What is the appropriate dosing of Ivermectin for COVID-19?

From the Guidelines

Ivermectin is not recommended for treating or preventing COVID-19, and there is no established safe or effective dose of ivermectin for COVID-19. The most recent and highest quality study, published in the Annals of Internal Medicine in 2024 1, states that the use of ivermectin is not supported for the treatment of COVID-19. This is consistent with guidelines from the Infectious Diseases Society of America, which also recommend against the use of ivermectin for COVID-19 treatment or prevention 1.

Key Points

• Ivermectin is approved for treating certain parasitic infections, but not for viral infections like COVID-19.
• Using ivermectin for unapproved purposes can be dangerous, with potential side effects including nausea, vomiting, diarrhea, low blood pressure, allergic reactions, dizziness, seizures, and liver injury.
• Large, well-designed studies have not shown benefit for COVID-19 treatment or prevention with ivermectin.
• Major health organizations worldwide, including the FDA and WHO, advise against using ivermectin for COVID-19 outside of clinical trials.

Recommendations

• Instead of using ivermectin, focus on proven methods to prevent COVID-19: vaccination, wearing masks, social distancing, and good hand hygiene.
• If you have COVID-19, consult a healthcare provider about approved treatments appropriate for your situation.
• Consider molnupiravir or nirmatrelvir–ritonavir combination therapy for treating symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting, as recommended by the American College of Physicians 1.

From the Research

Ivermectin Dosing for COVID-19

• The appropriate dosing of Ivermectin for COVID-19 is not universally established, but several studies provide insight into its potential use:
  • A study published in Trials 2 used a single dose of 0.2 mg/kg of oral Ivermectin for patients with mild and moderate COVID-19.
  • Another study published in BMC infectious diseases 3 used 200 mcg/kg/day of Ivermectin for 5 days in patients with severe COVID-19 pneumonia.
• The effectiveness and safety of Ivermectin in the treatment of COVID-19 are being investigated in various studies, including a systematic review and meta-analysis 4 and a narrative review 5.
• The dosing schedules and efficacy of Ivermectin in the treatment and prophylaxis of COVID-19 are being explored in ongoing research, with some studies suggesting its potential use in both early-treatment and prophylaxis of the disease 6, 5.
• It is essential to note that the use of Ivermectin for COVID-19 is not yet widely recommended, and its safety and efficacy are still being investigated in clinical trials.

Key Findings

• A study published in the American journal of therapeutics 6 found that numerous randomized and observational controlled trials of Ivermectin are reporting repeated, large magnitude improvements in clinical outcomes.
• The Frontline COVID-19 Critical Care Alliance (FLCCC) recommends the use of oral Ivermectin for both prophylaxis and early-treatment of COVID-19, based on the available evidence 5.
• Further research is needed to fully understand the potential benefits and risks of using Ivermectin for COVID-19, including its optimal dosing schedule and potential interactions with other medications.