WORLAND — In one year, the number of calls to the regional poison control center doubled from the five previous years on complications related to ivermectin.
According to a health advisory on Aug. 26, the Centers for Disease Control and Prevention (CDC) confirmed with the American Association of Poison Control Centers (AAPCC) that human exposures and adverse effects associated with ivermectin reported to poison control centers have increased in 2021 compared to the pre-pandemic baseline.
These reports include increased use of veterinary products not meant for human consumption.
According to Jennifer Rohda, RN and education coordinator for the Nebraska Regional Poison Center serving Nebraska, Idaho, Wyoming, American Samoa, and Federated States of Micronesia, from 2015 to 2019 the center received two reported cases, one intentional use and one unintentional.
They had no calls reported in 2020, Rohda said.
This year they have had four calls related to ivermectin, with all calls from intentional use for treatment of COVID-19.
Rohda said patients are advised to do symptomatic and supportive care as there is no antidote for ivermectin poisoning.
As seen with poison control numbers, the interest in ivermectin has grown over the past few months including here in the Big Horn Basin with anonymous mailings and billboards cropping up to promote the use, as well as requests to local veterinarians and health care providers.
Local physicians and veterinarians have received requests for ivermectin in recent months.
Dr. Ed Zimmerman of Big Horn Family Medicine in Worland said, “I have had patients ask for both ivermectin and hydroxychloroquine. I have declined to prescribe either of these medications.
“A systematic review and Meta-analysis of Randomized Controlled Trials failed to show any benefit from ivermectin or hydroxychloroquine and neither are recommended by any major medical organization. Ivermectin is a fairly safe medication when used appropriately, however there can be adverse effects from hydroxychloroquine,” he said.
“Instead, monoclonal antibody treatments are available for patients with medical risk factors for severe COVID disease,” he added. “And, of course, I strongly recommend everyone getting the COVID-19 vaccination to prevent severe disease. Anyone with questions about the safety or usefulness of the COVID-19 vaccines should feel free to reach out to me through social media or through Big Horn Family Medicine.
Banner Health Clinic referred calls to the public relations department in Phoenix, Arizona. Banner Health Associate Director of Earned Media David Lozano said, “Ivermectin is not an FDA-approved treatment for COVID. Clinical trials are ongoing to assess ivermectin for COVID, but no clear findings have been released that confirm this drug as a safe or effective form of treatment for COVID. For this reason, it is not currently a drug that Banner hospitals or providers will prescribe.
“We currently have a very effective form of treatment for COVID,” he added. “Monoclonal antibodies received emergency use authorization from the FDA late last year and have been proven to safely prevent hospitalizations and reduce severity of COVID symptoms.”
According to the FDA, “monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses. Casirivimab and imdevimab are monoclonal antibodies that are specifically directed against the spike protein of SARSCoV-2, designed to block the virus’ attachment and entry into human cells.”
The monoclonal antibodies are administered intravenously and are for symptomatic people with COVID-19 but who are not hospitalized.
Dr. Steve Tharp, veterinarian and owner of Tharp Veterinary Service, said he has used oral ivermectin for horses as worm medicine for years. Now, if he calls a supply house today for the oral ivermectin “I can’t get it.”
He said the horse numbers have not changed that much to warrant the supply to be diminished, so people are probably trying to get it for other uses.
“I can still procure injectable ivermectin for cattle,” Tharp said.
He said he has received calls from people inquiring about ivermectin and he tells them he cannot get the oral ivermectin. He said while there is the formula for cattle, he knows that some ivermectin has been used quite extensively in Africa for treatment of specific parasites.
Tharp advises people to talk to their medical provider about treatment for COVID.
“I personally and legally cannot diagnose or treat my two-legged brethren,” he said.
According to the CDC health advisory on Aug. 26, “Ivermectin is a U.S. Food and Drug Administration (FDA)-approved prescription medication used to treat certain infections caused by internal and external parasites. When used as prescribed for approved indications, it is generally safe and well tolerated.
“During the COVID-19 pandemic, ivermectin dispensing by retail pharmacies has increased, as has use of veterinary formulations available over the counter but not intended for human use.
“FDA has cautioned about the potential risks of use for prevention or treatment of COVID-19. Ivermectin is not authorized or approved by FDA for prevention or treatment of COVID-19, according to the CDC advisory. “The National Institutes of Health’s (NIH) COVID-19 Treatment Guidelines Panel has also determined that there are currently insufficient data to recommend ivermectin for treatment of COVID-19.
“Adverse effects associated with ivermectin misuse and overdose are increasing, as shown by a rise in calls to poison control centers reporting overdoses and more people experiencing adverse effects.”
The CDC also noted in its health advisory that “ivermectin is a medication that is approved by FDA in oral formulations to treat onchocerciasis (river blindness) and intestinal strongyloidiasis. Topical formulations are used to treat head lice and rosacea. Ivermectin is also used in veterinary applications to prevent or treat internal and external parasitic infections in animals. When used in appropriate doses for approved indications, ivermectin is generally well tolerated.
“Clinical trials and observational studies to evaluate the use of ivermectin to prevent and treat COVID-19 in humans have yielded insufficient evidence for the NIH COVID-19 Treatment Guidelines Panel to recommend its use,” it added. “Data from adequately sized, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19.”
According to the Nebraska Region Poison Center, in a fact sheet regarding ivermectin, Dr. Ron Kirschner, medical director of the center said “in vitro studies in early 2020 suggested that high dose ivermectin might inhibit coronavirus replication in cell culture.
“However, clinical benefits in patients with COVID-19 have not been demonstrated.” Despite some studies showing some antiviral activity with ivermectin, Dr. David R. Scrase, acting Cabinet Secretary of the New Mexico Department of Health, reported on Sept. 22 that two people who were hospitalized in New Mexico for ivermectin toxicity have died.
Rohda said if people follow a physician’s recommendations for its intended use — head lice, internal and external parasites — “it is a fairly safe drug.” She said there will be complications if people are taking doses meant for large animals.
“Be in communication with your doctor, and if you do not feel well give us a call (at) 1-800-222-1222,” she said.