[gmnash]

It's banned on YouTube because of multiple authoritative sources indicating it's not a safe and effective treatment for COVID-19.

Here is the FDA's stance: https://www.fda.gov/consumers/consumer-updates/why-you-shoul...

Here is the European equivalent of the AMA advising against it's use: https://www.ema.europa.eu/en/news/ema-advises-against-use-iv...

Here is an RCT in JAMA finding it ineffective: https://jamanetwork.com/journals/jama/fullarticle/2777389

And here is Merck, that sells Ivermectin, but whose vaccine didn’t make it through clinical trials, discouraging the use of Ivermectin for COVID-19: https://www.merck.com/news/merck-statement-on-ivermectin-use...

If Ivermectin worked on COVID-19, the manufacturer of Ivermectin that has made no money on vaccines for COVID-19 would probably be pushing it wouldn't they?

There have been some studies that found it effective in vitro, but as noted in other comments, at several times the safe dosage in vivo.

[analyte123]

Actually the EMA link says that current evidence for ivermectin is insufficient and it cannot currently be recommended outside of trials. This not the same as claiming that it does not work or that it is hazardous, although many journalists can seemingly not tell the difference. The FDA’s advisory is mostly about people overdosing on veterinary ivermectin. They emphasize that overdose and medication interactions are possible, veterinary ivermectin is not a good substitute for human ivermectin, and that ivermectin is not an approved treatment for COVID-19. Again, even within the paradigm of blindly listening to authoritative sources, this is not an assertion that normal doses of ivermectin for off-label use are dangerous and should be prohibited for prescription, let alone an order for tech companies to censor the mere mention of it.

When the FDA’s advisory came out, there were articles (eg [1]) referring to ivermectin-the-molecule as a “horse de-wormer” and drawing no distinction between animal and human use (and it has been proven safe and effective in humans, just not for COVID). The level of discourse around this feels like I am reading 90s drug war content.

[1] https://www.businessinsider.com/people-poisoning-themselves-...

[joe_the_user]

It seems it is you who is misrepresenting the ema link.

Key quote: "Although ivermectin is generally well tolerated at doses authorised for other indications, side effects could increase with the much higher doses that would be needed to obtain concentrations of ivermectin in the lungs that are effective against the virus. Toxicity when ivermectin is used at higher than approved doses therefore cannot be excluded."

IE, the dose needed for covid could quite possibly be harmful.

[analyte123]

Agreed on missing this facet of their advisory. However, the concentration of ivermectin in the early in vitro study was 35x higher than the plasma concentration reached for the approved ivermectin dose [1] whereas the doses used in ivermectin trials (https://ivmmeta.com) range from 1x to 10x the approved dose daily, with successful results as low as 4x approved dose (1x approved dose daily for 4 days)[2]. So whatever ivermectin is doing, it doesn’t seem to require the concentration that the initial in vitro study required.

[1] https://pubmed.ncbi.nlm.nih.gov/32378737/

[2] The approved dose is actually 200 mcg/kg. I used 12mg to correspond to a normal adult “approved dose” for these numbers.

[joe_the_user]

You've gone from "no, the EMA didn't really to object" to "here's why their objection is wrong". See how that works?

The thing about Covid is that it isn't "super deadly". It has about a 1% fatality rate. That's terrible for society as a whole when the disease is also extremely infectious. But it means that "I took X and recovered from Covid" isn't the most amazing thing.

"So whatever ivermectin is doing, it doesn’t seem to require the concentration that the initial in vitro study required." Maybe the trial dose does nothing at all and people are recovering like they normally do.

[analyte123]

This part of their objection was based on an assumption that doesn’t seem to be as bad as they thought. The trials are controlled to varying degrees of quality.

[bhk]

That excerpt could be interpreted in two ways:

1) Beware of overdosing, because extrapolating from in-vitro studies will yield dosages that are unsafe.

2) We know the dosage required for Ivermectin for be effective, and it is too high.

The first is fact-based and uncontroversial. The second would be completely unfounded and would contradict earlier parts of the statement, so the reasonable assumption is the first interpretation.

Appeals to authority are problematic to begin with. Appeals to authority that misconstrue the authorities (FDA, EMA, and Merck in this case) are counter-productive.

[6nf]

The dosage recommended for Covid is just the standard dose of 0.2mg/kg and is NOT a 'much higher dose' which was only used in one trial.

[jacquesm]

Yes, this is the key item. In vitro there has been some success but at dosage far higher (double digits) than what the safe dose is, and no in vivo trial has been done at those dosages (and likely never will due to the risks involved).

[6nf]

This is not correct, the dosage recommended now is 0.2mg/kg which is just the standard treatment dose when used for parasites.

[reedjosh]

There's a large body of evidence in the opposite direction as well.

I just pulled the following from Bret Weinstein's show notes. https://www.youtube.com/watch?v=kSWjl-JOIqs

British Ivermectin Recommendation Development group: https://bird-group.org

The BIRD Recommendation on the Use of Ivermectin for Covid-19: Executive Summary: https://bird-group.org/wp-content/uploads/2021/03/bird-execu...

Carvallo et al 2020. Study of the efficacy and safety of topical ivermectin+ iota-carrageenan in the prophylaxis against COVID-19 in health personnel. J. Biomed. Res. Clin. Investig., 2. https://medicalpressopenaccess.com/upload/1605709669_1007.pd...

Cobos-Campos et al 2021.Potential use of ivermectin for the treatment and prophylaxis of SARS-CoV-2 infection: Efficacy of ivermectin for SARS-CoV-2. Clin Res Trials, 7: 1-5. https://www.readkong.com/page/potential-use-of-ivermectin-fo...

Database of all ivermectin COVID-19 studies. 93 studies, 55 peer reviewed, 56 with results comparing treatment and control groups: https://c19ivermectin.com

Karale et al 2021. A Meta-analysis of Mortality, Need for ICU admission, Use of Mechanical Ventilation and Adverse Effects with Ivermectin Use in COVID-19 Patients. https://www.medrxiv.org/content/medrxiv/early/2021/05/04/202...

Kory et al 2021. Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. American Journal of Therapeutics, 28(3): e299: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/

Nardelli et al 2021. Crying wolf in time of Corona: the strange case of ivermectin and hydroxychloroquine. Is the fear of failure withholding potential life-saving treatment from clinical use?. Signa Vitae, 1: 2. https://oss.signavitae.com/mre-signavitae/article/20210508-3...

Yagisawa et al 2021. Global trends in clinical studies of ivermectin in COVID-19. The Japanese Journal of Antibiotics, 74: 1. https://www.psychoactif.org/forum/uploads/documents/161/74-1...

[glenra]

Nearly all of your links are broken. I think you copy-pasted the text of links that had been truncated with a "...", where the part prior to "..." is not sufficient to constitute a valid web address. For instance, the link for Carvallo et al 2010 should be this, which resolves: https://medicalpressopenaccess.com/upload/1605709669_1007.pd...

..rather than this, which doesn't:

https://medicalpressopenaccess.com/up

[reedjosh]

Thank you! I've fixed them.

[wrycoder]

In addition, there is this summary:

https://covid19criticalcare.com/ivermectin-in-covid-19/

and

https://journals.lww.com/americantherapeutics/fulltext/2021/...

Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.

Edit: There's a mountain of data here:

https://ivmmeta.com/

Edit: Clip from that last link:

•While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 27% of ivermectin studies show zero events in the treatment arm. •Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. All practical, effective, and safe means should be used. Not doing so increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage.

[andreilys]

If Ivermectin worked on COVID-19, the manufacturer of Ivermectin that has made no money on vaccines for COVID-19 would probably be pushing it wouldn't they?

Surprise, Merck is now working on anti-viral drug whose profits would be eaten into by an off-patent drug (ivermectin)

https://www.bloomberg.com/news/features/2021-03-25/merck-mrk...

[throwkeep]

> If Ivermectin worked on COVID-19, the manufacturer of Ivermectin that has made no money on vaccines for COVID-19 would probably be pushing it wouldn't they?

No, because it's out of patent. There's little profit to be made. Merck is instead pushing a new drug that they will have a monopoly on.

"Merck Announces Supply Agreement with U.S. Government for Molnupiravir, an Investigational Oral Antiviral Candidate for Treatment of Mild to Moderate COVID-19"

https://www.merck.com/news/merck-announces-supply-agreement-...

Big pharma 101.

As for Ivermectin effectiveness, it looks promising. There was an evidence based clinical review posted on Nature earlier this week:

"As per data available on 16 May 2021, 100% of 36 early treatment and prophylaxis studies report positive effects (96% of all 55 studies). Of these, 26 studies show statistically significant improvements in isolation. Random effects meta-analysis with pooled effects using the most serious outcome reported 79% and 85% improvement for early treatment and prophylaxis respectively (RR 0.21 [0.11–0.37] and 0.15 [0.09–0.25]). The results were similar after exclusion based sensitivity analysis: 81% and 87% (RR 0.19 [0.14–0.26] and 0.13 [0.07–0.25]), and after restriction to 29 peer-reviewed studies: 82% and 88% (RR 0.18 [0.11–0.31] and 0.12 [0.05–0.30]). Statistically significant improvements were seen for mortality, ventilation, hospitalization, cases, and viral clearance. 100% of the 17 Randomized Controlled Trials (RCTs) for early treatment and prophylaxis report positive effects, with an estimated improvement of 73% and 83% respectively (RR 0.27 [0.18–0.41] and 0.17 [0.05–0.61]), and 93% of all 28 RCTs."

https://www.nature.com/articles/s41429-021-00430-5

[_Wintermute]

Dexamethasone is off patent, it's cheap and widely available, it's also the standard of care for covid-19 patients on respiratory support.

What's the difference between dexamethasone and hydroxycholoroquine/ivermectin/next-consipracy-theory?

It's been proven to work. There's no conspiracy, just pharmacology is hard, and people's random hunches typically don't work out.

[darwingr]

I'll answer, assuming you asked with some good faith. Not every statement of doubt or disfunction is an allegation of conspiracy.

Dexamethasone effectively treats the late, inflammatory stage of COVID19 where most virus is dead but still physically present.

The promise of other licensed medications is partially from their antiviral properties which means they're only expected to be effective as early stage medications.

So that's the difference. Different application. In the same way you wouldn't use Dexamethasone as an interchangeable treatment with monoclonal antibodies or remdesivir, which are also early stage treatments.

[XorNot]

You've managed to miss the point entirely.

The point is that Ivermectin worked, Merck would be pushing it hard because it's a heck of a lot cheaper to make an existing drug you already make then get through R&D and clinical trials for a brand new drug which doesn't yet exist.

[spadez]

Isn't the patent for Ivermectin expired already? So can't anyone produce the pills?

If that is the case, its pretty obvious why they are not supporting it..

[reedjosh]

You have to give credit where it's due. People were suspicious of big pharma cos prior to the miracle vaccine, but today they line up to defend them.

[rubatuga]

> Here is an RCT in JAMA finding it ineffective:

For treating what? This study looked at trying to reduce mild COVID-19 symptoms. In fact, the current strongest evidence is for prophylaxis, as well as treating more severe cases. Also the study didn’t show that it was ineffective, it showed that it couldn’t disprove the null hypothesis. Please get your facts straight, before throwing a link to a overly specific RCT to prove your point.

[doesnotexist]

State the null hypothesis

[rubatuga]

That ivermectin has no effect on COVID-19 symptoms or outcome

[AndrewBissell]

> And here is Merck, that sells Ivermectin, but whose vaccine didn’t make it through clinical trials, discouraging the use of Ivermectin for COVID-19: https://www.merck.com/news/merck-statement-on-ivermectin-use...

If Ivermectin worked on COVID-19, the manufacturer of Ivermectin that has made no money on vaccines for COVID-19 would probably be pushing it wouldn't they?

You are misinformed. Merck has a particular formulation of Ivermectin that they sell but the vast majority of it is made off patent by other manufacturers for very little profit. If they had an exclusive patent on a drug that they could make any flimsy case for effectiveness against Covid I'm sure they would be pushing it, the way Gilead has with remdesivir.

[cblconfederate]

How can it be not safe since it s a very widely used antiparasitic

[lvs]

WHO statement: https://www.who.int/news-room/feature-stories/detail/who-adv...

[effie]

WHO has very low credibility at this point.

[lvs]

I don't know what you're referring to, but I'm going to infer that either your information sources are poor and/or you are incredibly susceptible to the power of suggestion.

[effie]

Ask and it shall be given to you.

https://www.bbc.com/news/world-asia-52088167

https://www.washingtonexaminer.com/news/who-investigator-adm...

[lvs]

I have no idea how this is relevant to guidance on an anthelminthic drug, but it seems you believe you have axes to grind, so I'll let you grind them alone.

[effie]

It's examples of how WHO is unreliable on multiple fronts.

Regarding ivermectin, this is documented here. https://ivmmeta.com/#who