About three months ago, when the Covid-19 situation was aggravating to a much worrying condition in Malaysia, I received a forwarded message through Whatsapp of someone trying to sell ivermectin for Covid-19. Coming from a pharmacy background, I took the liberty to explain to the sender on how this is illegal and how it can be detrimental to health with a hope that the chain of message gets broken right there. This however is only one example of many illegal sale or misinformation on ivermectin that was spreading like a wild fire recently. Why is the ivermectin craze worrying especially in the management of Covid-19?
What is Ivermectin?
Ivermectin is a drug used in animals to treat parasites and they come in different forms including pour-on, injectable, paste and “drench”. In humans, ivermectin tablets are used at a very specific dose to treat certain parasitic worms and topical formulation is used to treat head lice and skin conditions like rosacea as per FDA approval. It is important to understand that the formulation for animal and human use are different in terms of dosage and excipients (inactive ingredients) hence they’re only safe to be used as indicated. It is very crucial to understand that the FDA approves of a drug for human use only based on rigorous analysis of scientific data based on sufficiently large clinical trials especially prioritising safety use to maximise treatment outcome and minimise side effects. However, ivermectin has neither been approved nor received emergency use authorisation from the FDA for Covid-19 treatment or management. The recent reported cases of deaths due to ivermectin overdose is an evidence of why such scrutiny is important in approval of drug use in human.
Why the craze?
It is indisputable that the entire world is in desperate need of eradicating coronavirus to restore the lives and livelihood of many that are affected and when a clinical trial involving ivermectin was published by a higher institution in Egypt with a claim that it reduces death rate, it quickly gained popularity. However, the paper was later retracted when aspects of plagiarism was detected. Inconsistent information between publication and raw data, duplication of patient records and incongruent study dates were some of the reasons for the retraction. Despite the action taken, the paper was already cited more than 30 times and viewed over 150,000 times affecting the judgement of ivermectin use for Covid-19 among many before it was retracted. Even though there have been many ongoing studies on ivermectin use, this one in particular was the largest clinical trial with positive result claim which stood out and sparked discussion on the drug use in many parts of the world before it was retracted.
Can Ivermectin be used for treatment of Covid-19?
The answer is yes and no. Ivermectin can ONLY be used to treat Covid-19 within clinical trials as per WHO guidelines. Given that there is no sufficient data to prove that ivermectin is indeed effective in treating the condition, it is only allowed in clinical trials as of now. Covid-19 patients who are not included in the trials CANNOT be prescribed with ivermectin for the purpose of treatment or management of the condition except for approved off-label use in rare cases in a monitored environment (in Malaysia). Based on an independent group consisting of international panel of experts which reviewed 16 randomised controlled trials for ivermectin use, there is no significant data to support the use of the drug in treatment of Covid-19 as of now and they will continue to monitor the outcomes of ongoing clinical trials in different parts of the world.
Meanwhile, the most effective way to limit transmission of Covid-19 is to get Covid-19 vaccine when it is available and to follow the SOPs set by the authorities. Please remember, no one is safe until everyone is safe. So, get vaccinated and stay safe!
- Flawed ivermectin preprint highlights challenges of COVID drug studies, https://www.nature.com/articles/d41586-021-02081-w
- WHO advises that ivermectin only be used to treat COVID-19 within clinical trials, https://www.who.int/news-room/feature-stories/detail/who-advises-that-ivermectin-only-be-used-to-treat-covid-19-within-clinical-trials
- Why You Should Not Use Ivermectin to Treat or Prevent COVID-19, https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19
Thanusha M Ganesan is a content writer under Headliner by Newswav, a programme where content creators get to tell their unique stories through articles and at the same time monetize their content within the Newswav app.
Register at headliner.newswav.com to become one of our content writers now!
*The views expressed are those of the author. If you have any questions about the content, copyright or other issues of the work, please contact Newswav.