From the Guidelines
Ivermectin is not recommended as a primary treatment for mitigating inflammation due to the lack of strong evidence supporting its efficacy for this specific purpose. The anti-inflammatory effects of ivermectin appear to work through inhibition of NF-κB pathways and reduction of inflammatory cytokines like TNF-α, IL-1β, and IL-6, as suggested by in vitro and in vivo studies 1. However, these effects have not been consistently demonstrated in human clinical trials, and the drug is not currently approved for anti-inflammatory use.
Key Considerations
- Ivermectin is generally well-tolerated at approved doses, with common side effects including dizziness, nausea, diarrhea, and skin rash 1.
- The standard dosing for approved uses is typically 200 mcg/kg as a single dose, but specific anti-inflammatory dosing regimens have not been established in clinical practice 1.
- Patients should be aware that using ivermectin for inflammation represents off-label use, and they should consult with healthcare providers before considering this approach, especially since other established anti-inflammatory medications with stronger evidence bases are available 1.
Clinical Implications
- Larger, well-designed clinical trials are needed before ivermectin can be recommended specifically for anti-inflammatory purposes 1.
- The anti-inflammatory properties of ivermectin remain an active area of research but have not yet translated into standard clinical recommendations 1.
- Healthcare providers should exercise caution when considering ivermectin for off-label use, weighing the potential benefits against the lack of strong evidence and the availability of alternative treatments with more established efficacy 1.
From the Research
Ivermectin's Anti-Inflammatory Properties
- Ivermectin has been shown to have anti-inflammatory properties, in addition to its anti-parasitic effects 2, 3, 4, 5.
- The mechanism of ivermectin's anti-inflammatory activity is thought to involve the inhibition of the nuclear factor kappa-light-chain enhancer of the activated B (NF-κB) pathway, which modulates the expression and production of proinflammatory cytokines 3, 5.
- Ivermectin has been used to treat various inflammatory conditions, including rosacea, a chronic inflammatory disease, and has been shown to be well tolerated in these patients 2, 3.
Ivermectin's Potential to Mitigate Inflammation
- Ivermectin has been evaluated for its potential to mitigate inflammation in various diseases, including acute lung injury (ALI) and COVID-19 5, 6.
- In a study on ALI, ivermectin was shown to reduce the severity of lung injury and improve survival in mice 5.
- However, the evidence for ivermectin's efficacy in treating or preventing COVID-19 is uncertain and of very low to low certainty, and more high-quality studies are needed to determine its potential benefits 6.
Ivermectin's Effects on Inflammatory Markers
- Ivermectin has been shown to reduce the production of inflammatory cytokines, such as TNF-α and IL-6, in various studies 4, 5.
- Ivermectin has also been shown to impair T-cell activation, proliferation, and cytokine production, which may contribute to its anti-inflammatory effects 4.
- However, the exact mechanisms by which ivermectin exerts its anti-inflammatory effects are not fully understood and require further study.