OVER THE LAST year there has been a huge surge in seizures of a medication, typically used as a de-wormer in animals, but touted as a cure or preventative treatment against Covid-19. 

Some 4,958 units of the medication were seized between July 2020 and July 2021, the Health Products Regulatory Authority (HPRA) confirmed to The Journal last week. 

It represents an increase of over 3,000 per cent on the previous 12 months when just 158 units were seized.

Health authorities across the world have warned of potentially serious side effects associated with improper use of the medication, but misinformation groups continue to promote. 

Buying online

Although the most typical use for ivemectin is in de-worming products for animals such as horses, there are approved versions of the medication for use in humans. 

It can be prescribed for conditions in humans caused by parasitic worms as well as some skin conditions such as rosacea. Ivermectin products have not been approved for use as a Covid-19 treatment, or as a preventative measure. 

A number of websites, many based in India, are selling the drug in pill form without the need for a prescription. There are also several social media chat forums instructing people on how to buy the drug without a prescription or linking them up with specific individuals who will sell it to them. 

The use of this medication as a Covid treatment, or as a preventative drug to be taken daily, has been promoted by individuals and organisations that regularly share misinformation about the coronavirus, Covid vaccines and the pandemic in general. These types of posts are widely shared in Ireland. 

These groups and individuals often cite studies that ‘prove’ its efficacy, but these studies have largely been deemed unreliable and in some cases at risk of bias. 

The HPRA said ivermectin as a prescription-only medicine for human use must be subject of a ‘marketing authorisation’ granted the HPRA. All veterinary medicinal products supplied in Ireland, including ivermectin, must also be licensed either by the HPRA or by the European Medicines Agency.

The HPRA said the ivermectin units detained in the last year at port of entry have not been subject to these licensing or marketing authorisations and, therefore, are not authorised for sale in Ireland.

“Ivermectin is not currently authorised as a treatment for Covid-19 in Ireland and the HPRA continually recommends that patients do not seek to purchase prescription medicines that have not been prescribed by a medical doctor and dispensed by a registered pharmacy as there can be no guarantee as to their safety, quality or efficacy, in addition to the health risks for persons seeking to self-medicate,” the HPRA said.

There are a number of ivermectin veterinary medicinal products available to purchase from legitimate retailers in Ireland. These products can be purchased without the need for a prescription from a vet. 

Although these retailers must be licensed and the products contain warnings stating the are for animal use only, there is no requirement for a retailer to request information from a customer about the reason they are purchasing the product. 

The regulations around these types of veterinary medicinal products will change at the end of January next year when the government will remove an exemption to a European directive. From 28 January 2022, a prescription from a vet will be required to purchase any antiparasitics. 

The evidence

A number of health experts have publicly promoted the use of ivermectin as a Covid-19 treatment. One of the most prominent groups is the US-based Front Line Covid-19 Critical Care Alliance (FLCCC).

Co-founder Dr Pierre Kory, who is an intensive care specialist, spoke to Newstalk’s Pat Kenny recently, telling him the drug has been “proven” to be effective against Covid-19.

He cited a number of studies and trials, but several have been dismissed due to factors such as insufficient evidence, risk of bias or a weak methodology. His claims have been factchecked by The Journal.

While many of the studies cited by those promoting the use of the drug as a Covid treatment have been deemed unreliable, there are two major ongoing trials which should help to provide further clarity. 

In June this year, the University of Oxford said it was beginning an investigation into the use of ivermectin as a possible treatment for Covid. The study had so far recruited more than 5,000 volunteers from across the UK.

Following news of the ivermectin seizures in Ireland, the HSE has warned against the use of drug, stating that it is not an approved treatment for Covid-19 in Ireland or anywhere.

It said that while small studies have been done, “none suggested that this agent will have any benefit”.

Side effects

Experts have warned of potentially serious side effects of using this medication, particularly if the product was intended for use in animals as the dose can be significantly higher than is safe for humans. 

Serious side effects of overdose include inflammation of the brain, coma, as well as liver toxicity.

There have been a small number of individual reports of patients hospitalised after overdosing on ivermectin, including a patient in Sydney, Australia earlier this month who had taken several drugs they ordered online.

The patient, who was Covid-positive, suffered vomiting and diarrhoea after overdosing on the medications. 

Poison control centres in the US have also seen a surge in calls from people who are self-medicating with ivermectin, according to reports. There was a 245% increase in reported exposure cases from July to August from 133 to 459. 

Ireland’s National Poisons Information Centre (NPIC), which is based at Beaumont Hospital in Dublin, told The Journal that it has been made aware of one instance of poisoning involving ivemectin this year.

The NPIC said it received two enquiries about the use of ivermectin for Covid-19 treatment this year and both enquiries related to this patient.