Ivermectin: Could this be the ultimate cure and prevention of Covid-19?
Binyamin Rothstein, D.O.
When it comes to Covid, everybody seems to be either terrified, confused, or both. For good reasons, hundreds of thousands of people worldwide have died and continue to suffer from this disease. As a consequence, we have suffered socially and financially; suicides have skyrocketed as well as abuse and violence in the home. The concern has reached such a peak that regardless of proven safety or effectiveness, people are already lining up to get the vaccine that promises to save them from this pandemic.
Is all this really necessary? Several groups of investigators say no. A drug that has been on the market for almost 50 years and has been used billions of times around the world, seems to be the answer. The drug is ivermectin. Presently designated as a treatment against malaria, scabies, and a variety of parasites, it has shown itself to be a “miracle drug” for a variety of conditions.
In an article published in the Tokyo Journal of Antibiotics entitled: Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen; they summarized the drug as:
“Ivermectin proposes many potential effects to treat a range of diseases, with its antimicrobial, antiviral, and anti-cancer properties as a wonder drug. It is highly effective against many microorganisms including some viruses. In this comprehensive systematic review, antiviral effects of ivermectin are summarized including in vitro and in vivo studies over the past 50 years. Several studies reported antiviral effects of ivermectin on RNA viruses such as Zika, dengue, yellow fever, West Nile, Hendra, Newcastle, Venezuelan equine encephalitis, chikungunya, Semliki Forest, Sindbis, Avian influenza A, Porcine Reproductive and Respiratory Syndrome, Human immunodeficiency virus type 1, and severe acute respiratory syndrome coronavirus 2.”
The best part is that not only is it inexpensive but it has an excellent safety profile. Most of the side effects, are related to the die-off of parasites resulting in what is called a Mazzotti reaction where the patient gets sick not from the drug itself but rather due to spewing out of the contents of the parasites as they die off. In one study there was a 5.42% incidence of side effects that included mild and temporary symptoms such as nausea, diarrhea, heart burn, abdominal pain, numbness and tingling and fatigue (the study did not specify the total number of individuals with the symptoms as each symptom had 1-3 participants with a complaint, but just mentioned the symptoms themselves). Ivermectin has been shown to be safe even in chronic diseases such as heart disease, kidney disease, those who are taking immune suppressive medications, those who are taking anti-rejection medications, and for those on chemotherapy. A word of caution: it needs to be modified in people with liver disease as ivermectin is metabolized in the liver and therefore lower doses will be needed.
In an article published in the Lancet in January 2020, regarding the safety of ivermectin in pregnancy they found that “No study reported neonatal deaths, maternal morbidity, preterm births, or low birthweight.” 
Despite the fact that there are no actual safety studies on children weighing less than 15 kg (approximately 33 pounds) a study reported in the British Journal of Dermatology in April of 2020 stated that “Of 170 infants and children weighing less than 15 kg who were treated for scabies with oral ivermectin, there were only seven reported mild adverse events and no serious ones.”  But in the case of treating Covid in children, it is a moot point as the morbidity and mortality in pediatrics is negligible so treatment is generally not considered necessary.
In regards to treating the elderly and infirmed to prevent Covid, a story materialized in April of 2020 from the Valley View Nursing Home in Toronto, Canada (bear in mind that this is anecdotal and has not been confirmed with a formalized study, but it raises some interesting questions). There was an outbreak of scabies on the 4th floor that could not be controlled with topical medication. They elected to use ivermectin as a single oral dose (presumably 12-15 mg) to all of the patients on the 4th floor and to the rest of the nursing home only 6 mg as a single oral dose prophylactically. When Covid broke out, not one patient on the 4th floor got sick with Covid and only 6 patients on the rest of the institution got sick with Covid. This is in contrast to the nursing staff who almost in its entirety got sick with Covid. Bear in mind that basically all of the patients at that nursing home had at least one if not several comorbid conditions and all were debilitated and elderly, clearly the highest risk group for death from Covid-19. Additionally, there were no reports of side effects from the ivermectin. This story seemed to stimulate a lot of interest.
In July of 2020 the Indian Journal of Tuberculosis published a white paper on the use of ivermectin in the treatment and prevention of Covid 19 had this to say “Ivermectin in the dose of 12 mg BD alone or in combination with other therapy for 5–7 days may be considered as safe therapeutic option for mild moderate or severe cases of Covid-19 infection. It is cost effective especially when the other drugs are very costly & not easily available” .
Ivermectin has been and is being used around the world with few to no reports of side effects and reportedly almost 100% (99.8%) effectiveness against Covid. There are presently at least 39 studies ongoing to test the effectiveness of ivermectin in patients sick with Covid.
Before rushing out to get ivermectin, there are several facts to keep in mind. First and foremost is that despite all of the evidence and the extremely high safety profile, it is still not approved as a treatment for Covid-19 (your doctor can still prescribe it, but it is as an off-label use). Second is that as a preventative it must be taken on an empty stomach once a month. There are reports that prevention of Covid can also be had by taking a daily dose of 25 mg of Zinc once a day and 500 mg of quercetin twice a day with Vitamin C 1000 mg twice a day. Third is that as a treatment for an active case of Covid, ivermectin is taken on days 1 and 7 along with doxycycline 100 mg for 10 days and zinc 50 mg for 7 days. Fourth, there is no evidence, yet, of efficacy in advanced cases of Covid.
According to the American Hospital Formulary Service 2020, the dose for ivermectin is 150-200 mcg/kg of body weight. The average adult dose is 12-15 mg on an empty stomach.
To summarize, according to these reports and many others, taking ivermectin seems to be an effective means to both prevent and treat Covid-19.
There is an old Talmudic saying that G-d always sends the cure before the disease, and it surely seems to be the case with Covid and ivermectin.
J Antibiot (Tokyo). 2020 Sep;73(9):593-602. doi: 10.1038/s41429-020-0336-z. Epub 2020 Jun 12. Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen; Fatemeh Heidary , Reza Gharebaghi 2. Prophylactic Ivermectin in COVID-19 Contacts; Zagazig University, August 27, 2020; Waheed Shouman. https://clinicaltrials.gov/ct2/show/results/NCT04422561?term=ivermectin&cond=covid+19&draw=1 . Safety of oral ivermectin during pregnancy: a systematic review and meta-analysis; Patricia Nicolas, MSc †Marta F Maia, PhD †,Prof Quique Bassat, PhD ,Kevin C Kobylinski, PhD ,Wuelton Monteiro, PhD N Regina Rabinovich, MD; Open Access Published:January, 2020DOI:https://doi.org/10.1016/S2214-109X(19)30453-X  Br J Dermatol. 2020 Apr;182(4):1003-1006. doi: 10.1111/bjd.18369. Epub 2019 Sep 29. Ivermectin safety in infants and children under 15 kg treated for scabies: a multicentric observational study. M Levy, et al. Indian Journal of Tuberculosis; Volume 67, Issue 3, July 2020, Pages 448-451. Letter to the Editor: White paper on Ivermectin as a potential therapy for COVID-19. V.K.Arora, D.Behera, Surya, Kant, Tripathy