This is a genuine question, but why are you using ivermectin, then? The concentration at which it displayed anti-viral effects is achieved by 100x the anti-parasitic dose, and the anti-parasitic dose is where the safety data is coming from. Further, the anti-SARS-CoV-2 (in vitro) research was on Vero E6 cells at 5 μM, and when human primary air way epithelium was used, ivermectin failed to inhibit SARS-CoV-2 infection, even at 10 μM.
So, you’re either taking a dose that would never reach the concentration necessary to inhibit viral infection, or you’re using a dose that far exceeds the safety data, and it’s still very likely not doing anything at that concentration. This is also evidenced by the myriad of trials on ivermectin, where all the positive results come from small studies with shoddy design, and one of the large, randomized control trials that was a preprint, never peer-reviewed/nor published, was just retracted because they cooked the data. That’s this one, btw:
https://www.researchsquare.com/article/rs-100956/v4
sadly, that pre-print was cited in over 30 studies on ivermectin, and represented the strongest evidence in favor of ivermectin - it was the largest trial to date. Here’s a good breakdown of all the evidence supporting the notion the data was cooked/methods were faultyhttps://steamtraen.blogspot.com/2021/07/Some-problems-with-the-data-from-a-Covid-study.html?m=1
One can even (others have done it, I haven’t) rerun all the statistics of meta-analyses with and without that study and other poorly designed trials, and any incidence of benefit/positive association with ivermectin treatment is lost.
Here’s a meta-analysis on ivermectin RCTs:
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab591/6310839
“In comparison to SOC or placebo, IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease. IVM did not have an effect on AEs or severe AEs. IVM is not a viable option to treat COVID-19 patients.”
Further evidence here:
https://ebm.bmj.com/content/early/2021/05/26/bmjebm-2021-111678
“An important controversial point to consider in any rationale is the 5 µM required concentration to reach the anti-SARS-CoV-2 action of ivermectin observed in vitro,
17 which is much higher than 0.28 µM, the maximum reported plasma concentration achieved in vivo with a dose of approximately 1700 µg/kg (about nine times the FDA-approved dosification).
24 25 In this sense, basic fundamentals for assessing ivermectin in COVID-19 at a clinical level appear to be insufficient.”
“Nevertheless, assessments of ivermectin as prophylaxis or treatment for mild to severe COVID-19 continue being published in preprints
26 27 and protocol repositories,
28 29 which do not follow the recommended process to ensure quality standards in publications; whereas peer-reviewed reports (both observational and experimental studies) are slowly emerging, yet methodologically limited by heterogeneity in population receiving ivermectin, dosis applied and uncontrolled cointerventions.”
“Concluding, research related to ivermectin in COVID-19 has serious methodological limitations resulting in very low certainty of the evidence, and continues to grow.
37–39 The use of ivermectin, among others repurposed drugs for prophylaxis or treatment for COVID-19, should be done based on trustable evidence, without conflicts of interest, with proven safety and efficacy in patient-consented, ethically approved, randomised clinical trials.”
Again I’m genuinely just curious, but based on that, it seems unreasonable to take ivermectin outside of a clinical trial, since it has questionable efficacy, and at the doses it might work, safety is more of a concern.
my personal stance is that I can and will be convinced by good data, so I’m not arguing it couldn’t be effective; that data simply isn’t out there right now and needs to be borne out from appropriately designed clinical trials. For example, this one:
https://www.ox.ac.uk/news/2021-06-23-ivermectin-be-investigated-possible-treatment-covid-19-oxford-s-principle-trial
edit: not medical advice