Photo/Illutration Dexamethasone, a steroid drug for pneumonia patients (Takahiro Takenouchi)

Japan faces a dire shortfall of steroids and anticoagulant drugs as it grapples with the fifth and most serious wave of the COVID-19 pandemic, prompting the health ministry to call on hospitals and pharmacies not to load up on such medicines.

Dexamethasone, a steroid in tablet form that is ingested orally, is used to treat COVID-19 patients with moderate symptoms recuperating at home.

“If properly used, it is the only reliable drug for patients recuperating at home,” said Masaya Yamato, director of the Infectious Diseases Center at Rinku General Medical Center in Izumisano, Osaka Prefecture. “Being unable to obtain the drug presents a big problem.”

Nichi-Iko Pharmaceutical Co., based in Toyama, is the only company in Japan that manufactures Dexamethasone oral tablets.

It was inundated with orders equivalent to a month's worth of shipments during a two-day period in mid-August.

Orders have continued to pour in since then, outstripping the company’s ability to meet demand, a representative said.

The health ministry on Aug. 27 notified hospitals and pharmacies nationwide, as well as distributors of the steroid drug, not to stockpile the medicine.

On Aug. 31, it released new guidelines for COVID-19 treatment that allow patients recuperating at home to be prescribed with Dexamethasone ahead of time, before their symptoms suddenly deteriorate.

This is expected to fuel greater demand for the medication.

Some products like Heparin, a drug to prevent blood clots, are in short supply, too.

Heparin is typically prescribed to women who suffer recurrent pregnancy loss. An estimated 1.4 million women in Japan are believed to suffer from this condition.

Pregnant women at high risk of developing blood clots are of particular concern as they need to inject heparin calcium twice daily at home.

Because of the pandemic, the drug is increasingly being used to treat COVID-19 patients to prevent their symptoms from turning severe quickly.

Tokyo-based Mochida Pharmaceutical Co. on Aug. 24 announced it will adjust its shipping capacity for heparin calcium production.

Okayama University Hospital has treated COVID-19 patients as well as those who suffer recurrent pregnancy loss.

Deliveries of the drug in September are expected to drop to 1,400 vials from the usual 2,500 or so.

COVID-19 patients can be treated intravenously with Heparin, but women who suffer recurrent pregnancy loss may not be able to be prescribed with the drug they need, the hospital said.

Mikiya Nakatsuka, a professor of gynecology at Okayama University, said the rapid spread of COVID-19 cases had hugely impacted patients who suffer from other diseases and called on the public to be more vigilant against novel coronavirus infection to help maintain stocks of vital drugs.

(This article was written by Fumi Yada and Takahiro Takenouchi.)

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