Is Ivermectin Effective Against COVID-19?
T
hree years ago, quarantine and social isolation regulations went into effect. Globally people were staying indoors, masking, and doing what they could to reduce contact with others. Researchers and infectious disease experts faced the task of finding effective vaccines and treatments to protect against and treat COVID-19. Clinical trials commenced and researchers began considering existing and novel medications to treat the SARS-CoV-2 virus.
Ivermectin
Ivermectin belongs to a class of medications called anthelmintics. It kills worms found in the body. Ivermectin is prescribed to treat or inhibit parasites in animals. However, doctors do prescribe ivermectin tablets to humans at regulated doses.
Difference Between Ivermectin for Animals and Humans
Drugs used to treat animals (especially large ones such as horses or cows) often have higher concentration doses than those prescribed for humans. Those dosages, when taken by a person, can be toxic. Furthermore, when the U.S. Food and Drug Administration (FDA) reviews medications for safety and effectiveness, the agency studies how safe and effective the active and inactive ingredients are in clinical trials. But unfortunately, when the FDA evaluates the active ingredients in drugs for use in animals, those drugs aren’t reviewed for use in humans. The levels of inactive ingredients are higher than those used in human prescriptions thus the FDA and researchers don’t know how inactive ingredients will affect people.
Human Use of Ivermectin
Doctors prescribe ivermectin to people who are diagnosed with threadworm (a type of infection caused by roundworms that enter the body through the skin and travel through the airways and settle in the intestines) and river blindness (which may cause rash, vision loss, or blindness, and bumps under the skin).
Reports of people self-medicating with ivermectin to treat or prevent COVID-19 surfaced. Many of those people were hospitalized or required medical care after their use. As a result, the FDA investigated the reports of ivermectin use and issued a statement warning people not to use the drug.
Overdose Symptoms
Those who self-medicate with ivermectin can experience an overdose. Some of the symptoms are:
- Rash
- Hives
- Seizure
- Headache
- Loss of coordination
- Vomiting
Some may think they are safe if they take ivermectin to treat tropical parasites. But there is a risk with every medication, mainly if not used as approved. Even ivermectin, which is FDA-approved for human use at regulated doses, carries its risks. Ivermectin can adversely interact with other drugs such as blood thinners.
Early Studies
Early studies focused on finding a safe and effective treatment for COVID-19, including the antiparasitic drug ivermectin. Infectious disease and health experts conducted clinical trials to gauge its efficacy. One of the studies (A Five-day Course of Ivermectin For the Treatment of COVID-19 May Reduce the Duration of Illness) conducted a randomized double-blind (the researchers and trial participants don’t know who received the medication(s) or the placebo), placebo-controlled (placebos are used to compare the effectiveness of a medication against the effects of not having the medication) clinical trial to determine the swiftness of viral clearance and the safety of ivermectin in an adult population diagnosed with COVID-19. The clinical trial consisted of three groups of patients:
- Those who received oral ivermectin (12 mg) once a day for five days in a row
- A group who received oral ivermectin combined with doxycycline daily for five days
- A placebo group
While the researchers found the dosage safe, they also recognized that the effects of ivermectin compared to the placebo group were insignificant. As a result, the researchers reported that a larger trial is needed to provide more information.
Clinical Trials
Based on early clinical trials, infectious disease, and health research experts began large-scale clinical trials to determine the safety and effectiveness of ivermectin to protect against or to treat COVID-19. Unfortunately, results from several clinical trials show that ivermectin is ineffective as a treatment for COVID-19. Why? Because while in some studies, ivermectin is shown to inhibit the replication of SARS-CoV-2 in cell cultures ( the growth and maintenance of cells outside of their natural environment), pharmacokinetic ( the study of a body’s absorption, distribution, and excretion of a drug) and pharmacodynamic ( the study of the actions or effects a drug on a living organism) study found the concentrations required for ivermectin to be effective exceeds the doses approved for humans. The National Institutes of Health have published the results of several clinical trials studying the safety and effectiveness of ivermectin to treat COVID-19.
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FDA Recommendation
While the FDA has approved ivermectin for treating parasitic tropical diseases, they have not recommended or approved ivermectin to treat COVID-19. The FDA decided not to recommend or approve ivermectin based on the results of the randomized trials of ivermectin for COVID-19 treatment. In addition, they found that the clinical trials ACTIV-6 and I-TECH lacked proof that there is a clinical benefit to prescribing ivermectin to COVID-19 patients.
Options to Prevent and Treat COVID-19
There are safe and effective ways to prevent or reduce the effects of COVID-19. One effective way to limit the spread of COVID-19 is getting a COVID-19 vaccine.
Talk with your doctor if you have questions or concerns about COVID-19 prevention or treatments.
Christina Sisti, DPS, MPH, MS is a bioethicist and health care policy advocate. She works to create awareness and improve health care policy for those with long-term health issues.