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An Overview of COVID-19 Treatment
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Saffora Riaz, Farkhanda Manzoor, Dou Deqiang, Najmur Rahman
Ivermectin is an oral prescription used to treat infections accomplished by parasites. Specialists and campaigners promote the ivermectin use as a solution for COVID-19 solution all over the world. Ordinarily, ivermectin is used to treat ecto and endoparasites, i.e., head lice in people. Now the medication has been allowed to treat COVID-19 patients. The use of ivermectin is yet under trial according to the guidelines of the World Health Organization (WHO). Evidence about the role of ivermectin on the reduction of viral have very low certainty. Ivermectin is recommended for two reasons; first of all, our cells are protected due to their antiviral reactions. Second, restrict the entry of infectious agents into cells by limiting the binding of spike protein on the cell membrane receptors [63].
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Ivermectin is an oral medication used to treat a number of parasitic infestations (head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, lymphatic filariasis). Among 343 infants born after exposure to ivermectin, the frequency of birth defects was not increased (Gyapong et al., 2003). In studies of pregnant rabbits at doses sufficiently high to produce maternal toxicity, an increased frequency of congenital anomalies occurred (cleft palate, exencephaly, clubbed forepaws). Other agents are usually used before turning to an agent such as ivermectin of which little is known. Alternatives such as permethrin are better documented for use during pregnancy. It is an FDA category C drug.
Therapeutic Challenges in COVID-19
Published in Debmalya Barh, Kenneth Lundstrom, COVID-19, 2022
Alaa A. A. Aljabali, Murtaza M. Tambuwala, Debmalya Barh, Kenneth Lundstrom
There are only a few examples of drugs approved for the treatment of COVID-19 so far. For example, RDV has been approved by the FDA for the treatment of hospitalized adults and children with COVID-19 [56]. Recently, the European Commission granted conditional marketing authorization in the EU countries for RDV. Moreover, though mortality rates were not reduced by RDV treatment, the European Medicines Agency (EMA) approved RDV for adults and children over 12 years of age with severe COVID-19 who are suffering from pneumonia and need oxygen supplementation [57]. Despite the uncertainty of therapeutic benefits, FPV has been approved by the Indian Drug Regulator for the treatment of mild-to-moderate COVID-19 under restricted emergency use [58]. Moreover, FPV has also been commercialized in Russia, Bangladesh, Pakistan, Jordan, Egypt, and Saudi Arabia for COVID-19 therapy [58]. In contrast, the FDA has not approved ivermectin for the prevention and treatment of COVID-19 patients because of insufficient certainty and poor quality of evidence.
Characteristics of ivermectin toxicity in patients taking veterinary and human formulations for the prevention and treatment of COVID-19
Published in Clinical Toxicology, 2022
Ruby Hoang, Courtney Temple, Matthew S. Correia, Joseph Clemons, Robert G. Hendrickson
Ivermectin is FDA approved for the treatment of intestinal strongyloidiasis and onchocerciasis as a single 150–200 mcg/kg oral dose (12 − 16 mg in an 80 kg patient) [3,4]. Ivermectin is also indicated for the topical treatment of rosacea and pediculosis [4]. Veterinary ivermectin is used for the treatment of internal and external parasites in many species and commonly for gastrointestinal worms in horses [5,6]. Previous studies suggest that ivermectin inhibits cell replication of SARS-CoV-2 in vitro at plasma concentrations 10 times higher than concentrations obtained with recommended dosing [7]. Subsequent human studies do not support its use for COVID-19 outside of ongoing clinical trials [8]. At therapeutic ivermectin doses, adverse effects include headache, myalgia, arthralgia, diarrhea, vomiting, and weakness [3,9]. In overdose, seizures, hypotension, and obtundation have occurred [2,9]. Ivermectin is available in tablets by prescription or online and in paste or liquid veterinary formulations that are readily available for purchase through animal feed stores or online (Figure 1).
Ivermectin role in COVID-19 treatment (IRICT): single-center, adaptive, randomized, double-blind, placebo-controlled, clinical trial
Published in Expert Review of Anti-infective Therapy, 2022
Ahmed Hanei Elshafie, Hozaifa Khalil Elsawah, Mohamed Hammad, Eman Mohamed Sweed, Ahmed Salah Seif, Muhammad Mostafa Abdel Ghaffar, Feisal Mahmoud Goda, Esraa M Mosalam, Mahmoud S. Abdallah
Although there were many adverse drug reactions (ADRs) reported with ivermectin and HCQ, all reported adverse drug reactions were less than placebo. Moreover, no serious adverse events were reported with ivermectin or HCQ compared with the placebo group. The most reported adverse events for ivermectin were confusion, headache, sepsis, and respiratory deterioration. On the other hand, cardiological complications, elevated kidney enzymes, and delirium were more frequent with HCQ group. Mucor mycosis and sepsis were most reported ADRs in placebo group. The high rates of adverse events among the 3 arms may be attributed to concomitant use of corticosteroids or the natural progressive course of the condition. The manufacturer of ivermectin reported confusion and headache as very rare adverse event that happens in special situations such as treatment of onchocerciasis [41], while the manufacturer of HCQ reported that cardiac and visual adverse events are frequently reported and require discontinuation of the medication [42]. Moreover, the use of steroids is associate with increased risk of sepsis, mucormycosis and gastrointestinal serious symptoms [26].
Drugs repurposing for SARS-CoV-2: new insight of COVID-19 druggability
Published in Expert Review of Anti-infective Therapy, 2022
Sujit Kumar Debnath, Monalisha Debnath, Rohit Srivastava, Abdelwahab Omri
Ivermectin is a cheap and well-known drug approved as antiparasitic by the WHO and FDA. It showed in-vitro inhibitory activity against SARS-CoV-2. This drug is mainly used to treat mild to moderate COVID-19 infection patients. This drug is not approved by the FDA for the treatment of any viral infection. The evidence of ivermectin protection from COVID-19 infection is limited. Very little evidence suggested that reduction of COVID-19 death is possible using ivermectin. Early treatment of ivermectin in the clinical course may reduce the chances of severe disease progression. It was assumed that low cost and apparent safety suggest this drug may significantly impact the SARS-CoV-2 [92]. A clinical trial was conducted with a single dose of ivermectin (400 mcg/kg) on cough or fever patients [93]. No difference was observed in the proportion of PCR positives. Another randomized clinical trial was conducted on 476 patients to check the efficacy of ivermectin on the duration of symptoms [94]. The time of symptoms was not significantly different between the perceived 5-day course of ivermectin with placebo. Therefore, ivermectin cannot be recommended as a repurposed drug in COVID-19.