Ivermectin: A Closer Look at a Potential Remedy

Abstract

Amid the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the search for effective treatment and vaccines has been exponentially on the rise. Finding effective treatment has been the core of attention of many scientific reports and antivirals are in the center of those treatments. Numerous antivirals are being studied for the management of the coronavirus disease 2019 (COVID-19) pneumonia caused by the SARS-CoV-2. Remdesivir was the first drug to gain emergency FDA approval to be used in COVID-19. Similarly, favipiravir, an anti-influenza drug, is being studied as a potential agent against COVID-19. Contrastingly, hydroxychloroquine has been a controversial drug in the management of COVID-19. Nevertheless, the National Institute of Health (NIH), along with the World Health Organization (WHO), have discontinued clinical trials for hydroxychloroquine as the drug showed little or no survival benefit. Ivermectin, an antihelminthic drug, has shown antiviral properties previously. Additionally, it was described to be effective in vivo against the SARS-CoV-2. However, its survival benefit in patients with COVID-19 has not been documented. We herein propose the theory of inhaled ivermectin which can attain the desired lung concentration that will render it effective against SARS-CoV-2.

Pulmonary drug delivery: an effective and convenient delivery route to combat COVID-19

“…Ivermectin is an anthelmintic agent with known efficacy against some single strain RNA viruses, e.g., HIV-1 and dengue virus. Ivermectin can significantly reduce SARS-CoV-2 in-vitro replication by inhibiting the shuttle protein responsible for nucleocytoplasmic transport of the virus [ 60 – 62 ]. Oral ivermectin has been shown to cause lower mortality in COVID-19 patients [ 60 ], but effective plasma concentrations are not achievable with safe oral doses.…”

“…Ivermectin can significantly reduce SARS-CoV-2 in-vitro replication by inhibiting the shuttle protein responsible for nucleocytoplasmic transport of the virus [ 60 – 62 ]. Oral ivermectin has been shown to cause lower mortality in COVID-19 patients [ 60 ], but effective plasma concentrations are not achievable with safe oral doses. Meanwhile, due to the potential benefits of ivermectin in hospital mortality, it is extensively used in COVID-19 treatment or prevention regimens and there are different registered clinical trials which have tested oral, parenteral, and nasal ivermectin alone or in combination with other medications.…”

COVID-19 and Ivermectin: Potential threats associated with human use

“…It was shown that the short term and high dosage hydroxychloroquine failed to provide protection or treatmet against SARS-CoV-2, after 4 days of exposure [43] . Inhalant form of IVM has also been re-purposed as more economical and efficient way to curtail the SARS-CoV-2 infection [44] . At this point of rapidfire ideas and lab scale research, it is required to extract clinically relevant data regarding the promise of IVM against COVID-19.…”