Warn Against Using Ivermectin for COVID-19

You can help calm the hype about ivermectin for COVID-19.

It’s being fueled by reports that oral ivermectin reduces mortality and speeds recovery from COVID-19...and may prevent infection if used as post-exposure prophylaxis.

But continue to recommend against ivermectin for prevention or treatment of COVID-19.

Explain that the frenzy is partly based on FLAWED meta-analyses...including a preprint study that’s now retracted due to plagiarism and errors. Other meta-analyses withOUT this study do NOT suggest benefit.

Point out that national guidelines say more evidence is needed...and the AMA and pharmacy organizations strongly oppose its use.

Even the manufacturer of brand ivermectin (Stromectol) says there’s no scientific basis to use it for COVID-19.

Instead, address questions about COVID-19 vaccination...and consider monoclonal antibodies for post-exposure prophylaxis or treatment.

Clarify that off-label med use should still be evidence-based.

Be aware, patients taking ivermectin for COVID-19 may be getting excessive doses or quantities.

The usual oral ivermectin dose for parasites is 200 mcg/kg...or about 5 tabs/dose for an 80 kg patient...for a dose or two. It seems to have few safety concerns at this dose.

But some groups are promoting up to triple this dose for several days for COVID-19...leading to Rxs for hundreds of tablets.

Caution that ivermectin toxicity can lead to seizures, coma, and death...and may increase bleeding risk with warfarin.

Warn NOT to take topical ivermectin orally...or animal products, which may contain very high doses or unsafe ingredients for humans.

Review our chart, Treatments of Interest for COVID-19, to dive deeper into the data...and arm yourself with more talking points.

Key References
  • www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19 (9-27-21)
  • Cochrane Database Syst Rev 2021;(7):CD015017
  • Clin Infect Dis Published online Jun 28, 2021; doi:10.1093/cid/ciab591

Prescriber's Letter. October 2021, No. 371002

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