Nearly every major medical organization has warned against self-medicating with ivermectin, a deworming drug with both veterinary and human medical uses, to treat COVID-19.
Nevertheless, there remains a persistent belief, particularly on social media, in this drug's curative properties. Credible medical research does not currently support a benefit. But if you're still thinking about giving it a try, please consider a far safer alternative: enrolling in a clinical trial evaluating the effectiveness of ivermectin against the coronavirus.
You could even earn $400 for completing one of them: the multisite COVID-OUT trial led by the University of Minnesota Medical School. Researchers there are evaluating ivermectin and two other medications — fluvoxamine and metformin — as outpatient treatments to prevent severe COVID.
Participants are randomly assigned to one of six possible treatment groups. To be eligible, you must have received a positive COVID test in the last three days, be between the ages of 30 and 85, and not be hospitalized. Medications, in doses properly calculated for personal use, are shipped for free to your home. No in-person clinic or office visit is required. Nor do you have to live in Minnesota to participate. To enroll, go to bit.ly/396FlnZ.
With convenience like this, why go it alone? Over-the-counter ivermectin from farm supply stores is calibrated for livestock, with products containing potentially 100 times more than typically recommended for humans. An overdose could lead to seizures, coma or death. Additives in veterinary medications could also compromise safety.
Ivermectin's persistence as panacea reflects the dismal abundance of COVID disinformation. But it also reflects the reality that deep into the pandemic, there's a dearth of options for the newly infected.
The vaccine remains the gold standard for prevention. But it's important to expand early treatments to keep those with COVID out of the hospital.
Monoclonal antibodies are one option and appear to reduce hospitalization risk by 70% in high-risk unvaccinated people who become infected. But if other medications can improve on that, or could be deployed globally to areas where monoclonal antibodies or vaccines are not accessible. we should continue looking for them.
Conversely, if certain medications do not help, research can authoritatively rule them out. That may be the situation with ivermectin.
Early studies suggested that the drug could inhibit the coronavirus in a petri dish. That doesn't always translate to a real-world benefit, particularly when the concentration used was much higher than what humans could tolerate. One large study that raised hope by showing a positive effect in people was retracted after serious questions about its methodology.
Other studies suggesting ivermectin has some benefit have been small or raise more questions than answers.
For example, some research has occurred in countries where strongyloidiasis, a chronic roundworm infection, is prevalent. Ivermectin treats parasites. If researchers in these locations found a difference in mortality in COVID patients given ivermectin, it may be because the drug either had an effect on COVID or because the drug treated the existing parasites.
Teasing out which drug given had a positive effect in these locations is even more complicated. Dexamethasone is an effective COVID treatment. But because steroid drugs like it can cause a hyperinfection of existing parasites, in which they become hyperactive and crawl throughout the body, ivermectin is often given in conjunction.
"The data are more complex than people appreciate ... . What may be true in a hospitalized patient in Bangladesh and Iran may not be true in the U.S.,'' said Dr. David Boulware, a COVID-OUT investigator and professor at the U's medical school.
In addition to the COVID-OUT research, there's another clinical trial evaluating ivermectin as an early treatment. It's called the ACTIV-6 study, and it is evaluating ivermectin along with fluvoxamine (an antidepressant) and fluticasone (an inhaled steroid).
Enrolling in a trial (more info at bit.ly/2XtjJjj) is the safest option for those interested in ivermectin, and it contributes to a noble cause: advancing scientific knowledge.