Hydroxychloroquine. Remdesivir. Ivermectin. Several medications have been touted as miracle drugs for COVID-19 throughout the pandemic, often without solid medical evidence supporting their use. Almost like fad diets, arguments for these controversial treatments have come and gone, with ivermectin most recently taking the stage.
As a physician and COVID-19 genetics researcher, I am concerned. No substance we consume, whether one of these medications or a nutritional supplement, lacks risk. Self-medicating in an uncontrolled setting without consultation with medical professionals endangers people, especially when evidence suggests these medications do not help prevent or treat COVID-19.
Ivermectin is used to treat several types of parasitic infections. It works by interfering with a parasite’s nervous system to paralyze and ultimately kill it.
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The research
Ivermectin has been getting recent attention as test-tube studies have demonstrated that it can prevent the virus from continuing to grow. This has motivated clinical trials to determine if these results could apply in humans as well.
While such results are promising, experiments in a test tube are a lot different from clinical trials, given that you can test drug dosages that would be unsafe or unattainable in humans to determine if an effect exists. Such phenomena are why we so often hear about experiments claiming new cancer cures with less progress in the treatment of our friends and family.
What does the data show about ivermectin for treating COVID-19 in people? There are some promising findings in critically ill patients, but more high-quality data needs to be collected, particularly for those with mild or silent COVID. That’s currently in progress.
The risks
The high-quality aspect of the research is crucial because ivermectin is not without its risks. While ivermectin is generally well tolerated and safe at dosages recommended by the Food and Drug Administration (FDA), around three per cent of people can experience itchy skin, general itchiness or dizziness. At these doses, individuals can, in rare circumstances, have seizures or a life-threatening immune reaction. If one takes the blood thinner warfarin (Coumadin), ivermectin can interact with this medication and increase the risk of bleeding.
It is important to consult licensed health-care providers about medications and their potential harms because an increased risk of bleeding can, in extreme cases, translate into bleeding in the brain, which can be life-threatening. Your family doctor or nurse practitioner has the training required to determine if a medication is appropriate and, if so, whether they should decrease your dose to keep you safe.
Such a safety profile means that if ivermectin ultimately does prove to help treat COVID-19, your doctor could prescribe it, when appropriate, with a reasonable amount of confidence that its benefits will outweigh its potential harms. It is generally not being prescribed for COVID-19 outside of clinical trials now because evidence of it helping people is not yet there.
Good intentions, but unsafe choices
Recently, non-medical individuals have been taking this data inappropriately into their own hands and have self-prescribed and self-medicated with veterinary ivermectin, guided by social media personalities and politicians. These well-intentioned victims have been overdosing themselves with the medication and have been increasingly appearing in emergency departments.
This behaviour is dangerous because all medications (and nutritional supplements) have a higher risk of side-effects as you increase the dosage. The risk of seizure and life-threatening immune reactions are low at FDA-approved dosages of ivermectin. The chance is much higher when you significantly increase the dose, which is what would happen if you took amounts intended for mammals larger than you. It is not safe — a sentiment echoed by the FDA.
The benefit of the doubt
COVID-19 is terrifying and has left many feeling powerless over a deadly infection. Vaccination is the best treatment for COVID-19 because it prevents you from getting the disease altogether in most cases. For those who still contract the disease, most will have only a mild infection and not die.
Many people question this safe and effective treatment based on the false and exaggerated claims by anti-vaccination activists and some politicians. It is hardly surprising and entirely understandable that our neighbours would seek to take their safety and lives into their own hands if they felt it was the best option.
I am here to recommend that we all take a step back and reflect on how the pandemic has changed us. Reflect on the fear, vulnerability and frustration we have been cycling through these past 18 months. Today, please give health-care providers a chance and trust us. Wear your mask, get vaccinated if you have not already. Give us, your neighbours, the benefit of the doubt. We want to help you. Would you please help us?
Julian Daniel Sunday Willett does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
