Introduction: A Drug of Praise and Controversy
Ivermectin is a medication that has seen both widespread praise and significant controversy. While it holds a vital place in global medicine as a powerful agent against debilitating parasitic diseases, its role has been publicly debated for other uses, particularly viral infections [1.2.1, 1.4.3]. This has led many to ask a fundamental question: will ivermectin get rid of infections? The answer is complex and requires a clear distinction between its proven, approved applications and its unproven, often dangerous, off-label uses.
This article delves into the pharmacology of ivermectin, its FDA-approved uses, the scientific evidence regarding its efficacy against viral and bacterial infections, and the critical safety warnings issued by health authorities like the FDA and NIH [1.5.1, 1.5.6].
What is Ivermectin and How Does It Work?
Ivermectin belongs to a class of drugs called anthelmintics [1.2.4]. It is a broad-spectrum anti-parasitic agent derived from avermectin, a substance produced by the bacterium Streptomyces avermitilis [1.3.5]. Its primary function is to combat infections caused by parasites.
The mechanism of action is specific to invertebrates. Ivermectin binds to glutamate-gated chloride channels in the nerve and muscle cells of parasites [1.3.6]. This action increases the permeability of the cell membrane to chloride ions, leading to hyperpolarization of the nerve or muscle cell. The result is paralysis and eventual death of the parasite [1.2.2, 1.3.6]. Mammals are not affected in the same way because ivermectin has a low affinity for their neurotransmitter channels and generally cannot cross the blood-brain barrier to reach the central nervous system where these channels are located [1.3.6, 1.3.8].
FDA-Approved Uses for Ivermectin
The U.S. Food and Drug Administration (FDA) has approved ivermectin for very specific uses in humans. It is crucial to understand these indications, as they are backed by rigorous clinical trials demonstrating safety and efficacy.
- Oral Ivermectin (Tablets): The oral form, often sold under the brand name Stromectol, is approved to treat two conditions caused by parasitic worms [1.3.4, 1.2.3]:
- Strongyloidiasis: An intestinal infection caused by a type of roundworm known as a threadworm [1.2.4].
- Onchocerciasis: Also known as "river blindness," this condition is caused by a parasitic worm and can lead to skin issues and severe vision problems, including blindness [1.2.4].
- Topical Ivermectin: Formulations applied to the skin are approved for [1.2.1, 1.3.1]:
- Head Lice: Ivermectin lotion (Sklice) is an approved treatment for head lice infestations [1.2.3].
- Rosacea: A topical cream (Soolantra) is used to treat inflammatory lesions associated with this skin condition [1.2.3].
Beyond these FDA-approved uses, it is sometimes prescribed "off-label" for other parasitic infestations like scabies [1.3.6].
The Controversy: Ivermectin and Viral Infections
The central controversy surrounding ivermectin relates to its potential use as an antiviral, particularly against SARS-CoV-2, the virus that causes COVID-19. This interest was sparked by an early laboratory study in 2020 which showed that ivermectin could inhibit the replication of SARS-CoV-2 in a cell culture (in vitro) [1.4.6].
What Clinical Trials and Health Organizations Say
Despite the initial lab findings, extensive research and numerous large-scale, randomized controlled trials (RCTs) in humans have failed to produce sufficient evidence that ivermectin is effective for treating or preventing COVID-19 [1.4.1, 1.5.8].
Key findings from major health authorities:
- U.S. Food and Drug Administration (FDA): The FDA has not authorized or approved ivermectin for treating or preventing COVID-19 in humans or animals. The agency states that currently available data do not show ivermectin is effective against COVID-19 [1.5.6].
- National Institutes of Health (NIH): The NIH's COVID-19 Treatment Guidelines Panel recommends against the use of ivermectin for the treatment of COVID-19, except in a clinical trial setting. The panel concluded there is insufficient evidence to recommend its use [1.5.1, 1.5.3].
- Meta-Analyses: Multiple comprehensive reviews and meta-analyses of RCTs have concluded that ivermectin does not provide a statistically significant benefit in reducing mortality, preventing hospitalization, or lessening the severity of COVID-19 compared to a placebo or standard of care [1.4.1, 1.4.8].
Why In-Vitro Success Didn't Translate
The discrepancy between the initial lab study and human clinical trials is a common occurrence in drug development. The concentration of ivermectin used to inhibit the virus in the lab was up to 35 times higher than the doses approved and safe for human use [1.4.3]. Achieving such high concentrations in the human bloodstream would require dangerously toxic doses, leading to severe side effects [1.4.2].
Ivermectin vs. Other Infections (Bacterial, Fungal)
Ivermectin is an anti-parasitic drug, not an anti-bacterial or anti-fungal agent [1.2.5]. Its mechanism of action is targeted at the nervous systems of parasites and is completely different from how antibiotics work to kill bacteria. There is no scientific evidence or medical basis for using ivermectin to treat common bacterial infections like strep throat, urinary tract infections, or skin infections caused by bacteria.
Ivermectin Formulations: Human vs. Animal
One of the most dangerous aspects of the ivermectin controversy was the use of veterinary formulations by humans. The FDA has issued strong warnings against this practice [1.2.4].
| Feature | Human Ivermectin | Veterinary Ivermectin |
|---|---|---|
| Formulation | Tablets (e.g., Stromectol), topical lotions/creams (e.g., Sklice, Soolantra) [1.2.3] | Highly concentrated pastes, injectable solutions, or pour-on liquids [1.2.1] |
| Dosage | Specifically calculated for human weight and indication; typically low microgram-per-kilogram doses [1.2.3] | Dosed for large animals like horses and cattle, often weighing hundreds or thousands of pounds [1.2.1] |
| Active Ingredients | Purified and tested for human safety [1.5.6] | May contain inactive ingredients that have not been evaluated for safety in humans [1.2.7] |
| Regulation | Approved and regulated by the FDA for specific human conditions [1.3.4] | Approved and regulated by the FDA's Center for Veterinary Medicine for specific animal species [1.2.4] |
Taking veterinary ivermectin is extremely dangerous and can lead to overdose and severe toxicity [1.3.6].
Risks and Dangers of Misuse
Even when using FDA-approved human formulations, ivermectin is not without risks. When used improperly or at high doses, the side effects can be severe.
Common side effects at approved doses include:
- Nausea, vomiting, diarrhea [1.6.8]
- Dizziness [1.6.8]
- Itching and rash [1.6.4]
- Stomach pain [1.6.4]
Serious side effects, particularly with high doses or overdose, can include:
- Severe skin reactions (Stevens-Johnson syndrome) [1.6.4]
- Liver injury (hepatitis) [1.6.4]
- Neurological effects like confusion, seizures, and coma [1.6.7, 1.6.8]
- Hypotension (low blood pressure) [1.6.4]
- Death [1.3.6]
The CDC reported a significant increase in calls to poison control centers related to ivermectin exposure during the COVID-19 pandemic [1.5.1].
Visit the FDA's page for more consumer information on Ivermectin and COVID-19.
Conclusion
To answer the question, "Will ivermectin get rid of infections?" — yes, but only specific parasitic infections for which it is approved. It is a highly effective and important drug for conditions like river blindness and strongyloidiasis [1.2.2].
However, for viral infections like COVID-19 or any bacterial infection, the overwhelming scientific and clinical evidence shows it is not effective and major health organizations recommend against its use [1.5.3, 1.5.6]. The promotion of ivermectin for these unapproved uses has led to dangerous misuse of veterinary products and severe health consequences. Always consult with a healthcare professional and only use medications as prescribed and from a legitimate pharmacy.
