The U.S. Food and Drug Administration (FDA) has recently urged people not to take Ivermectin to treat or prevent COVID-19. This warning came after it has received multiple reports of patients hospitalised after taking the medication. Typically used to treat parasites in animals, Ivermectin has not been approved for either treating or preventing COVID-19 in humans. The Ministry of Health Malaysia in its response has also reiterated that is not yet able to endorse Ivermectin to prevent or treat COVID-19 illness. Science Media Centre Malaysia spoke to University Sains Malaysia’s virologist and immunologist, Dr Leow Chiuan Yee to understand the potential risks of use for prevention or treatment of COVID-19.
1. Can Ivermectin treat or prevent Covid-19?
The clinical test for Ivermectin is still ongoing, and FDA has not approved Ivermectin for use in treating or preventing COVID-19 in humans. Ivermectin is not an anti-viral (a drug for treating viruses), however, it is an anti-parasitic drug which has been widely used in the veterinary industry. Majority of the parasites are susceptible Ivermectin given the drug is effective in interfering with the nerve and muscle function of the parasites. However, the scientific pharmacological effect of Ivermectin on SARS-CoV-2 has not been proven. Any use of Ivermectin for the prevention or treatment of COVID-19 should be avoided as its benefits and safety for these purposes have not been established. Data from clinical trials are necessary for us to determine whether Ivermectin is safe and effective in treating or preventing COVID-19.
2. Is Ivermectin an approved drug?
Ivermectin is included in WHO essential medicines list for several parasitic diseases but for humans, it is only recommended to be used in the setting of clinical trials, in which patients are monitored closely by experienced clinicians and researchers for safety and efficacy. Ivermectin tablets are approved at very specific doses for some parasitic worms, and there are topical (on the skin) formulations for head lice and skin conditions like rosacea. However, the FDA has not approved Ivermectin for the use in treating or preventing COVID-19 in humans. The European Medicines Agency (EMA) has stated that Ivermectin cannot be recommended for the prevention or treatment of COVID-19 outside clinical trials. Several countries such as India and Philippines have reiterated and removed Ivermectin from their treatment guidelines due to insufficient scientific evidence.
3. Is Ivermectin safe for human consumption?
It received U.S Food and Drug Administration (FDA) approval to be used worldwide for a broad number of parasites to treat several neglected tropical diseases, including onchocerciasis, strongyloidiasis and helminthiases. It is safe for humans and there are approved uses for Ivermectin in people and animals, but it is not approved for the prevention or treatment of COVID-19. It must be noted that Ivermectin products for animals are different from Ivermectin products for people and no one should take any medicine including Ivermectin to treat or prevent COVID-19 unless it has been prescribed to you by your health care provider and acquired from a legitimate source. As of 14 August 2021, two cases of poisoning involving the use of Ivermectin have been reported by the National Poison Centre of Malaysia.
4. What are the side effects of Ivermectin?
Some of the side-effects that may be associated with ivermectin include skin rash, nausea, vomiting, diarrhoea, stomach pain, facial or limb swelling, neurologic adverse events (dizziness, seizures, confusion), sudden drop in blood pressure, severe skin rash potentially requiring hospitalization and liver injury (hepatitis). Laboratory test abnormalities include a decrease in white cell count and elevated liver tests.
5. When do you administer Ivermectin on Covid-19 patients?
Currently, there is only a clinical trial being done for Ivermectin under off-label use. Ivermectin would be given in the first week of hospitalisation to see if it could block the progression of the virus and prevent the disease from becoming more serious.
6. Is it safe to only take Ivermectin or does it need to be taken with other medications?
While there are approved uses for Ivermectin in people and animals, it is not approved for the prevention or treatment of COVID-19. You should not take any medicine to treat or prevent COVID-19 unless it has been prescribed to you by your health care provider and acquired from a legitimate source.
Levels of Ivermectin for approved uses can interact with other medications, like blood-thinners. You can also overdose on Ivermectin, which can cause nausea, vomiting, diarrhoea, hypotension (low blood pressure), allergic reactions (itching and hives), dizziness, ataxia (problems with balance), seizures, coma and even death.
**All previous posts about COVID-19 here: https://sciencemediacentremalaysia.com/tag/covid-19/
Dr Leow Chiuan Yee is a senior lecturer at Institute for Research in Molecular Medicine (INFORMM) at Universiti Sains Malaysia. He is currently running a research on vaccine development and immunology. Dr Leow is also a Young Scientists Network – Academy of Sciences Malaysia (YSN–ASM) alumni.