Mefenamic Acid in the Elimination of Fever in COVID-19

Verity is not Born in Controversy - Verity's Opponents Die Out!!!

?? I continue to elaborate on a reviewers rejected abstract I submitted for an oral presentation at the 19th World Congress of Basic and Clinical Pharmacology scheduled for July 2-7, 2023 in Glasgow, Scotland, United Kingdom.

?? As a reminder, I’m citing the entire original text of the abstract that I already published in a previous post:

? Clinical Efficacy and Safety of Pharmacotherapy of Fever/Pyrexia in COVID-19: Results of a Selective Anonymous Survey of General Practitioners in Ukraine.

? Introduction/Background & aims

? Most of the patients do require a drug to control the fever/pyrexia in COVID-19 [1-3]. In order to obtain insights into the clinical efficacy and safety of pharmacotherapy of fever/pyrexia in COVID-19, an anonymous survey was conducted.

? Method/Summary of work

? A Selective Anonymous Survey was conducted in Ukraine, in which 24 general practitioners (GPs) agreed to participate: that anonymous survey have been conducted since September 28, 2020 till September 30, 2022.

? Results/Discussion

? According to the results of the anonymous survey mentioned above, it was established that all 24 GPs detected COVID-19 in 2650 patients. In all patients (N=2650), clinical manifestations of COVID-19 were accompanied by an increase in temperature to the level of ≥38.2 °C in combination with such symptoms as chills, rapid heartbeat and headache, which disappeared under conditions of normalization of temperature (35.8-36.9 °C) after of using antipyretics by these patients: Acetylsalicylic acid was used by 0.2% of patients, Metamizole sodium by 3.5%, Paracetamol by 96.3%, Ibuprofen by 38.2%, Mefenamic acid by 58.1% (Figure). I's important to note that Ibuprofen and Mefenamic acid were used 4-6.5 hours after using Paracetamol due to the repeated increase in temperature to the initial level. It was in 58.1% of patients with COVID-19 (N=2650), who used Mefenamic acid once a day in a dose of 500-1000 mg for 1-2 days, that the body temperature remained within normal limits, and an improvement in the general condition was observed. Mefenamic acid caused insignificant adverse reactions in the form of nausea in 3.7% and skin rash in 0.1% of patients (N=2650).

? Conclusion(s)

? The results, which revealed the advantages of Mefenamic acid over other antipyretics in terms of clinical efficacy and safety in the treatment of COVID-19, don't lead to categorical conclusions about the connection of the pharmacological properties of this drug with the positive dynamics of the course of COVID-19, but also do not deny this in any way.

? Reference(s)

? [1] Dr. R. P. Pareek. Use of Mefenamic Acid as a Supportive Treatment of COVID-19: A Repurposing Drug. International Journal of Science and Research 2020; 9 (6): 69–73. https://www.ijsr.net/archive/v9i6/SR20530150407.pdf

? [2] M. Day. Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists. BMJ 2020; 368: m 1086. https://www.bmj.com/content/bmj/368/bmj.m1086.full.pdf

? [3] R. Vaja, J.S.K. Chan. The COVID-19 ibuprofen controversy: A systematic review of NSAIDs in adult acute lower respiratory tract infections. // British Journal of Clinical Pharmacology: 2021; 87: 776–784. https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1111/bcp.14514

????????The above abstract was rejected, causing me a flurry of emotions. Desperation combined with indignation that I had wasted my time writing, designing, and submitting the abstract. The reason for the rejection of my abstract, which was given to me, made me even more angry and depressed: my abstract, according to the reviewers' conclusions, does not meet the criteria. In addition to submitting a question about what criteria a rejected abstract does not meet, I went to my account at the web link https://wcp.eventsair.com/PresentationPortal/Account/Login?ReturnUrl=%2FPresentationPortal%2Fwcp2023%2Fabstracts and was shocked: when I submitted the abstract (it was at the beginning of November 2022) - the abstract text limit was 400 words, and then suddenly the limit increased to 10,000 words and I didn’t know about it. They suddenly changed the rules and I wasn’t informed, which leads me to suspect discrimination against my person. Yes, I suspect discrimination against me – discrimination for reasons unknown to me. There are many types of discrimination: racial, ethnic, gender, citizenship, I wasn’t liked by those on whom my fate depends, etc. I had to deleate so many sentences from the text of the abstract that the system registered my abstract as submitted. I can also assume the reason for the discrimination of my person: I am unemployed, my research was not funded, I am a citizen of Ukraine, where the situation is very uncertain due to the war and other sad changes in various aspects of activity, including scientific. In any case, I suspect very foul play on my part. I suspect a hidden contempt for me. I don't claim respect, but I don't think I deserve disrespect.

? I asked the organizers of the congress to give me an answer to the question about what was wrong with my abstract, which was rejected by the reviewers. My question was forwarded to Professor Clive Page and I received the following reply that my abstract was marked down on lacking sufficient novelty and for lack of detail in the abstract of the ethical approval. So, the verdict on my abstract has been passed. On the basis of the verdict, a sentence was passed, according to which the topic of my oral speech has no place at the congress. And since my abstract has no place at the congress, it certainly has no place for me either.

????????As Professor Clive Page (British Pharmacological Society) wrote to me, each abstract was reviewed independently by two referees - I understood that it wasn’t artificial intelligence. I wonder: what if these two independent referees predict tomorrow the end of the world or my death – the end of the world is inevitable and I will definitely die?

????????Let the whole Сommunity and social networks read my abstract and my extended account of what I didn’t tell in the abstract, because I intended to mention it in my oral presentation at the congress, if I would be allowed to do that. I don’t rule out the fact that I will waste time and energy as much as when preparing an abstract, and all my own arguments will be like “pearls before swine” or “holy unto the dogs”, but I will definitely not regret it.

????????I will start with a question about the ethical approval of my research. In Ukraine, all themes of scientific research on drugs, which claim to be funded and obtain a scientific degree, as well as initiative-research scientific works necessarily undergo a review procedure by ethical commissions/committees, but this applies only to those research works that are performed in a certain scientific institution. My own research was not carried out in any scientific institution. I am unemployed, but with a higher education and a scientific degree, which you can read about below. In Ukraine, there has not yet been such a case when ethical commissions/committees considered submissions from citizens conducting research outside of an official scientific institution. And I have never had such a thing that I went through the procedure of consideration by the ethics committee in order to submit an abstract for an oral presentation at a scientific conference or scientific congress. When my scientific dissertation was submitted for consideration by the Specialized Academic Council, I necessarily submitted it to the ethical commission of the scientific institution where I performed the specified scientific work. But in this case, I claim neither a scientific degree nor an award. And I haven’t conducted any experimental drug research on animals or humans that requires ethical approval. I feel as if the reviewers treated me like a homeless person: no one took into account that such a "homeless person" does not dress like a beggar, does not use urban slang, does not smell "homeless" of something repulsive, and "homeless" does what every person who had a home would do. But like every homeless person, I have no rights: it is enough to see in the information about me that my research is not connected with any scientific institution and I am shown the door. And here I feel again, hidden under the mask of politeness and tact, contempt towards me with discrimination of my person: the submitted abstract is not trustworthy, because I’m unemployed.

????????The set limit of 400 words didn’t allow me to talk about my own research in detail, so I will talk about it here. The material for my study was information on 2,650 patients who fell ill with COVID-19 for the period since March 1, 2020 till August 31, 2022. I received the mentioned information from 24 General Practitioners in Ukraine as a result of an Anonymous Survey conducted by me for the period since September 28, 2020 till September 30, 2022. Thus, in line with the above, my own research was a retrospective study. As everyone can see in the section “Results/Discussion” of my abstract all patients (N=2650) had clinical manifestations of COVID-19 which were accompanied by an increase in temperature to the level of ≥38.2°C in combination with such symptoms as chills, rapid heartbeat and headache, which disappeared under conditions of normalization of temperature (35.8-36.9°C) after of using antipyretics by these patients: Acetylsalicylic Acid was used by 0.2% of patients, Metamizole Sodium – by 3.5%, Paracetamol – by 96.3%, Ibuprofen – by 38.2%, Mefenamic Acid – by 58.1%. Ibuprofen and Mefenamic acid were used in 4-6.5 hours after using Paracetamol due to the repeated increase in temperature to the initial level. The body temperature remained within normal limits, and an improvement in the general condition was observed in 58.1% of patients with COVID-19 (N=2650), who used Mefenamic acid once a day in a dose of 500-1000 mg for 1-2 days. Among those 41.9% of patients who did not take Mefenamic Acid to eliminate fever in case of COVID-19, 18.8% required hospitalization due to complications (N=2650). Among the already mentioned 58.1% of patients who took Mefenamic acid as an antipyretic for fever as a manifestation of COVID-19, none required hospitalization, continuing further treatment at home (N=2650).

???????Frankly speaking, I’m overcome by such laziness to prove to the "Heavens" or what to call "Angels" in the person of representatives of the British Pharmacological Society and other world pharmacological societies that my research topic carries novelty, despite the fact that the drugs mentioned in my abstract have been around for a long time not new. This is not the first time I have had to constantly prove something over the past 20 years. If my abstract is distrusted, I suspect prejudice and discrimination against me. If there is a presumption of innocence, why not a presumption of trust? Until someone provides evidence that the research data presented in my abstract is fake, why not consider the story I have provided to be true? In Ukraine, and I think in the United Kingdom, for many, the word "novelty" of research in basic and clinical pharmacology is identified with the Drug Discovery and Development, including Clinical Trials of these new drugs, but when it comes to the Post-Marketing Period of the Drug/Medicine, it causes such manifestations of arrogance and disdain from the scientific "powers that be" ranging from an ironic smile to a cynical laugh. – you see, give them only new drugs because they themselves are used to only "licking the cream", not even worrying about what will happen to the leftovers. It is not the first time that I feel when I’m looked at from top to bottom, as if I were a representative of the lowest grade, like an underdeveloped creature that has no rights, only duties. Such scientists who see novelty only in the Discovery and Development of Medicines and despise the Post-Marketing Period of the Life Cycle of Medicines resemble cuckoos who lay eggs in other bird's nests without caring for their chicks, or parents who do not care about their own children growing up under under the care of foster parents or guardians. But it is not the first time in the last 20 years that I have had to endure mocking laughter at me for the fact that the subject of my study are drugs/medicines that are older than me in age. I welcome the discovery and development of new drugs and am convinced that without it the existence of pharmacology and medicine as a whole is impossible, but I’m also firmly convinced that the neglect of drugs that have already been discovered and developed long ago and now occupy a place in the pharmacotherapy of various diseases is a direct the road to nowhere, because it endangers the existence of pharmacology and medicine. Unfortunately, there are still those who tend to believe that having discovered and developed drugs that have passed preclinical studies and clinical trials, they have already received comprehensive information about pharmacological properties, as well as about benefits and risks. It is worth recalling many examples when drugs that have long been used in Practical Medicine received an additional therapeutic purpose due to substantiated additional information about their pharmacological properties, for example, Professor of Experimental Pharmacology John Vane and others proved the antiplatelet properties of Acetylsalicylic Acid while clinical trials and other studies since 1960s till 1980s established Aspirin's efficacy as an anti-clotting agent that reduces the risk of clotting diseases. In my scientific activity, which has not become as active as before, I paid attention to the works of Professor John Vane on Cyclooxygenases (COX), because the subject of my study became COX inhibitors, which are Non-steroidal in their chemical structure and Anti-inflammatory Drugs with the exception of Paracetamol/Acetaminophen and Metamizole sodium. Since 2010, I have been paying more attention to antipyretics. All Non-steroidal Anti-inflammatory Drugs (NSAIDs), as well as Paracetamol/Acetaminophen and Metamizole sodium, in addition to pain relief, also have an antipyretic effect, but only Acetylsalicylic acid, Paracetamol/Acetaminophen, Ibuprofen and Metamizole sodium (in Ukraine, Metamizole sodium is used as an antipyretic and painkiller, but this drug is not respected in the European Union and others, although its analgesic and antipyretic effect is superior to that of Paracetamol/Acetaminophen and Ibuprofen, which has repeatedly prompted physicians to secretly deviate from WHO recommendations and current treatment protocols and unofficially administer Metamizole Sodium to patients, which has repeatedly improved the quality of life of such patients and even saved lives). In 2015, from a personal conversation with one physician, I learned about the similar opinions of many physicians about the remarkable ability of Mefenamic Acid to normalize body temperature, eliminating fever in flu, acute respiratory viral infections, and other diseases with fever symptoms. I met physicians who attended scientific and practical congresses and conferences, some of whom became general practitioners during the health care reform in Ukraine. Many of them even wondered why scientists don’t pay due attention to Mefenamic Acid as an effective antipyretic, taking its place as the drug of choice in the treatment of fever of various origins next to Paracetamol/Acetaminophen and Ibuprofen.

????????I don’t have access to the British National Formulary because I’m not based in the UK, but I have been a member of the British Pharmacological Society. I could have named the British Pharmacological Society as an organization I was a part of and indicated that I was a member of the Engagement Committee, but the system asked for something else entirely. As a citizen of Ukraine, I don’t officially work anywhere and it isn’t known when I’ll be able to get a job legally. Instead, I found this year's publication for on the Mefenamic Acid for Patients website of ? Egton Medical Information Systems Limited registered in England and Wales https://patient.info/medicine/mefenamic-acid-for-pain-and-inflammation-ponstan , which clearly states that Mefenamic Acid is used for Relief of Pain and Inflammation in adults and in children over 12 years of age and not a single word about fever. I can assume that the British National Formulary has the similar things about Mefenamic Acid as the website mentioned above regarding the indications for use. I will then familiarize you with the information on the indications for the use of Mefenamic Acid on page 506 of the Fourteenth Edition of the State Formulary of Medicinal Products, approved by the Order of the Ministry of Health of Ukraine No. 1011 of June 13, 2022. In the aforementioned issue of the Ukrainian Drug Formulary, Mefenamic Acid has the following indications for use: SARS and influenza, pain of low and medium intensity (The document is underlined and next to it is a footnote in the form of an abbreviation in the Ukrainian language in Cyrillic БНФ, which means BNF in English and stands for British National Formulary; in Ukraine, the implementation of the Drug Formulary System was actively started in 2008, and in 2009, the First Edition of the State Formulary of Medicinal Products of the Ministry of Health of Ukraine was issued - the prototype for the Ukrainian Drug Formulary was the British National Formulary; further on in the text you can find several such underlines and footnotes of the БНФ – you will find details at the Internet link mentioned below on page 506): muscle, joint, traumatic, dental, headache of various etiologies, postoperative (footnote БНФ) and postpartum pain, primary dysmenorrhea, dysfunctional menorrhagia (footnote БНФ), including caused by the presence of intrauterine contraceptives, in the absence of pathology of the pelvic organs; inflammatory diseases of the musculoskeletal system: rheumatoid arthritis (RA that is in the Ukrainian language in Cyrillic РА with footnote БНФ), rheumatism, Bekhterev's disease. In detail, you can familiarize yourself with the above-mentioned information about Mefenamic Acid in the above-mentioned State Formulary of Medicinal Products in Ukrainian on pages 506-507 at the link https://moz.gov.ua/uploads/ckeditor/%D0%B4%D0%BE%D0%BA%D1%83%D0%BC%D0%B5%D0%BD%D1%82%D0%B8/dn_1011_13.06.2022_dod.pdf . I did the translation from Ukrainian to English myself, never having seen the information in the British National Formulary, because I never had access to the British National Formulary, and therefore my version of the translation from Ukrainian to English may not match the original version in the British National Formulary. According to the above-mentioned State Formulary of Medicinal Products of the Ministry of Health of Ukraine, nothing specific is written about the fact that Mefenamic acid is used for fever, but SARS and influenza are mentioned in the indications for use, which makes it possible to read the unwritten words "fever" or "pyrexia" between the lines. However, on page 506 of the same drug formulary, following the Internet link mentioned above, you can see in the section on Mefenamic Acid "Main pharmacotherapeutic action" the following: the mechanism of anti-inflammatory action is due to the ability to inhibit the synthesis mediators of inflammation, reduce the activity of lysosomal enzymes that participate in the inflammatory process; stabilizes protein ultrastructures and cell membranes, reduces vascular permeability, disrupts oxidative processes phosphorylation, suppresses the synthesis of mucopolysaccharides, inhibits the proliferation of cells in the focus of inflammation, increases cell resistance and stimulates wound healing; antipyretic properties are related to the ability inhibit the synthesis of prostaglandins and affect the center of thermoregulation; in the mechanism of analgesic action, along with influence on the central mechanisms of pain sensitivity, a significant role is played by local influence on the focus inflammation and the ability to inhibit the formation of algogens (kinins, histamine, serotonin); stimulates formation interferon. As can be seen from the information on the main pharmacotherapeutic effect of the mentioned Drug Formulary, Mefenamic Acid still has an antipyretic effect, but it is shown as a painkiller and anti-inflammatory agent, and the conditions of use of this drug in SARS and influenza are not specified. So, the antipyretic properties of Mefenamic Acid are at least mentioned in the Ukrainian Drug Formulary, but Mefenamic Acid is not clearly indicated as an antipyretic, although SARS and influenza are mentioned among the indications for use.

????????After my voluntary withdrawal from the British Pharmacological Society, which I have come to regard as a society of stagnation, degradation, which is so ludicrously disguised as Drug Discovery and Development, and suspected of hidden lobbying for the interests of the pharmaceutical business, but without serious concern for the health of patients, The British Pharmacological Society breathed a sigh of relief at getting rid of such an unpleasant person as me. And it is very difficult for me to be a pleasant person when it comes to the patient's condition caused by an elevated temperature, mainly fever. One of my physician colleagues talked about how she almost got into an argument with her father, also a physician, over whether to give her child an antipyretic when the body temperature fluctuated between 39.0 and 40.0 °C with SARS. You see, the old school of physicians of the former Soviet Union didn’t like antipyretics very much, because they believed that they suppress the immunity of the patient's body against the causative agent of an infectious disease. At last, that physician's child received an antipyretic. Of course, an increase in body temperature during infectious diseases indicates the body's immune activity and medical intervention is unnecessary if the body temperature fluctuates within subfebrile values, although I have repeatedly heard such opinions from Ukrainian physicians that it’s better to give the patient an antipyretic when the temperature increases to the level 37.5 °C and accompanied at the same time with tachycardia or tachyarrhythmia. As for fever, medical intervention is not only desirable – it’s simply vital, because it not only improves the state of health and quality of life, but also often saves the patient's life. After all, fever is a direct indication of intoxication of the body, and therefore it would be fair to ask whether antipyretics also have a detoxifying effect, since they contribute to an increase in sweating, etc. and is it correct to consider antipyretic therapy purely symptomatic? Even if the entire scientific world will consider the issue raised by me about the successful treatment of fever as "a long-read book in which you can only turn the pages and periodically change the design" or "Much Ado About Nothing" – then I will remain in opposition to such scientists.?

????????I don’t blame anyone, but only suspect the invisible referees who rejected my abstract for the above-mentioned congress, of being biased against me because of my citizenship and unemployment status, or of lobbying the interests of the pharmaceutical business, or something else. When it comes to antipyretics and at the same time only Paracetamol/Acetaminophen and Ibuprofen dominate the information space like two well-known political forces in the life of the United States of America – I have a suspicion of promoting business interests, while the manufacturers of these pharmaceutical products simply don’t care about the patient.

??????Thus, the issue of successful treatment of fever remains relevant today and, as the events of 2020 have shown, it’s an unresolved issue. And in that case, if the question remains unresolved, then not only any new research data, but also any ideas, as well as any observations, both active and passive, and even any other view of the revealed results both prospective and retrospective studies rightly claims to have the status of novelty. Given the conditions in Ukraine, which are definitely not conducive to scientific activity, I did not provide in my abstract a ready-made recipe for solving the problems of fever treatment and did not present the results of fundamental clinical prospective studies. Instead, I collected the anonymous opinions of physicians and their observations about the results of using Paracetamol/Acetaminophen, Ibuprofen, Acetylsalicylic Acid, Metamizole Sodium and Mefenamic Acid. I don't think my own study is worse than others just because I didn't "paint a pretty statistical picture" with calculations of the statistical significance of the study results – I didn't present it to focus on the importance of the clinical results of treating fever in COVID-19 above-mentioned antipyretics, to which it is fair to add the mentioned Mefenamic Acid. I am a physician by education. The period of my medical practice was short and was replaced by a period of scientific activity, but I still had the mindset of a physician. I came to Clinical Pharmacology from practical medicine. I have never worked in experimental pharmacology. In my work as a Clinical Pharmacologist, I was always interested in each drug first of all in its practical benefit for the patient and at least the minimal risk of adverse reactions, then in the direct (therapeutic) and side (including adverse effects) pharmacological action with available mechanisms, and only lastly I will be interested in the chemical composition and chemical structure of the molecule. I have repeatedly witnessed speculation about the statistical validity of clinical studies results, where the focus was on statistical significance to the neglect of clinical significance. In Clinical Pharmacology, the statistical significance of the effect of drugs cannot be higher than the clinical significance, otherwise Clinical Pharmacology ceases to be such in essence. Of course, statistical analysis and evaluation of research results is the cornerstone of modern science, but in Clinical Pharmacology, statistical analysis and evaluation should not be higher than clinical.

??? In the midst of the COVID-19 pandemic, discussions about the use of antipyretics for fever as a clinical manifestation of this new and unexpected SARS due to its severity and prevalence took place. An article was published in the British Medical Journal https://www.bmj.com/content/bmj/368/bmj.m1086.full.pdf , where it told that Scientists and Senior Doctors have backed claims by France’s Health Minister that people showing symptoms of COVID-19 should use Paracetamol (Acetaminophen) rather than Ibuprofen, a Drug they said might exacerbate the condition. The above mentioned article mentions that Jean-Louis Montastruc, a Professor of Medical and Clinical Pharmacology at the Central University Hospital in Toulouse, said that such deleterious effects from NSAIDS would not be a surprise given that since 2019, on the advice of the National Agency for the Safety of Medicines and Health Products, French health workers have been told not to treat fever or infections with Ibuprofen. The mentioned article also states that Ian Jones, a professor of virology at the University of Reading, said that Ibuprofen’s anti-inflammatory properties could “dampen down” the immune system, which could slow the recovery process. The same article also states that Charlotte Warren-Gash, Associate Professor of Epidemiology at the London School of Hygiene and Tropical Medicine, said about sensible to stick to Paracetamol as first choice for treating symptoms such as fever and sore throat. But as published on the website https://www.gov.uk/government/news/commission-on-human-medicines-advice-on-ibuprofen-and-coronavirus-covid-19 on April 14, 2020 the Commission of Human Medicines (CHM) Expert Working Group on Coronavirus (COVID-19) has concluded that there is currently insufficient evidence to establish a link between use of Ibuprofen, or other Non-steroidal Anti-inflammatory Drugs (NSAIDs), and susceptibility to contracting COVID-19 or the worsening of its symptoms, and therefore patients can take Paracetamol or Ibuprofen when self-medicating for symptoms of COVID-19, such as fever and headache, and should follow NHS advice if they have any questions or if symptoms get worse. Again, Paracetamol and Ibuprofen remain "owners of the territory, dividing the customers and they are so good and comfortable being a couple that they simply will not allow a third", and this "third" is Mefenamic Acid. How modest and unnoticed the article “Use of Mefenamic Acid as a Supportive Treatment of COVID-19: A Repurposing Drug” published in the International Journal of Science and Research https://www.ijsr.net/archive/v9i6/SR20530150407.pdf by Dr. R. P. Pareek looks – just like “the voice of one crying in the wilderness”!!! After all, in the above-mentioned article, with reference to already published scientific sources, it is said that Mefenamic Acid was found to be more effective and equally tolerable than Paracetamol as an antipyretic in paediatric patients with febrile illness and can be the best alternative to Paracetamol. Also in the same publication it is said that Mefenamic Acid has an anti-viral effect in synergy with the original antiviral drugs and can be repurposed for COVID-19 treatment along with its action as an antipyretic. Summarizing what was stated in the mentioned article, the author in the conclusion emphasizes that Mefenamic Acid can be used as an antipyretic in patients of COVID-19 with an additional benefit of it being also having the possibility of an anti-viral activity, but the studies are required to validate this opinion so as to repurpose the use of Mefenamic Acid in viral infections, such as of SARS-CoV-2. It was this June 2020 article mentioned above that inspired me to at least try to research the situation regarding the treatment of COVID-19, including the management of fever, and on September 28, 2020, I called one of the General Practitioners (GPs) whose contact details I had that was the beginning of the Anonymous Survey of GPs, which was completed on September 30, 2020, which I told about in the abstract rejected by the reviewers. Missing from the above-mentioned rejected by abstract of my retrospective study is the fact that I contracted COVID-19 in September 2022, approximately one year after I received my second dose of Spikevax. I didn’t take the booster dose. Favipiravir was prescribed to me by the physician, and I took care of the management of the fever personally, self-prescribing antipyretics. My fever with COVID-19 was manifested by an increase in body temperature to 38.6-39.1°C, and at the same time I also felt a headache, weakness, rapid heartbeat, difficulty breathing. I discovered the first symptoms of fever with the above temperature indicators for the first time in the morning and took 1.0 g of Paracetamol, after which my temperature indicators became within the normal range and I noticed the disappearance of the above accompanying symptoms, and also felt an improvement in my general condition, but in the evening the fever came back again and I took 1.0 g of Mefenamic Acid, after which the temperature indicators normalized within 2 hours, my condition improved and the next day the fever did not bother me until the evening. I didn’t take Ibuprofen or other antipyretics. The fever returned the next evening and I decided to use only Mefenamic Acid to eliminate it and was successful: the fever did not bother me the next day or the following days - with the temperature fluctuating between 35.8-36.9°C only on the last two evenings rose to subfebrile, but not higher than 37.3°C. But that's not all: in July 2022, I fell ill with a serious gastrointestinal disorder of unspecified etiology, complicated by dehydration and signs of kidney failure, as my blood Creatinine level significantly exceeded the reference values. The disease started with a fever with a temperature of 39.3°C, but the PCR test didn’t confirm the presence of SARS-Cov-2 in me, as it happened in September, which I have already told. Emergency personnel at my home rehydrated me, I was on a strict diet for three weeks, and I was offered a gastroscopy and colonoscopy, which I didn’t undergo due to my psychological unpreparedness for such clinical procedures. But I haven’t yet told how I managed to eliminate the fever. To eliminate the fever, I took 1.0 g of Paracetamol, but the fever was only eliminated for two hours and I took 1.0 g of Mefenamic Acid and the fever did not bother me for 12 hours – this was repeated for about three days, until I gave up on the fourth day from Paracetamol and began to take Mefenamic Acid three times a day every 4 hours and on the fifth day the temperature indicators fluctuated between 36.3-37.1°C, and in the following days they became 35.9-36.8°C. I would also like to note that Mefenamic Acid is an over-the-counter drug in Ukraine.

????????I won’t give any more examples of publications, but I will express my personal impression that the aspects of the Pharmacotherapy of Fever as a manifestation of SARS, including SARS-CoV-2, as well as influenza and other viral diseases, generally infectious or non-infectious, haven’t been studied for 50 %. I also want to add to the above that the issues of Clinical Pharmacology of antipyretics, both those that are officially indicated for the treatment of fever by the relevant authorized institutions, and those that are not included in the list of antipyretics, are shrouded in darkness. To ignore Mefenamic Acid as an antipyretic that can be used when the fever cannot be eliminated with the help of this "sweet couple" recognized leaders of Antipyretic Therapy Paracetamol and Ibuprofen, in my firm opinion (and I do not care that I risk being in the humiliating minority) is not has no scientific basis, and other reasons, among which I can suspect pseudo-scientific interests – interest in lobbying business interests. I will in no way allow myself to encroach on the "Holy of Holies", namely to make statements about the corruption of the British Medicines Regulatory System or the lobbying of business interests by British Pharmacological Science, but I will no longer be reassured by the thesis that the United Kingdom is not Ukraine, where the scientific conclusions of leading pharmacologists and regulatory decisions on medicines are adjusted to the interests of the pharmaceutical business, which is the reason for my unemployment because there are unspoken recommendations not to hire me because of my principled position on medicines. An in-depth study of the Clinical Pharmacology of Mefenamic Acid in Antipyretic Therapy, both alone and in comparison with Paracetamol and Ibuprofen, is vital and necessary from the standpoint of benefit to the patient, taking into account the individual characteristics of the patient's organism, as well as potential and identified health risks. health, work capacity and life in the case of the use of these drugs in humans. This is exactly what, and not only what I intended to convey in my oral presentation at the 19th World Congress of Basic and Clinical Pharmacology in July 2-7, 2023 in the Scottish city of Glasgow, if my abstract had not been rejected, but I will consider that my speech at the above-mentioned congress has already taken place, because the congress itself has already taken place, I have already visited the United Kingdom without humiliating conditions for me to visit and without humiliating conditions for leaving Ukraine, where there is no war, because it was prevented and all this happened in the Alternative Reality – Alternative Universe – Alternative Dimension, the theory of physical existence of which has both its opponents and its supporters.

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Verity is not Born in Controversy - Verity's Opponents Die Out!!!

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Dr Oleksandr Kashuba

PhD in Medicine by a specialty “Clinical Pharmacology"

Former Member of the British Pharmacological Society

Individual Associate Member of the European Association for Clinical Pharmacology and Therapeutics

Full Member of the American Society for Clinical Pharmacology and Therapeutics

Member of the American College of Clinical Pharmacology

Full Member of the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists

Member of the International Society of Pharmacovigilance

Member of the International Society for Pharmacoepidemiology

Unemployed Citizen of Ukraine living in the city of Kyiv