Medicines advice during COVID19
Reference & Guidance
· Continue to take preventer inhaler
· Carry your reliever inhaler with you
· Make an asthma management plan to help you recognise and manage your symptoms
When to seek medical advice: if your symptoms are getting worse, your reliever inhaler is not working or not lasting 4 hours
For those with SEVERE ASTHMA the NHS will contact you with further information on 23/03/20
· Follow general Covid-19 advice regarding hand washing using your usual emollient soap substitute.
· Continue to use you emollient to wash your hands when out
· Apply more emollient after hand washing
· If you feel you need to use a hand sanitiser gel, apply emollient afterwards, this will help reduce irritation
If someone with diabetes has coronavirus symptoms the following additional advice should be given regarding monitoring:
· Patients who check blood sugar levels at home, continue to do so but more frequently
· If patients do not check blood sugar levels at home they need to be aware of signs of hyperglycaemia: urinating more than normal, being very thirsty, headaches, lethargy and tiredness AND contact the practice if they have these symptoms
· For TYPE 1 diabetics check your blood sugar levels every 4 hours, including at night. If your blood sugar levels are high, check your ketone levels
When to seek medical advice: patients who have symptoms of hyperglycaemia and do not check blood sugar levels at home, presence of ketones, vomiting, unable to keep fluids down
Please see the foot of this page for additional information
Hypertension/ Heart failure
There has been a lot of discussion in the press and on social media about the possibility that treatment with ACEi or ARB could predispose individuals to adverse outcomes should they become infected with COVID-19.
The view of the British Cardiovascular Society (BCS) and the British Society for Heart Failure (BSF) is that there is no evidence to support this assertion and they share the view of the European Society of Hypertension and the Renal Association that patients should continue treatment with ACEi and ARB unless specifically advised to stop by their medical team.
Patients taking these drugs and presenting unwell with suspected or known COVID-19 infection should be assessed on an individual basis and their medication managed according to established guidance (Heart 2019;105:904-10).
BCS statement: https://mailchi.mp/bcs/bcs-newswire-795910
Renal Association UK Position statements on:
COVID-19 and ACE Inhibitor/Angiotensin Receptor Blocker use
For patients: novel corona virus infection and the use of blood pressure medications
European Society of Cardiology (ESC) Council on Hypertension (ECH)/ ESH position on:
Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers
There is no evidence from clinical or epidemiological studies that treatment with ACE-I or ARBs might worsen COVID-19 infection
· Access reliable sources of information such as:
https://www.nhs.uk/conditions/coronavirus-covid-19/ or https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response
· Limit exposure to social media
· Keep in contact with family and friends
· If you are taking prescribed medicines for pain relief, continue to do so, as prescribed. This includes NSAIDs.
· Paracetamol is the preferred option to treat the symptoms of coronavirus.
NSAIDs: NHS England- Message for All clinical staff: Anti -inflammatory medicines
Crohns & Ulcerative Colitis
· If you develop any coronavirus or flu symptoms, you should self-isolate and get in touch with your IBD team by phone before making any changes to your treatment.
· If at increased risk of infection due to direct contact, previous travel to a high risk area, or have co-morbidity that increases risk further advise patient to contact the IBD team
· If patients stop taking immunosuppressive medicine, they may have a flare which will increase the risk of complications if infected with coronavirus.
Full guidance can be accessed at the links provided.
· Continue to take all medicines as prescribed for active TB
· Contact TB team if you fall ill with COVID 19 symptoms.
When to seek medical advice: new symptoms of cough, fever or breathlessness
· Patients on long term steroids should not stop these abruptly; if a patient develops signs of an infection further management should be discussed with rheumatology team.
· If planning to change or start a new medication this should now be reviewed
· If patients develop symptoms of an infection follow current guidance and pause immunosuppressive therapy whilst in discussion with rheumatology team.
· Further guidance is being developed and NHS England have said that they will be directly contacting all transplant patients with advice on how to keep safe.
· In addition, people who are taking immunosuppressants should be aware that they shouldn’t make changes to medication unless advised to do so by their specialist.
· If a patient is diagnosed with COVID-19, it is recommended that the patient inform their transplant unit and they be monitored remotely during self-isolation.
· The MS society has information about Covid-19 and specific MS treatments on its website
If you take steroids for any reason DO NOT stop taking these without discussing it first with a Health Care Professional.
If you are taking high blood pressure medication there is no evidence from clinical or epidemiological studies that treatment with ACE-I or ARBs might worsen COVID-19 infection.
If you have type I Diabetes please make sure you have ketone testing strips. To remind you the sick day rules for everybody are as below.
Ketone testing for people with type I Diabetes
Type I Diabetes and managing worries about COVID19
Type I Diabetes and Sick day rules
Type 2 Diabetes and Illness summary
Type 2 Diabetes and Illness full guide