Assessment of Risks of Uncontrolled use of Drugs with Expected Effectiveness against COVID-19 by Patients with Breast and Prostate Cancer at the Pre-hospital Stage

Abstract

Aims: To reflect on the impact of self-medication in times of pandemic COVID-19 for patients undergoing treatment for breast or prostate cancer. Study Design:  this is a reflective study with a qualitative approach based on the documentary analysis of the package inserts issued by ANVISA or by the manufacturers of the analyzed drugs. Place and Duration of Study: Integrated Health Research Laboratory from the UFRJ-Macaé Multidisciplinary Center, between March 2020 and December 2020. Methodology: The documents analyzed were the package inserts of the five main drugs used by the Brazilian population during the first year of the pandemic, from March to December 2020, as well as the package inserts of some of the main antineoplastic drugs used to treat breast and prostate cancer. All inserts were issued by ANVISA or by the drug manufacturer. We chose to reflect on the impact of self-medication on the symptoms of COVID-19 and the most common cancers in women (breast) and men (prostate). Results: In Brazil, where, according to the Brazilian Association of Pharmaceutical Industries, around 80 million people are self-medicated, the poor quality of the supply of medicines, non-compliance with the obligation to present a medical prescription and the lack of information and education in the general population justify the concern with the quality of self-medication practiced in the country. The present study focused on the five main drugs described in the literature most used for self-medication and often with explicit contraindication by health agencies such as WHO and ANVISA, namely: chloroquine, hydroxychloroquine, ivermectin, vitamin D, dexamethasone. Conclusion: The study suggests that the analyzed drugs can harm the health of patients undergoing cancer treatment, as it shows that they can increase the risk of liver, kidney, heart or gastrointestinal damage. It is concluded that self-medication performed by a patient with breast or prostate cancer can bring moderate to severe risks with regard to drug interaction and metabolization pathways, as some of these drugs are mistakenly used as a form of prevention and treatment for COVID-19 not only do they have dangerous adverse effects for cancer patients, but they can also potentiate the adverse effects caused by cancer treatments.