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 recommend against ivermectin for prevention or treatment of COVID-19...and continue to question these Rxs.

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 medical and pharmacy groups (AMA, APhA, ASHP, etc) strongly oppose its use.

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

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

Stay alert for "red-flag" 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.

Keep in mind, you could be held liable if harm occurs in these cases. For example, 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.

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

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 (9-23-21)
  • Cochrane Database Syst Rev 2021;(7):CD015017
  • Clin Infect Dis Published online Jun 28, 2021; doi:10.1093/cid/ciab591
Pharmacist's Letter. October 2021, No. 371002



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