Understanding Ivermectin and Its Approved Uses
Ivermectin is an antiparasitic medication approved by the U.S. Food and Drug Administration (FDA) to treat specific conditions caused by parasitic worms in humans. These include intestinal strongyloidiasis (a type of roundworm infection) and onchocerciasis (river blindness) [1.8.3, 1.8.4]. Topical formulations are also approved for treating external parasites like head lice and skin conditions such as rosacea [1.8.3]. The drug works by paralyzing and killing parasites [1.8.2]. It is on the World Health Organization's List of Essential Medicines and has been used safely by millions for its approved indications [1.8.5]. However, its use is not without risks, and it is crucial to understand the specific circumstances under which it should be avoided.
Unapproved and Dangerous Uses: COVID-19
A critical point of caution is the use of ivermectin for COVID-19. Major health organizations, including the FDA, the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO), do not recommend ivermectin for the prevention or treatment of COVID-19 outside of a clinical trial [1.2.4, 1.6.1]. Clinical data has not demonstrated that ivermectin is effective against the virus in humans [1.6.1]. Self-medicating with ivermectin, especially with veterinary formulations, is extremely dangerous. Animal ivermectin products are highly concentrated for large animals and can lead to overdose and toxicity in humans, causing severe symptoms like nausea, vomiting, low blood pressure, seizures, coma, and even death [1.6.1, 1.7.5].
Who Should Avoid Taking Ivermectin?
Certain populations and individuals with specific health conditions should not take ivermectin or should only use it with extreme caution under a doctor's supervision [1.2.1].
Populations with Specific Risks
- Pregnant or Planning to Become Pregnant: There is insufficient data on the safety of ivermectin during human pregnancy. Animal studies have shown potential harm to the fetus [1.2.5, 1.9.2]. It should only be used during pregnancy if the potential benefit justifies the potential risk [1.2.1].
- Breastfeeding Individuals: Ivermectin passes into breast milk in low concentrations [1.9.1, 1.9.2]. A healthcare provider should be consulted to weigh the risks and benefits [1.2.1]. The WHO recommends avoiding it only in the first week after delivery [1.9.3].
- Children: The safety and effectiveness of ivermectin have not been established in children weighing less than 33 pounds (15 kg) [1.2.5, 1.9.5].
- Older Adults (Ages 65+): The liver and kidneys may not work as well in older adults, causing the body to process drugs more slowly. This can increase the concentration of ivermectin in the body and heighten the risk of side effects [1.2.5, 1.2.1].
Individuals with Pre-existing Health Conditions
- Liver Problems: Since ivermectin is metabolized by the liver, individuals with liver disease or a history of liver problems may not process the drug well. This can lead to increased levels in the body, raising the risk of side effects and further liver harm [1.3.5, 1.10.2].
- Asthma: Ivermectin may worsen asthma. Patients with asthma should consult their doctor to determine if the drug is safe for them [1.2.2, 1.3.5].
- Seizure Disorders: The medication can cause seizures, so individuals with a history of seizures should speak with their doctor before taking it [1.2.1, 1.3.5].
- Weakened Immune System: People with conditions like HIV may require additional doses or treatments, as a single dose might not be sufficient to clear a parasitic infection [1.2.1, 1.3.5].
- Allergies: Anyone with a known hypersensitivity or allergic reaction to ivermectin or any of its ingredients should not take the medication [1.3.3].
Potential Drug Interactions
Ivermectin can interact with other medications, altering their effectiveness or increasing the risk of adverse effects. It's vital to inform your doctor about all prescription drugs, over-the-counter medications, vitamins, and herbal supplements you are taking [1.2.1].
| Drug Class or Name | Example(s) | Potential Interaction with Ivermectin |
|---|---|---|
| Blood Thinners | Warfarin | Can increase the anticoagulant effect, raising the risk of bleeding [1.2.2, 1.3.5]. |
| Anti-Anxiety Medicines | Lorazepam, Clonazepam | May interact with ivermectin [1.4.1]. |
| Sedatives | Phenobarbital | May interact with ivermectin [1.4.1]. |
| Antiepileptic Drugs | Valproic Acid | May interact with ivermectin [1.4.1]. |
| Certain Antifungals | Ketoconazole, Itraconazole | Can increase the risk of ivermectin side effects by slowing its breakdown [1.4.2]. |
| P-glycoprotein Inhibitors/Inducers | Amiodarone, Clarithromycin, St. John's Wort | Many drugs can affect ivermectin levels by interacting with the P-glycoprotein transporter, either increasing or decreasing its concentration and effects [1.4.5]. |
Understanding Side Effects
Even when taken as prescribed, ivermectin can cause side effects. Common side effects include dizziness, itchy skin, nausea, and diarrhea [1.5.3]. More serious side effects can occur, such as:
- Severe skin reactions (e.g., Stevens-Johnson syndrome) [1.5.3]
- Neurological problems like confusion, balance issues, and seizures [1.2.4]
- Low blood pressure (hypotension) [1.2.4]
- Liver injury, though rare, has been reported [1.10.1, 1.5.5]
- Fast heart rate and trouble breathing [1.2.4]
If you experience symptoms like a severe rash, confusion, difficulty breathing, or a feeling like you might pass out, you should seek medical help immediately [1.2.4].
Conclusion
Ivermectin is a prescription medication that must be used responsibly under the guidance of a healthcare professional for its FDA-approved uses [1.2.1]. You should not take ivermectin if you are pregnant, have certain medical conditions like liver disease, or are taking interacting medications without consulting a doctor. It is critically important to never use ivermectin intended for animals, and to understand that it is not an approved or effective treatment for COVID-19 [1.6.1, 1.7.2]. Always obtain medication from a legitimate pharmacy and take it exactly as prescribed to ensure safety and efficacy [1.6.1].
For more information on the FDA's stance, you can visit their consumer update page: Why You Should Not Use Ivermectin to Treat or Prevent COVID-19
