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Ivermectin: What Everybody Ought to Know
There is a growing interest in a drug called ivermectin to treat humans with COVID-19. The debate on ivermectin’s usage has gone from the healthcare settings to social media platforms which exacerbates the discourse. Demand for approval of the drug is growing – despite leading health authorities consistently warning against its use.
What is Ivermectin?
Ivermectin is a drug identified in the 1970’s, approved by the FDA to treat people with intestinal infection caused by parasitic worms. It is also indicated to treat external parasites like head lice and for skin conditions such as rosacea.
Ivermectin is also used in animals to prevent heartworm disease. It’s important to note that pharmaceutical formulations for animal use are different from the ones for people, and safe when used as prescribed for animals only.
Ivermectin Is Not For The Prevention And Treatment of COVID-19
The FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans.1 Additionally, The European Medicines Agency (EMA) has said the available data does not support the drug’s use for COVID-19 outside well-designed clinical trials2, and the World Health Organisation (WHO) also concluded that ivermectin should only be used to treat the virus in a clinical trial setting 3 – in which patients are monitored closely by experienced clinicians and researchers for safety and efficacy. The drug’s manufacturer, MSD, also warned that its analysis of ivermectin identified no scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies and a concerning lack of safety data in most studies.4
Malaysia has taken a similar approach. Ivermectin is also not licensed for treatment of COVID-19. The National Pharmaceutical Regulatory Agency (NPRA) has only approved an “off-label’ use of ivermectin. “Off-label” use means the medication is being used to treat something not listed on its label. The “off-label” use in Malaysia is only for clinical trials, and not upon the request of patients in hospitals, let alone in community settings.5
Antiviral Action And Potential Side Effects of Ivermectin
There are many studies over the years that have shown antiparasitic drugs like ivermectin have an antiviral effect. However, in order to achieve this, a much higher dose is required.5 This can increase the risk of experiencing side effects associated with ivermectin such as drowsiness, nausea, vomiting and, in very rare cases, an increase in heart rate and seizures.
Ivermectin Is Not a Substitute For The COVID-19 Vaccine
There are no reliable published studies available that supports ivermectin use for prevention of COVID-19. Currently, vaccines are still the main strategy approved by WHO when it comes to protection against COVID-19.1 Hence, based on current evidence, ivermectin should not be used as a substitute for COVID-19 vaccine.
Final Take
The “off-label” use of ivermectin gained global attention due to some promising results by case studies and clinical trials. Yet, the evidence is inconclusive to recommend routine use for COVID-19. However, numerous clinical studies are currently undertaken globally, including in Malaysia 5 to study the potential use of ivermectin for COVID-19. It would therefore be premature to conclude absolutely that ivermectin has no place in COVID-19 treatment. On the basis of current evidence, however, its use cannot be recommended.
Lastly, for any further clarification, do speak to your healthcare provider to find out more on the subject matter or do approach or contact the pharmacist at any CARiNG Pharmacy stores or message us on our Facebook page.
*Article reviewed on 3 Aug 2021.
References
- National Institute of Health (NIH) COVID-19 Treatment Guidelines.
- (Web accessed July 2021). Web link::https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/
- EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials.
- (Web accessed July 2021). Web link:https://www.ema.europa.eu/en/news/ema-advises-against-use-ivermectin-prevention-treatment-covid-19-outside-randomised-clinical-trials
- WHO advises that ivermectin only be used to treat COVID-19 in clinical settings(Web accessed July 2021). Web link:https://www.who.int/news-room/feature-stories/detail/who-advises-that-ivermectin-only-be-used-to-treat-covid-19-within-clinical-trials
- Merck statement on ivermectin use during COVID-19 pandemic
- (Web accessed July 2021). Web link:https://www.merck.com/news/merck-statement-on-ivermectin-use-during-the-covid-19-pandemic/
- Ministry of Health Malaysia starts ivermectin trial for high risk COVID-19 patients (I-TECH Study)
- (Web accessed July 2021). Web link:https://kpkesihatan.com/2021/06/05/ministry-of-health-malaysia-starts-ivermectin-trial-for-high-risk-covid-19-patients-i-tech-study/
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