Appalachian Poison Centers Caution Against Treating COVID-19 with Animal Dewormer

Illustration: 100 Days in Appalachia
Illustration: 100 Days in Appalachia

“You are not a horse. You are not a cow. Seriously, y’all. Stop it.”

That is how the U.S. Food and Drug Administration responded last week on Twitter to a recent surge in demand for the livestock deworming drug ivermectin, as word falsely spread across the cyberworld that it was a safe and effective means of preventing and treating COVID-19.

No research conducted to date has substantiated this claim.

According to the Centers for Disease Control and Prevention, ivermectin was prescribed more than 88,000 times in the week ending August 13; just prior to the outbreak of the coronavirus in 2020, the average was 3,600 a week. Pharmacies across the country have reported shortages of the drug.

In Appalachia, 10 human ivermectin exposures were reported to the Kentucky Poison Control Center for all of last year, all but one of which were accidental exposures while administering the drug to livestock. Thus far in 2021, the Kentucky center has had 15 ivermectin human exposures reported; 13 were intentional misuse, 11 of which were intentional ingestion to treat COVID-19.

Ashley Webb, the center’s director, said that while this might not seem like a lot of cases, “we’re looking at the trends, and the trend is that we’re seeing significantly more calls about intentional ivermectin misuse than previously.”

The majority of the COVID-19-related cases of exposure occurred this month.

The West Virginia Poison Center is likewise receiving more calls related to ivermectin. Elizabeth Scharman, the center’s director, said there’s been a “tremendous” increase in the past month, and that there have been a few cases of poisoning.

Reported symptoms include nausea, vomiting, diarrhea and abdominal pain. 

“In more serious cases,” Webb said, “you’ve got patients that show up confused, possibly hallucinating, and there’s the risk of seizures, coma and, ultimately, respiratory and cardiovascular collapse.”

‘Off-label and Dangerous’

Ivermectin is used in animals to prevent heartworm disease and parasites. There’s a tablet form approved by the FDA for human consumption to treat conditions caused by parasitic worms. Topical forms are approved to treat head lice and for certain skin conditions. 

“There’s a prescription form for humans as a very small dose and in a very limited way,” Scharman said. There have been reported cases of people taking doses many times higher than is approved for humans. This is “dangerous and not effective,” she said, “so it doesn’t make a lot of sense.”

Webb said that about 25 percent of the calls that have been made to the Kentucky Poison Control Center have been related to people who received a prescription for the human version of the drug. The other 75 percent are from people who bought it at “feed stores and other farm-supply stores. And so it’s the animal product that they’re using.”

That product comes in highly concentrated paste or liquid form. It would be “almost impossible,” Webb said, to measure out an appropriate human dose from that concentration.

The National Institutes of Health is now conducting a trial to determine if the drug is effective in reducing the duration and severity of symptoms associated with mild-to-moderate COVID-19, but there is no current medical science to support it.

Scharman advises those with questions about ivermectin: “The main thing is to get vaccinated so you can prevent getting ill, then you don’t need to be experimenting on yourself with dangerous substances.”

“If you do get COVID,” she said, “and you’re in a high-risk group, we have some effective therapies that we can give on an outpatient basis to decrease your risk of hospitalization. If you do get COVID-19 and you’re concerned that you’re high risk, you should contact your health care provider because they can prescribe and get that set up for you.”

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