INSIGHT: Good, Ivermectin has shown promise against COVID-19 but….
Australian researchers have published a study revealing that a single dose of the anti-parasite drug, Ivermectin, can kill COVID-19 within 48 hours.
The next step is for scientists to determine the correct human dosage, to make sure the level used in vitro is safe for humans.
Medical expert in malaria and Parasitology, Carlos Chaccour sheds more light on the new found promising relationship between ivermectin and COVID-19 highlighting some of the dangerous side-effects of ivermectin especially when used on COVID-19 patients.
He however, said the research brings hope and requires more carefully conducted clinical trials on dosage and side-effects.
“I have been working with ivermectin for more than 10 years.
We need to talk about ivermectin and COVID-19
#SARS_COV_2 is a positive single-stranded RNA virus Ivermectin inhibits in vitro the replication of several positive single-stranded RNA viruses such as:
– Yellow Fever
A collaborative study by Monash University’s Biomedicine Discovery Institute (BDI) and the Peter Doherty Institute of Infection and Immunity (Doherty Institute), both Australia, demonstrated that ivermectin can stop SARS-CoV-2 growth in cell cultures by eradicating all genetic information within two days. Their findings were published in Antiviral Research
The new in vitro data from Caly et al. , show 50% inhibition of SARS_COV_2 replication after incubating VERO cells with 2.8 uM for 2 days.
How much is 2.8 uM Carlos?
That is a good question.
2.8 uM is the equivalent of a plasma concentration of 2100 ng/ml.
Lets put that into perspective.
The ivermectin dose used for river blindness is 200 mcg/kg.
That is one tablet of 3 mg for every 15 kg of weight.
The maximum plasma concentration reached with that dose is around 40 ng/ml.
That is 50-fold less that the concentration proven to cut viral replication in half.
There is however hope. Prove antiviral activity opens the door to carefully conducted and controlled trials.
Now, if you are considering using ivermectin on a compassionate basis you must know this:
Ivermectin can cross react with GABA-gated chlorine channels in the CNS and cause neurotoxicity.
This is normally prevented by the blood brain barrier (BBB), particularly by the P-gp.
If you do not have a fully functional BBB ivermectin may not be the safe drug it usually is.
Now, hyperimflammatory states, such as the one caused by COVID-19 make the BBB leaky.
I would be careful to use ivermectin in severely ill patients with proven efficacy.
Additionally, please be careful with drug-drug interactions. Many COVID-19 patients are receiving Lopinavir/Ritonavir.
Rito is a very good CYP3A4 inhibitor with some effect on the P-gp as well. It can boost ivermectin increasing Cmax and potentially penetration on the CNS.
The new direct effects on the virus reported by Caly and colleagues are very good news!
I understand the urgency. There is reason for hope! But this requires careful planning.
Some trials have already been proposed in the last few weeks.
Watch this space.”