On Ivermectin for COVID-19

Published March 27, 2021, 12:12 AM

by Rj Nieto


RJ Nieto
RJ Nieto

Everybody’s agog over Ivermectin, an antihelmintic drug that, based on preliminary studies, may be useful in our fight against COVID-19. And it appears that some people have already been taking it to prevent infections.

We should wait a little.

In a widely cited 2020 paper, a group of scientists led by Australian Leon Caly of the Royal Melbourne Hospital[1] said that the antiparasitic Ivermectin is effective in reducing SARS-CoV-2 in vitro.

Note that the operative term used was “in vitro” which, in a nutshell, means it’s done on a test tube. Hence, the same paper recommends not the immediate adoption of Ivermectin, but the need for “further investigation for its possible benefits to humans”.

And such investigations are ongoing. In a recent statement, Healthcare Professionals Alliance Against COVID-19 (HPAAC) said there are “73 ongoing clinical trials on its use” and that they “expect more data and evidence on its effectiveness in the next several weeks”.

Yes, Ivermectin is very promising, but we still have to wait for a few more weeks to ensure that it’s safe for treating or preventing COVID-19.

Some camps argue that Ivermectin is already being prescribed to humans as an antiparasitic, implying that it must be safe enough to take. However, past studies attesting to its safety were done using dosages that are insufficient for antiviral activity.

In a 2020 paper[2], a group led by Dr. Virginia Schmith of North Carolina-based pharmaceutical consulting firm Nuventra Pharma Sciences said that the current US FDA-approved dose for Ivermectin is not enough for use versus COVID-19.

This means that, if used against COVID-19, doctors will likely have to prescribe higher doses, meaning dosage levels that are still not proven to be safe. Specifically, Dr. Edsel Salvana of the UP National Institutes of Health, citing a 2018 paper[3],  said “at the doses required for possible antiviral activity, [Ivermectin] can cause brain damage”.

Let me state this more simply:

Completed studies show that Ivermectin is safe up to a certain dose, but that dose was designed for use of Ivermectin as an antiparasitic. A higher dose is needed if we will use Ivermectin as an antiviral, i.e. anti-COVID. And that’s the problem, because taking too much Ivermectin can cause brain damage. Too low a dose and Ivermectin is useless, too high and it’ll fry your brain.

How much Ivermectin is enough, and how much is too much?

That is the most important question today, and that’s why we have to wait for more data.

This same stance is shared by my friend Dr. Ethel Pineda, who I follow on social media. Interestingly, in response to her statement, someone asked her why she demonizes Ivermectin when it’s promising in the first place.

A call for prudence, a call of the exercise of a healthy amount of caution, is not demonization: we should not treat a problem from hell with a solution from hell.

There is no presumption of safety for medicines. Otherwise, we’d already be extinct as a species.

We have been waiting for over a year, and a few more weeks won’t make much of a difference. So why don’t we wait a little so the scientists can finish their studies, so we can be sure that it’s not only effective, but also safe?

Guys, let’s wait a bit more. After all, good things come to those who wait.

(As a side note, I strongly encourage medical professionals with relevant specializations to speak out on social media and help educate the masses. I know that mass communication may not be your forte, so I am offering to help hook you up with friends in media to help craft your statements. You can find my email address at the bottom of this article.)

[1] Caly, L., Druce, J.D., Catton, M.G., Jans, D.A. & Wagstaff, K.M. The FDA‐approved drug ivermectin inhibits the replication of SARS‐CoV‐2 in vitro. Antiviral Res. 178, 104787 (2020).

[2] Schmith VD, Zhou J, Lohmer LR. The approved dose of ivermectin alone is not the ideal dose for the treatment of COVID. Clin Pharmacol. 2020. https://doi.org/10.1002/cpt.1889.

[3] Chandler R. E. Serious neurological adverse events after ivermectin-do they occur beyond the indication of onchocerciasis? Am J Trop Med Hyg 98, 382–388. 10.4269/ajtmh.17-0042 (2018)

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