Andreea Molnar*, Stephanie Lau, Maja Berges, Raymond B Masa, Joshua J. Solano, Scott M Alter, Lisa M Clayton, Richard D Shih, David L DeMets, Dennis G Maki and Charles H Hennekens
Ivermectin is not approved by the United States (US) Food and Drug Administration (FDA) for the treatment or prevention of COVID-19. Nonetheless, ivermectin prescriptions increased 11-fold from 3589 per week pre-COVID-19 to 39,102 by early 2021. In recent polls, 85% of the public trust their family medicine physicians as a source of reliable information on COVID-19 vaccinations. Ivermectin is FDA approved to treat intestinal strongyloidiasis and onchocerciasis orally, as well as ectoparasites and skin conditions topically. Possible side effects include skin rash, nausea, vomiting, diarrhea, stomach pain, facial or limb swelling, dizziness, seizures, confusion, hypotension, and liver injury. The United States (US) National Institutes of Health, World Health Organization, US FDA and European Medicines Agency have all advised against ivermectin for treatment or prevention of COVID-19 outside randomized trials. To do more good than harm in COVID-19 requires concerted efforts by competent and compassionate family medicine physicians who are deservedly the most trusted by the US public. In the US today, widespread vaccinations, masking, social distancing, crowd avoidance and frequent hand and face washing are remarkably effective and safe options. For ivermectin in COVID-19, family medicine physicians should reassure all patients that if a sufficient totality of evidence emerges, then this drug can be considered a therapeutic innovation and regulatory authorities will approve the drug. Thus, we strongly recommend that family physicians exert all reasonable efforts to increase vaccinations and have a moratorium on the prescription of ivermectin for COVID-19.