Black fungus patients increase but drugs not available in Telangana, say doctors

HYDERABAD: Shortage of medicines to treat black fungus affliction is a major challenge. Different grades of amphotericin drugs are not available in the city.

Ear, nose and throat doctors in private hospitals and pharmacists say they do not understand why such a shortage.

Amphotericin B deoxycholate is a conventional drug that has side-effects affecting kidney but doctors say they can get a kidney specialist to manage the patient and stop the fungus invasion if the medicine is available. 

“This medicine is cheap but not available in Telangana. It costs about Rs 400,” a doctor said.

Private hospital managements have reached out to stockists in Chennai and Bangalore for different grades of amphotericin. ENT specialists have also contacted their colleagues in Mumbai and Delhi. The drug is available in these cities.

An ENT specialist said, "There is need for aggressive intervention by the state government.  We are having patients with invasion in the eyes. Surgical removal of fungus is possible by removing the eyeball and cleaning the region from nose to eyes. But, in order to not allow the fungus to regrow, we need amphotericin.”

The conventional drug will also do, and we need to urgently save the affected patients from this life-threatening invasion."

At present, doctors are also using antibiotics and alternative drugs but they say this is not helping.

Dr Srinivas Kishore, ENT surgeon at Asian institute of gastroenterology says, "We have 40 patients in the hospital and require 1,000 vials. Till we get the medicine we are managing somehow, but the drug is required for complete recovery."

Doctors are not able to understand why this shortage. Production was always less, though. Since the last one week, there has been constant hue and cry over black fungus. Production should have been scaled up and the drug made available in a matter of a few days, say senior ENT doctors.

The raw materials for different grades of amphotericin are available in the market. A senior pharmacist says, "In my 42 years of practice, there has never been such a steady shortage of medicines. Where have all the stocks gone? There are no old stocks in the market, they say, but this cannot be the case.”

Each stockist would have at least 10,000 vials in different centres for antifungal treatment.

The grade of liposomal amphotericin B is an advanced version and it is costly. The price for this medicine ranges from Rs 2,000 to Rs 3,000 for 50 mg. This has minimal side-effects on kidney compared to conventional amphotericin. The production of this particular grade was always limited.

Each patient in the present situation requires 100 vials for cure. ENT specialists urge the government to intervene and make the drug available as soon as possible for all hospitals.