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Is Ivermectin a Miracle or a Menace vs COVID?

Is Ivermectin a miracle or a menace against COVID-19? It's a miracle vs. onchocerciasis. COVID? A new study suggests ivermectin is not great.

Let me be perfectly honest. I love ivermectin. Is ivermectin a miracle? Absolutely! It has saved the eyesight of millions of people in Africa and Latin America. I give it to my two dogs once a month to prevent heartworm, a devastating disease. Is ivermectin a miracle against COVID? That is a question that is yet to be answered fully, but a new study makes that possibility less likely at this time.

The New Ivermectin Data:

We continue to be bombarded by comments that insist ivermectin works great against the coronavirus. These folks have watched online videos that “prove” the drug is incredibly effective. There are anecdotes galore.

What about the science? Does it answer the question: is ivermectin a miracle or a menace against COVID-19? Here is the latest study published in JAMA Internal Medicine (Feb. 18, 2022).

Here was the Question this study attempted to answer:

“Does adding ivermectin, an inexpensive and widely available antiparasitic drug, to the standard of care reduce the risk of severe disease in patients with COVID-19 and comorbidities?”

Here are the Findings:

“In this open-label randomized clinical trial of high-risk patients with COVID-19 in Malaysia, a 5-day course of oral ivermectin administered during the first week of illness did not reduce the risk of developing severe disease compared with standard of care alone.”

The Meaning of this Study:

“The study findings do not support the use of ivermectin for patients with COVID-19.”

Conclusions:

If that was not clear enough, here are the conclusions:

“In this randomized clinical trial of early ivermectin treatment for adults with mild to moderate COVID-19 and comorbidities, we found no evidence that ivermectin was efficacious in reducing the risk of severe disease. Our findings are consistent with the results of the IVERCOR-COVID19 trial,17 which found that ivermectin was ineffective in reducing the risk of hospitalization.”

 

Science vs. Politics:

We know that many visitors to this website are absolutely convinced that ivermectin is the magic bullet against COVID-19. Ideally, that would be supported by the available data. We continue to wait for bigger and better clinical trials. In the meantime, we have to rely on the available evidence.

Here is a preprint published in Research Square (Oct. 25, 2021). These scientists are from prestigious institutions in the UK, including the Imperial College of London, Oxford University and the University of Liverpool. At one point, they published a favorable ivermectin paper in Open Forum Infectious Diseases, July 6, 2021.

In it they describe their findings:

“In 11 randomized trials of moderate/severe infection, there was a 56% reduction in mortality deaths on ivermectin; with favorable clinical recovery and reduced hospitalization.”

Sounds great, right?

In their new preprint published on October 25, 2021, they go on to note that:

“Our meta-analysis was first presented in January 2021 and published in July 2021. It suggested that ivermectin resulted in a significant 56% improvement in survival, favourable clinical recovery, and reduced hospitalisations. Such optimistic results from multiple meta-analyses have escalated public interest in using ivermectin for the treatment and prevention of COVID-19, despite the WHO only recommending its use within clinical trials.”

The Great Ivermectin Reversal:

These authors point out that there were substantial problems with some of the studies they relied upon in their first meta-analysis of ivermectin.

They now say:

“These instances suggest that the data available to support the use of ivermectin for COVID-19 is not reliable. In July 2021, after the potentially fraudulent studies were identified, we retracted our published meta-analysis and began working on an updated analysis, assessing the effects of stratifying by trial quality on the overall results.”

The reason for the embarrassing retraction was that some of the studies in the original analysis turned out to be fraudulent. Others were poorly conducted or biased and therefore untrustworthy. They came from countries like Iran, Iraq, Egypt, Lebanon, Argentina and Turkey.

Once the authors eliminated the fraudulent or questionable research, they found that:

“…ivermectin results in a non-significant 4% increase in survival.”

They conclude:

“These observations demonstrate that the significant effect of ivermectin on survival was dependent on the inclusion of studies with a high risk of bias or potential medical fraud.”

Before public health authorities can recommend ivermectin for routine use against COVID-19, they will need a large, well-controlled clinical trial demonstrating the drug’s effectiveness.

The People’s Pharmacy and the History of Ivermectin:

I was among the very first people to answer the question: is ivermectin a miracle? That was over 30 years ago.

Here is what I wrote in The People’s Pharmacy syndicated newspaper column on November 9, 1987:

“It’s not often that a drug for animals becomes a major breakthrough for human health. But Merck’s new medication, ivermectin, has not only made life easier for our family pet, but it could save the eyesight of millions of people around the world.

“Rick, our Labrador retriever, arrived five years ago as a warm bundle of wiggles and soft ears. He’s 90 pounds of lovable mischief now, and because we live in a part of the country where the dog parasite, heartworm, is a constant danger, we have always had to give him medicine to protect him against this potentially fatal mosquito-borne disease.

“Until a few months ago, this was a daily struggle. He hated the taste, and no matter how we disguised it, we’d often find the bright pink pill carefully deposited beside the dog dish. Then we’d have to pry his jaws open and poke it down his throat.

Ivermectin A Miracle for Dogs!

“But that daily tussle is history now. The vet prescribed a new heartworm preventive, Heartgard (ivermectin), which is given only once a month. Rick almost seems to like it, making our life, and his, a lot easier.

“Probably the best thing about ivermectin, though, is not what it can do for dogs but its potential in relieving human suffering. It will help defeat a parasitic disease which affects up to 40 million people in tropical countries and is one of the leading causes of blindness in the developing world.

River Blindness:

“We’ll never forget the guitarist we heard in Mexico (I was teaching at the medical school in Oaxaca and Terry was doing research for her doctorate in medical anthropology). His music was hauntingly beautiful, the kind of extraordinary sound we would have expected in a fine concert hall, but he was dressed like a beggar. His little granddaughter, who was leading this blind musician down the street by the hand, was barefoot and ragged herself.

“We later learned this man was a victim of onchocerciasis, or river blindness. The parasite responsible for the disease is spread by the bite of a black fly which is found in parts of Latin America and is widespread in Africa. Entire villages know the despair of darkness, with the fear of blindness affecting even children learning to read.

“The parasite enters the body as a microscopic worm called a microfilaria and grows into a two-foot long adult lodged under the skin which produces intense itching. The female, which may live as long as 11 years, produces millions of tiny young which migrate through the body, causing scarring and damaging the eye.

Is Ivermectin A Miracle? Absolutely!

“Public health authorities have had little success until now fighting this dreadful disease. The two drugs that were available against the parasite caused severe side effects and had to be taken for lengthy periods.

“Ivermectin, under the brand name Mectizan for human use, will turn the tide in this battle. It kills the parasite at the microfilaria stage before it harms the eye. By taking Mectizan, people can save their sight and prevent transmission. A single dose is good for six months or more, so one or two pills a year should be enough.

“Unfortunately, many of the people affected by river blindness can’t get to doctors or afford medicine. In an unprecedented move, Merck & Co., which manufactures Mectizan, is making it available free of cost.

“This generous giveaway will make the drug available through public health channels so that river blindness can be controlled even in the poorest areas.

“According to WHO expert Dr. Colin Ginger, no one need ever go blind from onchocerciasis again. Merck is to be congratulated for this farsighted contribution to world health.

Is Ivermectin a Miracle for COVID?

The answer to this 21st century question is still unclear. There is a lot of gossip, rumor and innuendo around this medication. We wrote about ivermectin for COVID back on July 20, 2021:

Here is a link to the article titled:

“Could Drug for Parasites Also Fight Coronavirus?
Ivermectin is a drug for parasites. It saved the sight of millions in Africa. It protects dogs against heartworm. Does it work against COVID?”

A reader wants to know: Is ivermectin a miracle against COVID?

Q. I have been hearing on the grapevine that many people are using ivermectin both to prevent and treat COVID-19. What little credible information I could find about it says that it is designed to be used in animals, not humans. Apparently, it is dosed according to weight.

I also read that the studies that purportedly prove its value in humans have serious methodological flaws. Do you have any further information about using ivermectin in humans?

A. The ivermectin story is complicated and controversial. This drug was first introduced by Merck in 1981 to treat parasites in animals.

It was later introduced to overcome river blindness (onchocerciasis) in humans. Ivermectin has saved the eyesight of millions of people in Africa. Ivermectin has also been prescribed off label to treat lice and scabies in children and adults.

Data on the use of ivermectin against COVID-19 are confusing. Some high-profile research papers have recently been retracted (Nature, Aug. 2, 2021). Until there are bigger and better clinical trials, we doubt that many physicians will prescribe ivermectin for COVID-19. Experts expect the results of ongoing trials by the end of the year.

Using Ivermectin from Feed Stores:

Some people are so desperate for an effective COVID treatment they are purchasing ivermectin from farm supply stores. A Tweet from the FDA responded:

“You are not a horse. You are not a cow. Seriously, y’all. Stop it.”

Here is the official FDA response:

“Why You Should Not Use Ivermectin to Treat or Prevent COVID-19”

“Here’s What You Need to Know about Ivermectin
• FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans. Ivermectin tablets are approved at very specific doses for some parasitic worms, and there are topical (on the skin) formulations for head lice and skin conditions like rosacea. Ivermectin is not an anti-viral (a drug for treating viruses).
• Taking large doses of this drug is dangerous and can cause serious harm.
• If you have a prescription for ivermectin for an FDA-approved use, get it from a legitimate source and take it exactly as prescribed.
• Never use medications intended for animals on yourself. Ivermectin preparations for animals are very different from those approved for humans. “

Poison control centers are fielding questions from people who take animal doses of ivermectin. At least one person was hospitalized in Mississippi because of ivermectin toxicity.

Ivermectin in India

Many people do not ask is ivermectin a miracle. They are absolutely convinced it is! We have received lots of messages that India ended their first COVID surge by distributing ivermectin to the entire population. We have found no reliable data to prove that assertion.

It is true that India had a horrendous Delta outbreak. It overwhelmed hospitals. India also had a rapid decline in cases, which is wonderful news. Then they had another outbreak due to Omicron, just like we did. Rates have come down there, as well as here.

We have not been able to locate any scientific studies that attribute the rapid decline to ivermectin. We have found medical articles about ivermectin written by Indian researchers, though.

An article in the Medical Journal, Armed Forces India (July, 2021) offered this conclusion:

“So far, research related to Ivermectin in COVID-19 has serious methodological limitations resulting in indecisive evidence. The use of Ivermectin for prophylaxis or treatment for COVID-19 should be done based on robust evidence generated from multicentric randomised clinical trials.”

Final Words:

We would like to answer the question: is ivermectin a miracle? Clearly, this is absolutely true when it comes to parasites. It would be wonderful if ivermectin were highly effective against COVID-19…maybe even the miracle that everyone is hoping for.

Before we declare it such, though, we need excellent research. We expect large, well-controlled trials to provide solid information in the near future. It would be wonderful if this old, inexpensive and relatively safe drug could end the COVID pandemic. Only data will tell us if that is possible. Let’s keep politics out of the discussion.

You may also be interested in this very comprehensive article by Dr. Derek Lowe. He writes about the pharmaceutical industry and drug discovery for Science Translational Medicine.

Here is a more up-to-date analysis of ivermectin research by Dr. James Heathers in The Atlantic (Oct. 23, 2021). It is titled:

The Real Scandal About Ivermectin
Claims about the drug are based on shoddy science—but that science is entirely unremarkable in its shoddiness.

This very thoughtful paper explains why so many may have been so misled into thinking that ivermectin is a miracle medicine against COVID-19. That case has yet to be made. We hope you will take the time to read Dr. Heathers’ very thoughtful article.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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