Ivermectin is an anti-parasitic drug that was developed during the 1970s as a partnership between the Kitasoto institute in Japan and Merck & Co. led by Satoshi Omura and William Campbell. It’s a broad-spectrum anti-parasitic drug that was first used in veterinary medicine before its introduction in human medicine.1 It has been the drug of choice in the treatment of onchocerciasis and strongyloidiasis infections and therapeutic mass treatment in lymphatic filariasis. It may also be used in the treatment of arthropod ectoparasite infestations such as scabies. With the advent of the Covid-19 Pandemic, Ivermectin has gained some popularity due to its off-label use for the prophylaxis and treatment of Covid-19.2
As a parasitic drug, Ivermectin binds selectively and with a high affinity to glutamate-gated chloride ion channels in muscles of invertebrates and nerve cells of the microfilaria. This action of Ivermectin causes an increase in the permeability of the cell membrane to chloride ions and results in hyperpolarization of the cell leading to paralysis and death of the parasite. It may also impair the normal intrauterine development of Onchocerca volvulus microfilaria and may inhibit their release from the uteri of gravid female worms.3.
Reports from in vitro studies suggest that Ivermectin acts by inhibiting the host alpha/beta nuclear transport proteins, which are part of the key intracellular transport process that viruses hijack to enhance infection. In addition, Ivermectin may interfere with the attachment of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) spike protein to the human cell membrane. Some studies have also reported potential anti-inflammatory properties which have been postulated to be beneficial in people with Covid-19.4.
For the confirmed indications and at the approved doses, more than 3.7 billion doses of Ivermectin since 1987 have been distributed worldwide and well tolerated at much greater heights than the standard doses of 200µg/kg over 4-5 days with a small percentage of mild or transient adverse effects.5 From another study, over 800 million doses have been reported and have been given to more than 80 million people to date.
The side effects of Ivermectin depend on the condition being treated. In the absence of parasitic infection, the adverse effects of Ivermectin in therapeutic doses are minimal. The side effects include; tiredness, loss of energy, stomach pain, loss of appetite, nausea and vomiting, diarrhoea, drowsiness, dizziness, joint pain and swelling, swollen and tender lymph nodes, itchiness, rash, fever, eye problems. While no adverse effects have been recorded in retrospective studies, administration of Ivermectin in pregnant women is not advised.
On May 7, 2021, during the peak of the delta surge in Utter Pradesh, WHO flagged off an aggressive house-house test and treat program with a medicine kit. The program involved visiting homes in villages and remote hamlets to test everyone with symptoms of Covid-19 with the Rapid diagnostic test kits. Those that are positive were quickly isolated and given a medicine kit with advice on disease management. 5 weeks later, there was a remarkable reduction by 97.1% in the recorded cases.6 It was later revealed that the contents of those medicine kits in Utter Pradesh were Ivermectin and Doxycycline. When compared to other regions where the medicine kits were not distributed, there was a significant difference and it became apparent that whatever was in those medicine kits must have been pretty effective. Utter Pradesh has been a population that experienced a considerable drop in Covid-19 morbidity and mortality. One may be forced to ask if Ivermectin was so effective in the eradication of covid-19, then why has it not been systematically deployed all over the world.6
Ivermectin treatments of Covid-19 were conducted in Peru by Mega Operación Tayta (MOT) in different states. In these MOT states, excess deaths dropped sharply by 74% over 30 days compared to other non-MOT states with minimal Ivermectin distribution which recorded a 25% decrease in death. After a restrictive Ivermectin treatment policy was enacted by a new Peruvian president, there was a 13-fold increase in death over the next two months. This was proof of the effectiveness of Ivermectin treatment during the Covid-19 pandemic as the rate of deaths decreased significantly with its introduction and subsequently increased after the withdrawal of the drug.5
The guide to Ivermectin dosing is based on the condition being treated.
• COVID-19 – a 5-day course of Ivermectin has been shown to cause earlier clearance of the virus and may limit replication in the host. 150-200µg/kg of Ivermectin once daily for 5 days + 200mg of doxycycline on day 1 and 100 mg twice daily for the next 4 days + Zinc sulphate 80-100mg daily for 10 days have been effective in the management of severe and critical cases of Covid-19.7
• Onchocerciasis- 0.15mg/kg orally once every 12 months. For cases of heavy ocular infection, it may require treatment every 6 months.
• Filariasis/ascariasis/strongyloidiasis – 0.2mg/kg orally once every 12 months
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The contents of this website are based upon the views of Dr. Walker and his experience. This product is not intended as medical advice nor to diagnose, treat, cure or prevent any disease. The information is likewise not to replace the advice of a qualified health care provider. The information provided herein is intended as a sharing of general knowledge only and is not intended to be, nor is it, medical advice or a substitute for medical advice. That being said, please consult your healthcare provider before using supplements or providing supplements to children under the age of 18. If you have or suspect you have, a specific medical condition or disease, please consult your healthcare provider.
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