Still listed in India as a possible treatment option for mild COVID-19 patients under home isolation Ivermectin, according to the World Health Organisation’s recent direction, is not recommended for general use.
This orally-administered drug is included in India’s revised national COVID-19 treatment protocol for people with mild infection even though its maker has now clarified that there is no evidence of its efficacy against the viral disease.
“Safety and efficacy are important when using any drug for a new indication. WHO recommends against use of ‘Ivermectin’ for COVID-19 except within clinical trials,” Soumya Swaminathan, WHO’s chief scientist, tweeted earlier this week.
Indian physicians who continue to use this drug state that it is an approved anti-parasitic agent. “It has shown, in laboratory settings, to inhibit SARSCOV2 replication. It may be effective for the management of early onset, mild COVID-19 for adult patients. In a clinical setting, it is observed that there is an early viral clearance in patients who are put on Ivermectin. Symptomatically, there is no faster resolution observed, in terms of fever, cough, or sore throat despite the use of Ivermectin. There are no severe adverse effects noted in patients with non-severe COVID-19,” said Vighnesh Naidu Y, consultant physician, Yashoda Hospitals, Hyderabad
“Ivermectin is used for the treatment and eradication of two life-threatening illnesses which are onchocerciasis, responsible for blindness, and filariasis, which is debilitating,” said Sheela Chakravarthy, director, Internal Medicine, Fortis Hospitals, Bannerghatta Road.
She added that Ivermectin was also found to be effective in reducing the multiplication of certain RNA viruses such as SARS and COVID RNA.
“It has shown efficacy to bind to the spike protein site of the RNA virus thereby reducing the multiplication and attachment of the virus to the ACE receptor in the nasal epithelium. So, the usage of Ivermectin during the early stage of COVID-19 will prevent attachment of the virus to the nasal epithelium. The consumption of Ivermectin 12 mg once daily for three days is now recommended in the isolation protocols of Karnataka,” she explained and noted that there were multiple randomised controlled trials claiming the efficacy of this drug.
Shafiq Ahmed, consultant, Urology HCMCT Manipal Hospitals, said that Ivermectin was first used in third world countries and a few papers emerged on its results in COVID-19 infection and as chemoprophylaxis for healthcare workers and their contacts which was also tested in-vitro.
‘A safe drug’
“It is used for treatment of COVID-19 infection in mild to moderate cases. Since it’s a very safe drug, there are no major side effects reported till date. Therefore, It has been suggested from the recent literature and individual experience that the people who have not been vaccinated so far or those having mild symptoms of COVID-19 should take Ivermectin as prescribed by their doctor,’’ he said.
Archana Dhawan Bajaj, Gyneacologist, Obstetrician and IVF expert, Nurture IVF, stating that there was a need to study Ivermectin further said that the rationale for its current use was the fact that it prevented replication of SARS COVID virus in-vitro. “Small cohorts of studies have been done in parts of the world and a lot has been studied in Australia and New Zealand where they have used Ivermectin and have found good results. And it seems to be a drug which does not have too many potential side-effects in its use. A lot of healthcare professionals worldwide are using it. Of course, more needs to be studied into the use of Ivermectin and scientific rational behind its use has really not been proven beyond doubt so use of Ivermectin though done worldwide and sometimes even indiscriminately,’’ she said.