Following a dramatic increase in poisoning concerns related to the use of ivermectin—often used as a large animal de-wormer—by people attempting to prevent or treat COVID-19 has led both the Centers for Disease Control and Prevention and the Missouri Department of Health & Senior Services to issue advisories against that practice.
The Missouri DHSS issued a Health Alert on August 24, warning people against self-medication with ivermectin for the Treatment and Prevention of COVID-19 and the CDC issued a Health Advisory on August 26. Health Alerts in Missouri convey information of the highest level of importance which warrants immediate action or attention from Missouri health providers, emergency responders, public health agencies, and/or the public.
The Missouri DHSS alert came after receiving reports that some people in Missouri were using ivermectin to prevent or treat a COVID-19 infection. Inappropriate use of this medication, especially consuming veterinary formulations, may cause significant harm. The DHSS is urging Missourians not to use ivermectin for self-medication against COVID-19. All health care providers who encounter illnesses due to ivermectin ingestion should report cases to the Missouri Poison Control Center at 1-800-222-1222.
Ivermectin is a Food and Drug Administration (FDA)-approved antiparasitic drug that is used to treat several neglected tropical diseases and scabies. Ivermectin is not approved by the FDA for the treatment of any viral infection, including COVID-19.
The National Institute for Health (NIH) has recently concluded that there is insufficient evidence to recommend either for or against the use of ivermectin for the treatment of COVID-19. Several clinical trials that are evaluating the use of ivermectin for the treatment of COVID-19 are currently underway or in development. The World Health Organization (WHO) also recommends that this drug only be used within clinical trials.
Nevertheless, the Missouri DHSS has received reports that some people were using ivermectin to prevent a COVID-19 infection, including veterinary formulations of the drug. In Mississippi, two-thirds of recent calls placed to the state’s poison control center were related to “ingestion of livestock or animal formulations of ivermectin purchased at livestock supply centers.”
The FDA has urged people to stop taking veterinary formulations of this drug to treat or prevent COVID-19 after receiving multiple reports of patients who have been hospitalized after “self-medicating with ivermectin intended for horses.” According to the FDA, animal drugs are often highly concentrated because they are used for large animals like horses and cows, and such high doses can be highly toxic in humans. Patients who overdose with ivermectin can experience nausea, vomiting, diarrhea, low blood pressure, allergic reactions, dizziness, and problems with balance, seizures, coma and even death. Other adverse effects have included decreased consciousness, confusion, agitation, and hallucinations. Additionally, the effect of many inactive ingredients found in animal products is not known because those ingredients aren’t evaluated for use in people.
The Missouri Poison Center has concerns about the recent intentional misuse of the Ivermectin as a preventative or treatment of COVID-19. The center has managed at least 22 cases in 2021 as compared to two cases in 2020 where an individual intentionally has ingested a prescription product or a veterinary formulation not intended for human use.
The Poison Center does not recommend taking ivermectin that is not prescribed to them by a healthcare provider. Ivermectin products made for animals are not safe for human consumption. Missourians are urged to contact a specially trained pharmacist or nurse at 800-222-1222 for advice if they have been using ivermectin or an ivermectin-containing product and are experiencing symptoms.
CDC Recommendations for the Public
• Be aware that currently, ivermectin has not been proven as a way to prevent or treat COVID-19.
• Do not swallow ivermectin products that should be used on skin (e.g., lotions and creams) or are not meant for human use, such as veterinary ivermectin products.
• Seek immediate medical attention or call the poison control center hotline (1-800-222-1222) for advice if you have taken ivermectin or a product that contains ivermectin and are having symptoms. Signs and symptoms include gastrointestinal effects (nausea, vomiting, abdominal pain, and diarrhea), headache, blurred vision, dizziness, fast heart rate, and low blood pressure. Other severe nervous system effects have been reported, including tremors, seizures, hallucinations, confusion, loss of coordination and balance, decreased alertness, and coma.
• Get vaccinated against COVID-19. COVID-19 vaccination is approved by FDA and is the safest and most effective way to prevent getting sick and protect against severe disease and death from SARS-CoV-2, the virus that causes COVID-19, including the Delta variant.
• Protect yourself and others from getting sick with COVID-19. In addition to vaccination, wear masks in indoor public places, practice staying at least six feet from other people who don’t live in your household, avoid crowds and poorly ventilated spaces, and wash your hands often or use hand sanitizer that has at least 60 percent alcohol.