Ivermectin Q

I know the difference between TV and real life, but I just saw something that made me wonder. I was watching a 10-year-old episode of House (Season 7) and, while spitballing for the patient-of-the-week’s treatment, Taub suggests ivermectin, the anti-parasitic for horses that certain pro-MAGA types swear cures covid-19. Clearly, this could be an in-joke for the writer and the medical script consultant who never imagined this obscure drug would break out into the public discourse a decade down the road. Or, it could indicate that doctors occasionally use the stuff for something other than horse worms, and this isn’t being mentioned in the current public debate.

Could someone better informed about the specifics than I am weigh in on this? Is ivermectin ever legitimately used for humans?

Absolute it is used legitimately for humans as an anti-parasitic.

It’s also not just used for horses but for most livestock and, I believe, it’s also in Heartguard for pets. The dosing and other ingredients will matter, however, so it’s rather important for humans not to take any without consulting a physician. And they certainly shouldn’t take formulations for animals they can buy at farm supply stores.

That said, there is currently no evidence it does much as an anti-viral in humans.

It has been/is used for parasitic infection that humans are occasionally prone to. Human-sized doses for parasites~scabies comes to mind.

The drug of choice for scabies is generally considered to be topical permethrin.

Topical ivermectin has been used for scabies and off-label against pinworms, but in the U.S. ivermectin seems to be prescribed most often for Strongyloides and roundworm infections.

The current fuss relates to 1) the lack of good evidence for its clinical utility as an antiviral, and 2) the foolishness of people who self-medicate with veterinary ivermectin meant for use in large animal antiparasitic therapy.

Pluto just got his chewables for heartworm, flea and tick prophylaxis. Maybe if he slurps me enough I can get a therapeutic blood level of ivermectin.

Thanks for the quick replies! Not that I need to know soon or anything…

Do you remember what illnesses they thought the patient my have had, or the symptoms? Or can you at least name the episode?

I’m curious to check, but don’t want to go through all of Season 7, though I might be able to find a doctor’s blog online that lists the treatments they tried. (I’ve seen several doctors review the show for its medicine.)

I think it was “Man of the House,” or the one about the motivational speaker who went from alpha male to 70s Alan Alda after getting roughed up in a bar fight. It’s about midway through the season.

Sentence two of the wiki lists the parasitic infections it is used for in humans.

You apparently didn’t see this thread:

Just to be clear:

Ivermectin was originally developed as a veterinary medicine, and was first marketed as such in 1981. It was fully approved for use in humans in 1988, has full FDA approval, and is on the WHO’s List of Essential Medicines. It’s been used by hundreds of millions of people since 1988. When, as they say, it’s used as directed, for its intended purpose, it’s a safe and effective medication. Its intended purpose is as an antiparasitic, and more specifically a dewormer.

Given the typical House plot structure, I’m assuming someone suggested the patient’s symptoms might be caused by parasitic worms, and suggested their usual diagnosis-by-treatment: if they administer ivermectin (a common and effective dewormer) and the patient improves, the problem is worms, and they continue treatment for that; if not, it’s something else, and they move on.

The issue with COVID is that for somewhat obscure reasons a lot of people have latched onto ivermectin as a supposed treatment. Ivermectin is an antiparastic, and COVID is of course caused by a virus, so ivermectin is (almost certainly) useless. Prescription ivermectin is quite safe, but quite pointless for treating COVID.

It gets worse than that, though. Ivermectin is a common prescription dewormer in humans, but in the U.S., parasitic worms in humans aren’t particularly common, and you have to actually get a qualified medical professional to give you a prescription to obtain it, which makes it pretty hard to get for those who think it treats COVID. On the other hand, parasitic worms are fairly common in livestock, and veterinary formulations of ivermectin are widely available. So, a lot of people have tried self-medicating with veterinary ivermectin.

The dosages and concentrations intended for horses (maybe the most widely available formulation in the U.S.) are, of course, wildly wrong for application in humans. But it gets worse. Veterinary formulations included ingredients that can be highly toxic to humans. Prescription ivermectin is safe but useless for treating COVID. Veterinary ivermectin is not only useless for treating COVID, it’s actively dangerous.

(This has, by the way, led to quite a few people, including on this board, to try to fight misinformation about ivermectin by constantly referring to it as “horse medicine”, even when discussing prescription ivermectin formulated for humans).

ETA: and ninja’d by a reference to my own previous thread…

Over three billion doses of Ivermectin have been given to humans (and over five billon to animals) over the past few decades. Side effects are rare and tend to be minor and transient. There has been a lot of research looking into its use for Covid over the past year. Claims that there has been no research or no evidence are false.

Ivermectin is a well-known medicine that is approved as an antiparasitic by the World Health Organization and the US Food and Drug Administration. It is widely used in low- and middle-income countries (LMICs) to treat worm infections.2,3 Also used for the treatment of scabies and lice, it is one of the World Health Organization’s Essential Medicines.4 With total doses of ivermectin distributed apparently equaling one-third of the present world population,5 ivermectin at the usual doses (0.2–0.4 mg/kg) is considered extremely safe for use in humans.6,7 In addition to its antiparasitic activity, it has been noted to have antiviral and anti-inflammatory properties, leading to an increasing list of therapeutic indications.8

Yes, there’s been a lot of research into it. None of that research has supported the conclusion that it’s effective against covid.

I detect strawmen here.

What the overwhelming majority of health professionals and scientists have been saying for quite some time now is that research to date has been heavily unconvincing, and that there’s no good evidence supporting ivermectin’s clinical use in treating or preventing Covid-19 infection. Much of the hype has come from an Egyptian trial reported in a preprint by Elgazzar et al, only to have problems with suspected data fabrication and plagiarism uncovered.

"Gideon Meyerowitz-Katz, an Australian chronic disease epidemiologist who also reviewed the Elgazzar data, found (similar faults). Researchers often summarize large bodies of literature by statistically synthesizing trials in what are called meta-analyses. “If you remove this one study from the scientific literature,” he told The Guardian “most meta-analyses that have found positive results would have their conclusions entirely reversed.”

“Where to look for higher quality data? A group called the Cochrane Collaboration spends its time conducting meta-analyses of the best-conducted clinical trials. After excluding dozens of ivermectin studies with “high risk of bias,” the collaboration left little room for optimism: “Based on the current very low- to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent Covid-19.” The group recommended that ivermectin use be restricted to clinical trials that might actually generate high quality data.”

“The World Health Organization and the Infectious Diseases Society of America concur. Even Merck, an ivermectin manufacturer, avers that there is “no meaningful evidence for clinical activity or efficacy in patients with Covid-19.”

That there has been a bunch of research going in regarding ivermectin and Covid-19 means zilch unless that research is rigorously done and comes up with positive, reproducible findings. Earlier, there was a shitload of research into hydroxychloroquine and a hype machine equivalent or greater than that which has boosted ivermectin. The verdict is that HCQ is not beneficial against Covid-19.

@ Chronos Your statement is only true if you have chosen to ignore the research that doesn’t support your claim.

That’s a meta-study which includes many other meta-studies. That smells a lot to me like trying to package junk bonds together in such a way as to produce solid investments. You can’t do it, because they’re all correlated.

I’ve prescribed ivermectin maybe a half dozen times in the last 20 years, all for cases of scabies that did not clear with repeated topical permethrin treatment. It worked like a charm.

That is not a meta-study. It is a list of 113 studies using Ivermectin for Covid. A small number of them are meta-studies of other research. The list contains links for anyone who wants to read the studies for themselves.

And it then goes on to say things like how likely you would be to get those results from independent studies. But they aren’t independent, because the meta-studies are all collating mostly the same original studies, including the fraudulent one.

I frankly don’t know what to make of the site that collates studies of COVID-19 treatments including Sativa, vitamins and aspirin (among others), most with some significant rates of success.

Yep, these sites appear to be the same FLCCC gang that is now pushing Ivermectin and was pushing hydroxychloroquine last year, but now tell us that it’s not useful after all. I have no desire to even chase this silly stuff down any more.

97% of the 31 early treatment studies report a positive effect (13 statistically significant in isolation).

What are the odds?

The probability that an ineffective treatment generated results as positive as the 281 studies is estimated to be 1 in 734 trillion.

And yet today, they say that hydroxychloroquine varies between “unknown benefit” and actual “harm”, depending on which phase it is administered.

FLCCC are a bunch of quacks. Grifting quacks. But hay, you too can “avoid censorship”. Just give them money.