications in pwMS on immunomodulatory therapies, and only a marginal increase in the risk of a more severe course of COVID-19 on rituximab and ocrelizumab. 

With regards to specific therapies:

Self-injected therapies (glatiramer acetate [Copaxone], beta-interferon [Avonex, Betaferon, Plegridy, Rebif])

  • These medications are not immunosuppressive.

  • You should continue these medications and follow the standard advice regarding prevention of COVID-19 infection.

Intermittent immunotherapies (plasma exchange, intravenous gammaglobulin [IVIg]):

  • These therapies have a minimal impact on immune function.

  • You should continue these therapies and follow the standard advice regarding prevention of COVID-19 infection.

Regular potentially immunosuppressive MS therapies (natalizumab [Tysabri], fingolimod [Gilenya], siponimod [Mayzent], dimethyl fumarate [Tecfidera], teriflunomide [Aubagio]):

  • These therapies are mildly immunosuppressive, there is currently no evidence that they increase the risk of COVID-19 infection. Specifically, studies of natalizumab, dimethyl fumarate and teriflunomide have not shown any cause for concern.

  • Because of the very real risk of relapse on discontinuing these therapies compared to the currently low risk of COVID-19 infection, the present advice is that these medications should be continued.

  • Your neurologist may wish to monitor your immune cell counts more frequently.

  • You should follow the standard advice regarding prevention of COVID-19 infection.

Immunosuppressive therapies (prednisolone, methotrexate [MTX], azathioprine [Imuran], mycophenolate mofetil [Cellcept], cyclophosphamide [Cytoxan]):

  • The level of immunosuppression with these medications is variable and depends upon the dosage and combination of treatments.

  • Because of the very real risk of relapse on discontinuing these therapies compared to the currently low risk of COVID-19 infection, the present advice is that these medications should be continued.

  • Your neurologist may wish to monitor your immune cell counts more frequently.

  • You should follow the standard advice regarding prevention of COVID-19 infection.

Pulsed immunosuppressive therapies (rituximab [Rituxan], ocrelizumab [Ocrevus], alemtuzumab [Lemtrada], cladribine [Mavenclad], autologous haematopoietic stem cell therapy [AHSCT])

  • These therapies are immunosuppressive to varying degrees and for variable periods of time.

  • Because of the pulsed nature of these therapies there are options to delay courses of treatment.

  • Decisions on whether or not to delay a course of these therapies should be discussed with your neurologist.

  • Because of the very low risk of COVID-19 in many states and territories the use of alemtuzumab has resumed sometimes with additional precautions of self-isolation immediately before and after therapy.

  • A study of cladribine has not shown any cause for concern.

  • The risk/benefit profile of rituximab and ocrelizumab in those with additional risk factors for worse outcomes from COVID-19 (age >60 years, male gender, comorbidities, higher levels of disability) needs to be considered carefully on a case-by-case basis.

  • You should follow the standard advice regarding prevention of COVID-19 infection, in some situations, on the advice of your neurologist, it may be appropriate to take additional precautions.

 

Advice regarding aHSCT:

Autologous Haematopoietic Stem Cell Treatment (aHSCT) includes intensive chemotherapy treatment. This severely weakens the immune system for a period of time. People who have recently undergone treatment should extend the period they remain in isolation during the COVID-19 outbreak. People who are due to undergo treatment should consider postponing the procedure in consultation with their healthcare professional.
 

Seeking medical advice for relapses and other health concerns:

People with MS should still seek medical advice if they experience changes in their health that may suggest a relapse or another underlying issue such as an infection. This can be done using alternatives to in-person clinic visits (such as telephone or video consultations) if the option is available. In many cases, it is possible to manage relapses at home. 

The use of steroids for treating relapses should be carefully considered and only used for serious relapses. Where possible, the decision should be made by a neurologist experienced in the treatment of MS. People who receive steroid treatment for a relapse should be extra vigilant and may want to consider self-isolation for an appropriate amount of time to reduce their risk from COVID-19. People with MS should continue to participate in rehabilitation activities and stay active as much as possible during the pandemic. This can be done through remote sessions where available or in clinics as long as facilities are taking safety precautions to limit the spread of COVID-19. People with concerns about their mental health should seek advice from their healthcare professional