Experts are warning county residents not to use ivermectin to treat COVID as sales of the anti-parasitic medicine rise in the county.
The drug, which is commonly used as a dewormer in animals such as horses and cows, has been touted as an at-home cure for COVID and is being purchased at higher rates from livestock feed stores.
But little research supports the claim ivermectin is effective in treating COVID, said Mark Winter, managing director at the Southeast Texas Poison Center. And although ivermectin also exists for humans, the type sold at feed stores for large animals is different and the dosing much greater, leading to a risk of poisoning or overdose, he said.
The poison hotline has seen a 116 percent increase in calls relating to ivermectin in 2021 and received more than 50 calls from Aug. 25 to Sept. 3, he said. Many of the recent calls have come from hospitals, with patients ending up there after ingesting too much of the drug, he said.
“They’ve gone to the feed store, and they’ve found ivermectin paste for the treatment of horses up to 1,250 pounds,” he said. “And in that little tube, that’s got the equivalent of 30 doses for somebody that might weigh 200 pounds.”
The increase in poison calls about ivermectin has been seen across the country. In July, there were 133 calls nationwide related to the drug, according to the National Poison Data System, which collects data from the country’s 55 poison control centers. That number rose to 459 in August, an increase of 245 percent.
The increased use prompted the U.S. Food and Drug Administration to issue an additional warning against using the drug.
“You are not a horse. You are not a cow. Seriously, y’all. Stop it,” the organization tweeted Aug. 21.
WHAT IS IVERMECTIN?
Ivermectin is used in animals as a deworming medicine, retired veterinarian Jackie Cole said. And although it’s effective at ridding animals of parasites, that application requires careful dosing, she said.
But the drug can also be used in humans as an anti-parasitic, Winter said. It’s approved in low doses for use in humans to kill the worms that cause river blindness, reducing some of the damage, and to treat roundworm. Some topical forms can also be used to treat head lice and rosacea, according to the FDA.
The ivermectin used in animals and humans is not the same, however.
In addition to the different dosage for humans and animals, the drugs also have different active ingredients, according to the FDA. The type of ivermectin used in animals also contains inactive ingredients that haven’t been studied in people.
“People should never take animal drugs, as the FDA has only evaluated their safety and effectiveness in the particular species for which they are labeled,” Steven Solomon, director of the FDA’s Center for Veterinary Medicine, said in an April 10, 2020, letter to stakeholders.
“Using these products in humans could cause serious harm.”
A GROWING PROBLEM
The poison control center began receiving calls about ivermectin a year ago, but the call numbers have increased recently, Winter said.
He attributed part of the increase to Austin-based podcaster Joe Rogan, host of “The Joe Rogan Experience,” who posted an Instagram video Sept. 1 announcing he had tested positive for COVID and was using ivermectin, among other drugs, as part of his treatment.
The use of ivermectin to treat COVID can be traced back to a study released online April 2020 and published June 2020 in the science journal Antiviral Research. The study reported that ivermectin inhibited the spread of COVID in vitro, meaning in a test tube or culture dish.
“The leap of logic is, well, if it will kill it in a test tube, it might be able to kill it in the body,” Winter said.
But that’s not necessarily the case.
Laboratory experiments are used in the early studies of drug development, but they do not necessarily mean that those results will be translated into the human body. So additional testing is needed before determining whether ivermectin will be effective in treating COVID, according to the FDA website. Those trials are underway.
Consuming too much ivermectin can lead to a range of symptoms from abdominal pain to cramps, nausea and vomiting, which may be early signs of poisoning, Winter said.
More serious effects include symptoms in the nervous system such as confusion, an inability to walk, vertigo or dizziness, slurred speech and, in some cases, seizures, Winter said.
“We’ve had some significant adverse effects,” he said.
Although there have been no reported deaths in Texas, Winter said that remains a possibility if too much of the medicine is consumed.
In addition to the incorrect dosage, the drug also may interact with common medications, Winter said. So far, 54 drugs have been reported to interact with ivermectin, but that list is not complete, he said.
“We tend to forget about routine medications when we add another drug,” he said.
Some of the effects depend on how the drug is consumed, Winter said. Some people inject it, leading to irritation at the injection site. Other people consume it orally, he said.
“If you take it by mouth, you have a three- to six-hour delay before you start to develop some of the symptoms I’ve talked about,” he said. “On average, they can last one to two days.”
The drug can also be applied as a lotion, which leads to poor absorption of the medicine, Winter said.
Despite the warnings from experts, not everyone is listening. Feed stores around the county reported higher sales of ivermectin, with many selling out.
Texas City Feed & Supply normally sells one to two bottles a week, Manager Gary Schaper said.
“We’ve been selling 10, 12 bottles a day, so it’s not real hard to guess what they’re using it for,” he said.
Ivermectin is sold there in several forms, but the most popular by far is the liquid form, Schaper said.
The desire for ivermectin is so great that League City Feed & Pet Supply had sold out as of Friday, said owner Cary Funderburg, who does not recommend people use the drug off-label. It’s unknown when stores will be able to refill the supply since the manufacturer also has a back order, he said.
The increase of COVID cases has led people to seek treatment options online, which often contain misinformation, Winter said.
“Those internet sites, the dose that they’re recommending can be four times higher than the therapeutic dose of ivermectin for parasitic infections,” he said.
Winter also has seen recommendations to use ivermectin to treat post-COVID syndrome, with suggestions to take high doses of the drug for as long as a month. But the long-term effects of such a high dosage are unknown, he said.
Those who test positive for COVID should only use treatment regimens approved by a physician, according to the FDA. Vaccination remains the most effective way to limit spreading the disease, according to the organization.
Those who experience adverse effects after ingesting ivermectin should call the poison control center at 1-800-222-1222, Winter said.
“If patients have questions, call us,” he said.