thank you for the links etc provided brother, I will review properly later when I’ve got chance (and it may well change my view).
I was basing most of my thinking around the Indian study on prevention in front line health care workers (I’m not sure if that’s referenced above).
im dosing it at 18mg once per week.
some other points I considered were
- very few side effects or negative impact - so at worst it will just do nothing
- the FDA couldn’t have approved the vaccines in the way they did using the legislation they did (just what I understand anyway) if there was a viable treatment available. This creates the prospect of a compelling reason for big pharma to not want ivermectin seen as viable and therefore a reason to discredit any research (we can see other examples of big pharma affecting FDA decisions to favour them, such as mon k in red rice yeast?)
I could absolutely be wrong and I’ll happily admit that. Just explaining my reasoning.
I believe you are referencing Behera et al., then, which is a case control study with small sample size so it’s subject to confounding factors. Additionally, they found no effect from one dose and saw the 73% reduction only at 2 doses 72 hours apart, 300μg/kg. I could be wrong but if I remember correctly the 95% confidence interval was still pretty wide, and it’s not an RCT. The problem with many ivermectin trials, even the ones that show negative results, is that they are underpowered. Still, those that show positive results (and negative results) are consistently poorly designed, changing primary endpoints, questionable blinding/randomization, many reporting ORs <0.1 for clinical endpoints, no adherence to CONSORT guidelines, no prospective registration, etc.
I’m not saying ivermectin might not come out to be a useful drug based on the results of a well-powered study, I don’t really think it’s likely, but there is absolutely not enough evidence, and quality evidence is extremely lacking, to suggest it as a reasonable treatment. I believe the current recommendation by scientific bodies is that is should only be used in clinical trials to establish safety and efficacy for covid-19.
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This is the largest or one of the largest RCT to date and shows no significant effect of ivermectin on treating mild covid patients. It is still technically underpowered based on the 95% CI, but if ivermectin were a miracle drug like lots of people think it is (not accusing you of that) a trial this size would be more likely to show it.
pharmacokinetics are also unlikely to work out since we have no idea how it is being distributed/sequestered in different tissues, or even being able to reach an effective concentrationAn 18mg tablet puts the blood concentration at 5 orders of magnitude off from the IC50 where it displayed anti-viral activity in monkey kidney cells.
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“The broad-spectrum antiparasitic agent ivermectin has been very recently found to inhibit SARS-CoV-2 in vitro and proposed as a candidate for drug repurposing in COVID-19. In the present report the in vitro antiviral activity end-points are analyzed from the pharmacokinetic perspective. The available pharmacokinetic data from clinically relevant and excessive dosing studies indicate that the SARS-CoV-2 inhibitory concentrations are not likely to be attainable in humans.”
“The analyzed data show that at least at the clinically relevant dose ranges of ivermectin the published in vitroinhibitory concentrations and especially the 5 μmol/L level causing almost total disappearance of viral RNA are virtually not achievable with the heretofore known dosing regimens in humans. The 5 μmol/L concentration is over 50 times higher than the levels obtainable after 700 μg/kg
Invalid Link Removed and 17 times higher vs. the largest Cmax found in the literature survey (247.8 ng/ml)
Invalid Link Removed. Moreover the authors’ claim for achieving viral inhibition with a single dose is inappropriate because practically the infected cells have been continuously exposed at concentrations that are virtually unattainable even with excessive dosing of the drug. With other words the experimental design is based on clinically irrelevant drug levels with inhibitory concentrations whose targeting in a clinical trial seems doubtful at best.”
I would encourage you to read the full text, too.
Overall, I’m not saying that it’s impossible that ivermectin could be shown to be a useful tool if the data from appropriate trials says otherwise, just that it’s unreasonable to treat it like that is the case right now. At the anti-parasitic dose, I am very convinced that ivermectin would do nothing. I think that if it has any effect as an anti-viral, it’s at much higher and more frequent doses, which no doctor, health professional, or laymen should advocating anyone else do (not accusing you of this, though I have seen it on this forum several times).
Again, I’m not a doctor and this is not medical advice, just my opinion based on what I’ve read and discussed.
Also, I’m not hating on ivermectin, there’s a reason it’s been given to 300 million people, 4 billion doses, the person who synthesized it won the Nobel prize in 2015, etc., it is a miracle drug for its anti-parasitic purposes.