COVID Drug Names in India: Current Status of Each

This guide to covid drug names covers what each one is, its CDSCO approval history, and which ones the January 2023 MoHFW clinical guidance still recommends versus which ones it now excludes.

What is remdesivir and is it still used for COVID-19 in India?

Remdesivir is an intravenous antiviral that CDSCO cleared for restricted emergency use in hospitalised COVID-19 patients on 21 June 2020, initially for severe disease and later extended to moderate disease with high risk of progression. It remains in the current protocol, but with a narrower window than in 2020.

The 5 January 2023 AIIMS/ICMR-COVID-19 National Task Force guidance lists remdesivir only for moderate or severe disease at high risk of progression, started within 10 days of symptom onset, in patients on supplemental oxygen but not on invasive mechanical ventilation or ECMO, for a maximum of 5 days. The same guidance notes no evidence of benefit beyond 5 days and flags it as not recommended when eGFR is below 30 mL/min/m² MoHFW/AIIMS/ICMR clinical guidance, revised 05/01/2023.

Hetero's COVIFOR and Cipla's CIPREMI were among the first Indian-manufactured generic remdesivir brands cleared for the domestic market in 2020 CDSCO SEC recommendation, 25.08.2020. CDSCO's approval carried an active-surveillance reporting condition on manufacturers, a requirement documented in a peer-reviewed analysis of that surveillance data PMC safety analysis of remdesivir surveillance.

Is molnupiravir still recommended for COVID-19 in India?

No. Molnupiravir, an oral antiviral marketed by Merck and licensed to several Indian generic manufacturers in 2021, appears explicitly under "DO NOT USE IN COVID-19" in the current national protocol. This is a reversal from its late-2021 restricted emergency use clearance.

CDSCO's expert panel had approved molnupiravir for restricted use in emergency situations in late 2021, and multiple Indian companies launched generic versions soon after. But two CDSCO-approved Indian trials of molnupiravir, run by Aurobindo and MSN Laboratories, were stopped early after enrolling more than 2,000 moderate-COVID patients without showing significant clinical benefit. The drug was absent from ICMR's list of recommended treatments from early 2022 onward, and the January 2023 protocol formalises the exclusion by name MoHFW/AIIMS/ICMR clinical guidance, revised 05/01/2023. WHO's own living guideline still permits molnupiravir only as a fallback for high-risk patients when nirmatrelvir-ritonavir is unavailable, and advises against it entirely for moderate-risk patients WHO living guideline, therapeutics and COVID-19.

What is favipiravir and why is it no longer part of India's protocol?

Favipiravir is an oral antiviral, developed originally by Japan's Toyama Chemical, that Glenmark Pharmaceuticals became the first Indian company to receive regulatory clearance for, launching it under the brand FabiFlu for mild-to-moderate COVID-19 in June 2020 at roughly ₹103 per tablet. It, too, now sits on the "do not use" list.

Approval came through India's accelerated pandemic pathway following a special expert committee recommendation, not through a completed Phase 3 efficacy trial in the Indian population CDSCO SEC recommendation, 25.08.2020. Independent reviewers questioned the strength of that evidence base within months of the launch. The January 2023 national guidance settles the question by naming favipiravir directly alongside molnupiravir, azithromycin, doxycycline, ivermectin, hydroxychloroquine, lopinavir-ritonavir, convalescent plasma and neutralising monoclonal antibodies as agents that should not be used in COVID-19 MoHFW/AIIMS/ICMR clinical guidance, revised 05/01/2023.

What is dexamethasone's role in COVID-19 treatment and why does it stay on the protocol?

Dexamethasone is a low-cost corticosteroid, and it is the one drug on this list with trial evidence solid enough that it never left the protocol. The UK's RECOVERY trial, a 6,425-patient randomised platform trial, found 28-day mortality of 22.9% in the dexamethasone arm against 25.7% with usual care alone, a reduction concentrated in patients on oxygen or ventilation NEJM, Dexamethasone in Hospitalized Patients with Covid-19.

India's current protocol prescribes dexamethasone 6 mg/day, or an equivalent methylprednisolone dose, for moderate and severe disease requiring oxygen, for 5 to 10 days or until discharge, whichever comes first. It explicitly states there is no evidence of benefit in mild disease not requiring oxygen, and flags a real risk of secondary infection, including invasive mucormycosis, at higher doses or longer duration MoHFW/AIIMS/ICMR clinical guidance, revised 05/01/2023. Unlike remdesivir, molnupiravir or favipiravir, dexamethasone is off-patent, cheap, and stocked in nearly every Indian hospital pharmacy already, for reasons unrelated to COVID-19.

Is Paxlovid (nirmatrelvir-ritonavir) available or approved in India?

Paxlovid itself, Pfizer's branded nirmatrelvir-ritonavir combination widely used in the US and Europe, has no significant retail footprint in India under that brand name. Availability has instead run through voluntary licensing for generic manufacture, not a standard CDSCO retail launch.

Pfizer's 2021 voluntary licence with the Medicines Patent Pool allowed sub-licensed generic manufacturers, including Indian companies, to produce and supply nirmatrelvir-ritonavir combinations to around 95 lower- and middle-income countries. Hetero's generic version, Nirmacom, became the first such generic to receive WHO Prequalification WHO Prequalification, Hetero nirmatrelvir/ritonavir. WHO's living guideline still names nirmatrelvir-ritonavir its preferred agent for high-risk non-hospitalised patients globally WHO living guideline, therapeutics and COVID-19, but it never became a routine line item in India's own national protocol the way remdesivir and dexamethasone did.

What about tocilizumab and anticoagulation in India's current COVID-19 protocol?

Tocilizumab, an interleukin-6 receptor blocker, remains a conditional option in the current protocol, not a first-line drug. It is reserved for rapidly progressing severe disease not responding adequately to steroids, ideally within 24-48 hours of severe-disease onset or ICU admission, and only after active tuberculosis, fungal and systemic bacterial infection have been ruled out MoHFW/AIIMS/ICMR clinical guidance, revised 05/01/2023.

Prophylactic-dose anticoagulation, using unfractionated heparin or weight-based low-molecular-weight heparin such as enoxaparin, sits alongside dexamethasone in the moderate and severe disease columns of the same protocol, conditional on no bleeding risk or contraindication. Neither tocilizumab nor prophylactic anticoagulation is a home-treatment drug; both apply only in the ward or ICU setting the protocol defines for moderate and severe disease.

How should a hospital pharmacy track which COVID-19 drugs are still in active use?

Tracking covid drug names against the current protocol matters: a hospital pharmacy needs a clear, dated line between what's named and what's excluded, since both lists changed materially between 2020 and 2023. Stocking discontinued drugs such as favipiravir or molnupiravir on the assumption that 2021 ordering patterns still hold wastes capital that could sit in dexamethasone, oxygen consumables or the anticoagulants the current protocol still calls for.

The inverse failure is just as costly during a genuine surge: running short on dexamethasone, prophylactic-dose LMWH, or remdesivir for the narrow moderate-to-severe window it still covers creates a real care gap at exactly the moment demand spikes. A formulary review tied to each protocol revision, not to a fixed annual calendar, is the only way to keep pace with a drug list that has already changed twice since 2020. Medyzen's guides on managed hospital pharmacy services and pharmacy inventory management for expiry and dead stock cover how that kind of protocol-linked stock review works in practice.

Sources

1. 1Clinical Guidance for Management of Adult COVID-19 Patients, revised 05/01/2023 — AIIMS/ICMR-COVID-19 National Task Force/Joint Monitoring Group, Ministry of Health & Family Welfare, Government of India
2. 2CDSCO Subject Expert Committee Recommendation, 25.08.2020 — Central Drugs Standard Control Organisation
3. 3Safety and clinical outcomes of remdesivir in hospitalised COVID-19 patients: a retrospective analysis of active surveillance database — PMC, National Institutes of Health
4. 4Dexamethasone in Hospitalized Patients with Covid-19 — New England Journal of Medicine, RECOVERY Collaborative Group
5. 5Therapeutics and COVID-19: living guideline — World Health Organization
6. 6WHO Prequalification of Medicines Programme — Hetero nirmatrelvir/ritonavir (Nirmacom) — World Health Organization
7. 7Central Drugs Standard Control Organisation — Drugs and Cosmetics Act, 1940 and Rules, 1945

This article is for informational purposes and is not a substitute for professional medical advice. Clinical protocols evolve; consult current MoHFW guidance and a treating physician.