If you haven’t heard of Ivermectin yet, it may surprise you that people are rushing to get their hands on this drug that’s used to treat livestock and people infested with parasitic worms… and is being touted as a “miracle cure” for Covid-19.
In South Africa, the most notable figure to appear to endorse Ivermectin is world-renowned sports scientist, Tim Noakes.
So if Noakes is talking about Ivermectin as a potential treatment for Covid-19, there are a lot of questions to be asked about it and if this is, in fact, the “miracle cure” that he and swaths of the Internet believe it is.
Or is this Hydroxychloroquine all over again?
What is Ivermectin?
According to the United States government’s National Institutes of Health (NIH) COVID-19 Treatment Guidelines, Ivermectin is “an anti-parasitic drug that is used to treat several neglected tropical diseases, including onchocerciasis, helminthiases, and scabies.” It is used primarily in livestock and was regarded as a revolutionary treatment in the 1980s that has the “potential to reduce the rate of malaria transmission by killing mosquitoes that feed on treated humans and livestock”. It works by paralysing and killing parasites.
Why is Ivermectin being used as a treatment for Covid-19?
The NHI also discusses how Ivermectin is being used as a mechanism for Covid-19 treatment, saying that it has the potential to breakdown proteins, potentially analogous to those we see in the Covid-19 virus.
“Ivermectin acts by inhibiting the host importin alpha/beta-1 nuclear transport proteins, which are part of a key intracellular transport process that viruses hijack to enhance infection by suppressing the host antiviral response,” the NHI report reads. “Ivermectin is therefore a host-directed agent, which is likely the basis for its broad-spectrum activity in vitro against the viruses that cause dengue, Zika, HIV, and yellow fever.
“Ivermectin has been shown to inhibit the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in cell cultures.”
Physicians in the United States are also endorsing the drug as a Covid-19 treatment, with pulmonary and critical care specialist at Aurora St Luke’s Medical Center in Milwaukee, Dr Pierre Kory touting it as a “miracle cure”.
“Ivermectin is highly safe, widely available, and low cost. Its discovery was awarded the Nobel Prize in medicine, and is already included on the WHO’s World’s List of Essential Medicines,” says Kory . “Ivermectin is effectively a miracle drug against Covid-19.”
Is it effective?
Gastroenterologist Professor Thomas Borody told Sky News Ivermectin used in conjunction with two other drugs is making it look like “corona is very simple to kill”.
In test-tube experiments conducted in a study conducted by an Australian research team at Monash University’s Biomedicine Discovery Institute (BDI) with the Peter Doherty Institute of Infection and Immunity at Royal Melbourne Hospital, Ivermectin has been found to be “an inhibitor of the Covid-19 causative virus (SARS-Cov-2) in vitro” with an effect of roughly a 5000-fold reduction in the virus after 48 hours.
“Ivermectin materially reduced SARS-CoV-2 viral RNA material in the cell culture by 93% just after 24 hours and by 99.8% 48 hours later,” the study states. “This represents a 5000X reduction in Covid-19 RNA, suggesting that the drug was reducing “essentially all viral material.”
However, further studies need to be conducted to see whether these results can be replicated.
What are regulators saying?
As is typically the case, this is where we encounter a stumbling block. While the FDA has approved Ivermectin as a treatment for a number of diseases, they say that “pharmacokinetic and pharmacodynamic studies suggest that achieving the plasma concentrations necessary for the antiviral efficacy detected in vitro would require administration of doses up to 100-fold higher than those approved for use in humans.”
And this could result in some pretty devastating long term effects.
“Even though ivermectin appears to accumulate in the lung tissue, predicted systemic plasma and lung tissue concentrations are much lower than 2 µM, the half-maximal inhibitory concentration (IC50) against SARS-CoV-2 in vitro,” they say. “Ivermectin is not approved for the treatment of any viral infection, including SARS-CoV-2 infection.
“Ivermectin intended for use in animals should not be used to treat Covid-19 in humans.”
In fact, the FDA issued a statement as far back as April last year, recommending that people don’t use Ivermectin as a treatment for Covid-19 because the studies done have not factored in what side effects it will have when used to treat Covid-19.
“This type of study is commonly used in the early stages of drug development. Ivermectin was not given to people or animals in this study. Additional testing is needed to determine whether ivermectin might be safe or effective to prevent or treat coronavirus or Covid-19.
“FDA is concerned about the health of consumers who may self-medicate by taking ivermectin products intended for animals, thinking they can be a substitute for ivermectin intended for humans. People should never take animal drugs, as the FDA has only evaluated their safety and effectiveness in the particular animal species for which they are labeled. These animal drugs can cause serious harm in people. People should not take any form of ivermectin unless it has been prescribed to them by a licensed health care provider and is obtained through a legitimate source.”
Furthermore, the South African Health Products Regulatory Authority (Sahpra) has declared the import of Ivermectin illegal.
“Our stance is unambiguous. This drug is not approved by Sahpra and any attempt to import it into the country will be dealt with by Sahpra’s regulatory compliance unit in conjunction with law enforcement agencies such as the SAPS and the SIU,” says Sahpra chief executive Dr Boitumelo Semete-Makokotlela, in a statement reported on by IOL. “Sahpra is focused on quality, safety and efficacy and its ultimate goal is to protect the health and well-being of all those who live in South Africa. The use of such a drug could potentially lead to harmful effects or even death.”
The verdict: Should we use Ivermectin to treat Covid-19?
For now, the answer should be a resounding no. Covid-19 is not malaria and simply repurposing a drug may seem like an easy solution, but we spent an entire year jumping over regulatory hurdles in the efforts to develop a Covid-19 vaccine – so why would we abandon the caution and scrutiny that was necessary to make sure that the vaccines being administered around the world are safe and effective.
A single study doesn’t make a case for Ivermectin being an effective and safe “cure” for Covid-19, multiple, peer-reviewed studies are required. Regulatory bodies are there for a reason and a few anecdotal stories about how Ivermectin makes treating Covid-19 look easy doesn’t change the fact that we’re not fully aware of side-effects, long-term consequences or any number of conditions that need to be met to declare a drug safe for use.
With that said, I’m not a doctor, nor do I have any semblance of comprehensive knowledge in this field. And the early signs seem to be good. So time will tell, but it seems wiser to wait and see how it plays out, whether regulators do approve it, while more studies are conducted and the evidence that it’s safe for use has been verified. And if you’re on the fence, rather consult with your doctor and let them advise you accordingly.