HEALTH ALERT NETWORK
HEALTH DISTRICT 4

USE OF PRODUCTS CONTAINING IVERMECTIN TO PREVENT

OR TREAT COVID-19

August 19, 2021

Ivermectin is not authorized or approved by Food and Drug Administration (FDA) for prevention or treatment of COVID-19. FDA has cautioned about the potential risks of use for prevention or treatment of COVID-19. Ivermectin-related calls to poison control centers across the U.S. have increased five-fold from pre-pandemic baseline. Our regional poison center is experiencing a small but increasing trend of ivermectin-related calls from Idaho.

Clinical Use

• Ivermectin is approved by FDA in oral formulations to treat onchocerciasis (river blindness) and intestinal strongyloidiasis. Topical formulations are used to treat head lice and rosacea. Ivermectin is also used in veterinary applications to prevent or treat internal and external parasitic infections in animals. When used in appropriate doses for approved indications, ivermectin is generally well tolerated.

• The National Institutes of Health’s (NIH) COVID-19 Treatment Guidelines Panel has determined that there are currently insufficient data to recommend ivermectin for treatment of COVID-19.

• ClinicalTrials.gov has listings of ongoing clinical trials that might provide more information about these hypothesized uses in the future.

Recommendations for Clinicians

• Educate patients about the risks of using ivermectin without a prescription or ingesting ivermectin formulations that are meant for external use or ivermectin-containing products formulated for veterinary use.

• Advise patients to immediately seek medical treatment if they have taken any ivermectin or ivermectin-containing products and are experiencing symptoms.
     o Signs and symptoms of ivermectin toxicity include gastrointestinal effects (nausea, vomiting, abdominal pain, and diarrhea), headache, blurred vision, dizziness, tachycardia, hypotension, visual hallucinations, altered mental status, confusion, loss of coordination and balance, central nervous system depression, and seizures.
     o Ivermectin may increase sedative effects of other medications such as benzodiazepines and barbiturates.
     o Call the poison control center hotline (1-800-222-1222) for medical management advice.

• Educate patients and the public to get vaccinated against COVID-19. COVID-19 vaccination is safe and the most effective means to prevent infection and protect against severe disease and death from SARS-CoV-2, the virus that causes COVID-19, including the Delta variant.

• Educate patients and the public to use COVID-19 prevention measures including wearing masks in indoor public places, physical distancing by staying at least six feet from other people who don’t live in the same household, avoiding crowds and poorly ventilated spaces, and frequent handwashing and use of hand sanitizer that contains at least 60 percent alcohol.

Recent Trends in Ivermectin Prescribing and Adverse Events

Since early July 2021, outpatient ivermectin dispensing has rapidly increased, reaching more than 88,000 prescriptions in the week ending August 13, 2021, a 24-fold increase from the pre-pandemic baseline.

In July 2021, ivermectin-related calls to poison control centers across the U.S. increased five-fold from pre-pandemic baseline. These reports are also associated with increased frequency of adverse effects and emergency department and hospital visits.

In some cases, people have ingested ivermectin-containing products purchased without a prescription, including topical formulations and veterinary products. Veterinary formulations intended for use in large animals such as horses, sheep, and cattle (e.g., “sheep drench,” injection formulations, and “pour-on” products for cattle) can be highly concentrated and result in overdoses when used by humans. Animal products may also contain inactive ingredients that have not been evaluated for use in humans. People who take inappropriately high doses of ivermectin above FDA-recommended dosing may experience toxic effects requiring prolonged hospitalization.

 
For More Information

CDC Health Advisory: Rapid Increase in Ivermectin Prescriptions and Reports of Severe Illness Associated with Use of Products Containing Ivermectin to Prevent or Treat COVID-19

NIH COVID-19 Treatment Ivermectin Guidelines

FDA Consumer Alert on Use of Ivermectin to Treat or Prevent COVID-19

FDA FAQ: COVID-19 and Ivermectin Intended for Animals

FDA MedWatch Adverse Event Reporting program

CDC Coronavirus (COVID-19) website

U.S. Government Coronavirus (COVID-19) website

American Association of Poison Control Centers

Press Release: American College of Medical Toxicology Reports Data on Adverse Effects and Toxicity from Unapproved Use of Ivermectin for the Prevention or Treatment of COVID-19

Treatments Your Healthcare Provider Might Recommend if You Are Sick