Much ado about Ivermectin

Published April 6, 2021, 5:29 PM

by Dr. Kaycee Reyes

On ‘wonder drug’ as prophylaxis and treatment against COVID-19

HARD TO SWALLOW PILL Ivermectin as an antiviral drug has not yet been approved by the FDA, EMA, and WHO

COVID-19 has been around for more than a year, and a lot of us can’t wait to get back to normal. As several vaccines are now approved and being deployed, new treatments are coming to light too. Until recently, there has been a lot of discussion on Ivermectin as a possible prophylaxis and treatment against COVID-19. This had critics and proponents alike, with both sides having arguments that are equally valid and considerable.

But what is Ivermectin, and why is it controversial nowadays? Moreover, what is the stance of the medical community here and abroad? And could Ivermectin be the breakthrough drug to help us get back to normalcy sooner?

Ivermectin was discovered in the mid-’70s and approved for use in 1981 as a veterinary drug to treat internal and external parasitic infections. Shortly after, in 1988, it was approved for use in humans against tropical diseases such as onchocerciasis or river blindness, and later on for other helminth infections. Ivermectin is widely available, inexpensive, and safe, with some touting it as a “wonder drug” because of its effectivity against several parasitic infections.

But late last year, the drug made international headlines as it was claimed to be one of possible treatments for COVID-19. Particularly, the international group Frontline COVID-19 Critical Care Alliance (FLCCC) recommended the use of Ivermectin as a prophylaxis and treatment from early to late stage of the viral disease as part of their “I-MASK+Prevention and Early Outpatient Treatment Protocol for COVID-19,” or I-MASK+Protocol.

Taken incorrectly, adverse side effects may include tremors or seizures, confusion, coma, and even death.

After looking at the drug’s antiviral and anti-inflammatory properties, FLCCC reviewed trials that have shown favorable results on its use among those exposed to the virus and the patients themselves. In addition, the use of Ivermectin for COVID-19 has been supported by local group Concerned Doctors and Citizens of the Philippines, citing its safety, the need for urgency with rising cases in the country, and its efficacy as evidenced by several randomized controlled trials. 

The use of the drug, however, has also been met with criticism. It is said that while it has shown to inhibit COVID-19 replication in vitro, it is needed in much higher doses than what is recommended for humans. In general, international health institutions cite that there is insufficient studies and research for Ivermectin to be considered either as prophylaxis or treatment for COVID-19. Moreover, taken incorrectly, adverse side effects may include tremors or seizures, confusion, coma, and even death. 

In the Food and Drug Administration (FDA) advisory released this month, it states that it has not approved the use of Ivermectin as an antiviral drug. In conjunction, the European Medicines Agency (EMA), the US FDA, and the World Health Organization also do not approve its use as a treatment for COVID-19 at the moment. More substantial evidence is needed to gauge its safety, efficacy, and effectivity. 

But the good news is several trials are already underway—73 in fact, according to the Health Professionals Alliance Against COVID-19 (HPAAC), a local group comprised of more than 100 healthcare organizations in the country. HPAAC also agrees with international health agencies to wait for results before considering its administration to patients. A few successful cases do not translate to its effectivity or safety among larger groups. It is understandable that there is a race against time for those infected, but going in too soon to use the drug without enough evidence is risky and may do more harm than good.