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Ivermectin Scripts, Poison Center Calls Boom During Delta Surge

— CDC warns healthcare providers to steer patients away from the controversial drug

MedpageToday
The packaging and blister pack of Ivermectin tablets USP 6mg.

Prescriptions for ivermectin and related calls to poison control centers have shot up sharply during the latest COVID wave, and the to steer patients away from the drug.

Scripts for the antiparasitic have risen rapidly since July, jumping to more than 88,000 in the week ending August 13, CDC researchers reported in a Health Alert Network warning. That's way up from a peak earlier this year of 39,000 for the week ending January 8, and a 24-fold increase over the of 3,600 scripts per week from March 2019 to March 2020.

Related calls to U.S. poison control centers have kept pace, rising three-fold in January of this year (compared with the pre-pandemic baseline), and spiking five-fold over baseline in July, according to the researchers, citing data from the American Association of Poison Control Centers. Absolute numbers were not provided.

Those reports were associated with an "increased frequency of adverse effects and emergency department/hospital visits," said CDC.

Examples of these encounters include an adult who, in an attempt to prevent COVID infection, drank an injectable ivermectin formulation that was intended for use in cattle. This patient presented to the hospital with confusion, drowsiness, hallucinations, tachypnea, and tremors. The person ultimately recovered after a 9-day hospital stay.

Another adult patient presented with altered mental status after taking ivermectin tablets purchased on the internet, the CDC said. This patient had COVID, and had been taking five tablets a day for 5 days to treat the disease. Symptoms eventually resolved after stopping the drug during a hospital stay.

The agency noted that ivermectin for large animals such as horses, sheep, and cattle can be highly concentrated and lead to overdose in humans.

Signs and symptoms of ivermectin toxicity include gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain, as well as neurologic effects such as headache, blurred vision, decreased consciousness, confusion, hallucinations, and seizures.

Ivermectin overdose is also associated with hypotension, coma, and death, CDC stated. The drug can also potentiate the effects of other compounds that depress the central nervous system, including benzodiazepines and barbiturates.

CDC recommends that instead of prescribing ivermectin, physicians should urge patients to get vaccinated against COVID-19, and use prevention measures such as masking in indoor public spaces, physical distancing, avoiding crowds and poorly ventilated spaces, and frequent handwashing and use of hand sanitizer that contains at least 60% alcohol.

Federal agencies have launched an offensive against ivermectin prescribing this week, with the FDA issuing a about ivermectin earlier this week. The agency made a splash with about the warning, stating, "You are not a horse. You are not a cow. Seriously, y'all. Stop it."

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    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.