Ivermectin is an anti-parasitic and anti-inflammatory substance that has recently become a topic of discourse among scientists around the world due to its potential inhibitory effect on SARS-CoV-2 virus replication. What does ivermectin treat? Is it effective against the coronavirus?
Action of ivermectin
Ivermectin has an anti-inflammatory effect. It works by inhibiting the production of inflammatory cytokines. Ivermectin also has an anti-parasitic effect. This substance causes the influx of chloride ions into the muscle and nerve cells of invertebrates, which causes paralysis of the parasite and its death.
In Poland, the only product registered and available in pharmacies is Soolantra cream. In the preparation, ivermectin is present in a concentration of 1%. This preparation is indicated for topical use in the treatment of rosacea.
The effectiveness of ivermectin
The effectiveness of ivermectin in this case is explained by its anti-inflammatory and antiparasitic effect on Demodex mites. These invertebrates are the physiological flora of the hair follicles, but in rosacea their number is increased and exacerbates the symptoms of skin inflammation. The 1% ivermectin cream has been recognized by the FDA as an alternative to the gold standard 0.75% metronidazole cream.
Ivermectin indications
Ivermectin cream for external use
Ivermectin cream is indicated for the treatment of symptoms of rosacea (maculopapular acne) in adult patients.
For external use, ivermectin can also be used in the treatment of scabies and head lice, while preparations that could be used for this purpose are not generally available in Polish pharmacies.
Ivermectin tablets
Oral ivermectin preparations are not registered in Poland.However, this substance is used in the worldin the treatment of external and internal parasites, both in humans and animals . Ivermectin is well absorbed from the gastrointestinal tract. It does not cross the blood-brain barrier, which makes its safety profile quite high.
Additionally, ivermectin does not act on human and mammalian cells in the same way it does on invertebrate cells. There are no channels in humansglutamate-gated chloride, and these are the binding sites for ivermectin.
What does ivermectin treat?
Ivermectin effectively treats diseases such as:
- scabies
- head lice
- onchocerkoza (river blindness)
- strongyloidosis (caused by intestinal nematodes)
- filariosis
For this substance, Professor Omura was awarded the Nobel Prize in 2015. Ivermectin significantly increases the chances of completely eliminating filariasis and onchocercosis.
Currently, ivermectin is being studied in the fight against malaria.
Can ivermectin be used to prevent and treat COVID-19?
BothEMA (European Medicines Agency),andWHOpositions contradict this hypothesis. Experts carefully reviewed the current results of clinical trials and unanimously concluded that at this point in time, the available evidence is not sufficient to support the use of ivermectin in the treatment of COVID-19 outside of clinical trials.
It has been theorized that ivermectin may block SARS-CoV-2 virus replication. However, for the time being, only the results of laboratory tests can be relied on. In addition, the EMA emphasizes that researchers used a much higher dose of ivermectin in the tests than the maximum dose currently allowed for treatment.
This could indicate a potential toxic effect, so both organizations have adopted a position to implement appropriate clinical trials on the basis of which such a strategy for combating COVID-19 can be further considered.
Ivermectin dosage
In the case of ivermectin in the form of a cream, the dosage is as follows: once a day, lubricate your face with the cream for 4 months. Clinical trials show that in a large number of patients the effects of the therapy are visible after only 2 weeks of using the cream.
Sources report that after 12 weeks of treatment, in almost half of the patients acne lesions have completely disappeared or decreased significantly.
There is no need to modify the dose for patients over 65 years of age
Since rosacea is a chronic disease, patients usually use the preparation for more than 12 months. In clinical trials, only about 250 patients have used the preparation for more than a year. However, long-term use of the drug is not expected to endanger the patient's safety.
Contraindications to the use of ivermectin
Contraindication to use is hypersensitivity to ivermectin or auxiliary substances present in the preparation.
Ivermectin - precautions
Cream with 1% ivermectin may cause reactionsallergic and cutaneous.
Ivermectin should be administered with caution to patients with hepatic and / or renal impairment.
The use of ivermectin in pregnant or lactating women is not recommended.
Ivermectin - side effects
Skin irritation has been observed in approx. 1% of patients using the drug in the form of a cream.
Other side effects resulting from topical application are: burning sensation of the skin, itching, dry skin.