SIOUX FALLS, SD (KELO) — Throughout the rise of the COVID-19 pandemic, the world has been searching for ways to prevent and cure infection from the virus. Some of these practices– masking, vaccination and the use of monoclonal antibodies– have proven effective. Other less conventional methods however have also been proposed including some that, beyond being ineffective, can also be dangerous.
One such unapproved treatment that has been gaining traction is the use of ivermectin, a drug used in the U.S. to treat and prevent parasites in livestock. Ivermectin is not approved or recommended by the U.S. Food and Drug Administration (FDA) for the treatment of COVID-19 in humans.
What ivermectin is approved for in humans is its use in treating people with intestinal strongyloidiasis and onchocerciasis, two conditions caused by parasitic worms. However, human-grade ivermectin is only available for approved usage via prescription.
KELOLAND News spoke with Elise Reinalda, a South Dakota veterinarian, about what the ivermectin available to purchase is actually used for.
“It’s a de-wormer that’s used in dogs, cats, horses, cows, pigs; quite a variety of animals — to get rid of worms,” said Reinalda.
Reinalda said the issue of people attempting to consume veterinary grade ivermectin is a known problem within the industry, with the FDA having sent out a letter to the American Association of Bovine Practitioners to warn of people coming in to buy it for their own consumption.
This is something Reinalda has seen first-hand. “I’ve even had a couple people come in and try to get it,” she said.
Reinalda says that even though ivermectin is technically the same drug that’s been used in human medical trials, there are still differences.
“The concentration of the drug and how it’s delivered can be completely different — ivermectin toxicity in animals is a thing that can cause blindness, seizures and even death — it’s not something to be taken lightly.”
This is a sentiment echoed by Jennifer McKay, a Medical Information Officer and Hospitalist with Avera Medical Group. “The big thing, right, is that medications dispensed by veterinarians are going to be formulated by animals, which means the concentration, the dosing, is going to be a little bit different.”
Bioavailability, says Reinalda, is another issue. “So, dogs and cats absorb the molecule different than a calf or a cow, so the bioavailability when you actually ingest it — how much gets absorbed through the bloodstream — can be different,” she said. “Also, if they’re on different medications, they can interact with those other medications and cause adverse effects.”
One important note with concentration is that it is not as simple as comparing size and weight and hypothetically scaling down to the correct dosage for a human.
“Even between dogs and cats, pigs, horses, cows; everyone has a different dose they’ve found and proven to work for that species,” said Reinalda.
In a statement to consumers, the FDA says they have received multiple reports of patients requiring medical support and hospitalization after ingesting ivermectin intended to treat horses. Beyond the dangers presented by taking the drug, also worth noting is the lack of proof that it is effective against COVID-19.
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).FDA
Use of interest in the drug has risen as people in prominent positions have advocated its study and use. These include popular podcaster and commenter Joe Rogan, who recently announced he was positive for COVID-19, and that he was treating his illness with ivermectin. Rogan also used monoclonal antibodies to treat his COVID-19.
Other voices advocating ivermectin are Republican U.S. Senators Ron Johnson of Wisconsin, who was recently suspended from YouTube for spreading ‘misinformation’ about the drug, and Rand Paul of Kentucky, who recently made statements at a Kentucky town hall event suggesting that researchers are not pursuing ivermectin as a possible COVID-19 treatment because of their disdain for former President Trump.
Both Johnson and Paul also made similar claims about hydroxychloroquine, an anti-malarial drug also used to treat lupus which was touted by former President Donald Trump as a treatment for COVID-19. A clinical trial by the U.S. National Institutes of Health found in 2020 that “the drug provides no clinical benefit to hospitalized patients.”
While there is no proof of ivermectin being effective in helping with the treatment of COVID-19, McKay notes that there are studies being done. “If we’re going to be doing it,” she says “then we want to be giving it under the guise of a clinical trial.”
McKay says that at this time, studies have only shown that there is a possibility that ivermectin might be helpful in assisting in the treatment of COVID-19.
McKay said side-effects of ivermectin in these studies include stomach aches, nausea, vomiting and even paralysis.
While there is research ongoing, McKay specifies that ivermectin will never be a cure for COVID-19.
“It’s not going to work like an antibiotic does,” she said. “Keep in mind that people who survive severe COVID in particular also have a lot of other stuff supporting them, like high-flow oxygen, like good nursing care — it’s just not going to be that magic bullet like an antibiotic is.”
At best, according to McKay, ivermectin could possibly have application as a drug to support more effective treatments such as the use of monoclonal antibodies.
One area where McKay advises caution is in the potential for harm caused by potential shortages of ivermectin.
“Ivermectin is actually important to be treating other things,” she said. “We also have to recognize that this is part of how we keep our food supply safe, this is how other countries have to take care of their people because many places don’t have clean drinking water.”
A similar issue was seen in 2020 when a rush was made to secure doses of hydroxychloroquine for testing, leading to shortages which affected those who required it to treat conditions such as lupus and arthritis.
When it comes to fighting COVID-19 McKay emphasized the importance of the things that are known.
“We do have a lot of scientific evidence for other stuff like vaccines, like masks,” she said. “So if you really want to follow the science, do the stuff that we do have large scale data sources for.”
Asked if she would prescribe ivermectin for COVID, McKay said she would not, but would consider directing the patient toward finding a clinical study to take part in.
Importantly, clinical trials will revolve around human-grade ivermectin. Both McKay and Reinalda are unified on the fact that people should not be taking ivermectin, or any other medications, meant for animals.
Jacob Newton: “Is there any situation in which a person, to your knowledge, should take animal de-wormer?”
Reinalda: “No. I mean you’re dealing with a 1,500-1,200 pound animal compared to a 120 pound human. That concentration alone, how it’s delivered, even packaged and sent is completely different.”
Jacob Newton: “Is there any situation from a medical standpoint that you can see where a person should take bovine or equine ivermectin?”
McKay: “No. No, please don’t. Please don’t. We don’t want to have to take care of you for that. We want to be doing things like delivering babies and telling you you’re free of your cancer and keeping you healthy.”
“The important thing right now,” said McKay. “Is just to let people know that you can still get vaccinated. We got our FDA approval. It’s a really miraculous kind of vaccine because it goes to your cells and your cells immediately begin producing those antibodies.”
The Sanford Poison Control Center had one recorded Ivermectin exposure call for August, 2021 and said via email that they do not recommend using any form of veterinary Ivermectin in humans.