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dcyphr | Ivermectin as a potential COVID-19 treatment from the pharmacokinetic point of view

Ivermectin as a potential COVID-19 treatment from the pharmacokinetic point of view

Endorsers
Leanna Zelle
  I am a pre medical student at Missouri State University studying Cellular and Molecular Biology, and minoring in Chemist...
Jeffrey Ma
  B.S. in Computer Science and Mathematics from Yale University in 2022. Founder of dcyphr. ...

APA citation: Momekov, G. and Momekova, D. (2020). Ivermectin as a potential COVID-19 treatment from the pharmacokinetic point of view. medRxiv. doi: 10.1101/2020.04.11.20061804

DOI: 10.1101/2020.04.11.20061804

dcyphr-d by Daniel Amuedo on 2020-06-18

2
Contributors
Leanna Zelle

I am a pre medical student at Missouri S...

Daniel Amuedo

I am a premedical student at Missouri St...

Abstract

In cell samples grown in a laboratory setting, the antiparasitic medication ivermectin has shown to be effective against SARS-CoV-2. This has peaked interest because it could possibly treat COVID-19. This study looks at the feasibility of ivermectin as a treatment for COVID-19. The dose needed to be effective against COVID-19 is likely too high for humans to use safely.


Introduction

As the COVID-19 pandemic continues, several possible drugs are being explored as a treatment option. Due to public uncertainty and political pressure, some drugs have been highly mentioned in the media even though they have not been properly tested for human use or its effectiveness against COVID-19. The media has also failed to mention possible side effects or explore the feasibility for obtaining the medication in a large scale. Many medication suggestions are based on preliminary research. These medication publications often have not shown any sign of being safe and effective for treating humans with COVID-19. In the case of ivermectin, a study was done where a SARS-CoV-2 infected cell sample was constantly exposed to the drug at different concentrations. At a high concentration of 5 micromoles/liter, the virus was totally eradicated over time. Though this is a clear result, ivermectin has gotten an enormous amount of media coverage without any research about the feasibility of this in humans.


Materials and Methods

Published dose recommendations and the side effects that arose after high dosing were examined. These values were compared to the necessary concentration to be effective against the virus in preliminary studies of ivermectin and COVID-19.


Results

When ivermectin is used to treat parasitic diseases, the doses range from 150 micrograms/kilogram (ug/kg) to 400 ug/kg per year. The drug works by paralyzing and killing the parasites through a special binding site that only invertebrates have, so mammals will not have many side effects if the correct dose is given. It has been found that humans do not have adverse side effects up to an 800 ug/kg dose over a year. The largest dose predicted to be healthy for a human is 2000ug/kg. The 5 micromol/Liter dose seen in the preliminary ivermectin study discussed earlier is converted into the dose a human would need to take to be effective against COVID-19, the human would need to take over 50 times more than 700ug/kg. Moreover, a single dose of ivermectin is prescribed per year to patients with parasitic diseases. In the preliminary study exploring ivermectin, the human would have to be constantly exposed to ivermectin for it to be effective against COVID-19. Even with excessive dosing of the drug, humans cannot metabolize the concentration needed to see an effect of the drug on COVID-19.


Discussion

Hydroxychloroquine is a common antimalarial drug that has a more appropriate dosing to treat COVID-19 in humans. Remdesivir is an antiviral drug that also has a realistic treatment dosage for humans and has shown to be effective against SARS-CoV-2. Ivermectin would need an unrealistic dose to treat humans. A dose so high has never been attempted in humans, and it is thought that the drug could get through the blood brian barrier, causing lethal neurological side effects. The use of a drug after minimal preliminary research is not scientifically or ethically appropriate. Due to some tragic events that have already occurred after the misuse of proposed COVID-19 treatments, it should be strongly encouraged to avoid self medication of ivermectin or any other drug which has not been FDA approved for COVID-19 related illnesses.