FLCCC I-CARE Early Treatment Protocol Review (2022)

The Front Line COVID-19 Critical Care (FLCCC) Alliance was initially formed as a working group during the early COVID-19 pandemic days in response to multiple early reports of COVID patients with an inexplicably high need for prolonged mechanical ventilation and an excessive death rate. Based on rapidly emerging clinical trials evidence, the FLCCC team has developed the I-MASK+ protocol for prophylaxis and at home treatment of early stage COVID-19 and has now divided the I-MASK protocol into I-CARE and I-PREVENT protocols.

It is critical to recognize that infection with SARS-CoV-2, the virus that causes COVID-19, progresses through a number of stages and phases. Treatment is therefore highly stage-specific. COVID-19 is a clinical diagnosis; a confirmed antigen or PCR test is not required. Treatment should be initiated immediately after the onset of flu-like symptoms. The multiple therapies and drugs in this protocol have different mechanisms of action and work synergistically during various phases of the disease.

I-CARE COVID Treatment Protocol for Outpatients

The I-Care protocol has been updated several times and below is their latest version (version 1.3: June 29, 2022).


FIRST LINE THERAPIES (In order of priority; not all required)
  • Ivermectin: 0.3 to 0.6 mg/kg – one dose daily for at least 5 days or until symptoms resolve. If symptoms persist longer than 5 days, consult a healthcare provider. See Table 1 for help with calculating correct dose. Due to a possible interaction between quercetin and ivermectin, these drugs should be staggered throughout the day (see Table 2). For COVID treatment, ivermectin is best taken with a meal or just following a meal, for greater absorption. 
  • Hydroxychloroquine (HCQ): 200 mg twice a day for 5 to 10 days. Best taken with zinc. HCQ may be taken in place of, or together with, ivermectin. While ivermectin should be avoided in pregnancy, the FDA considers HCQ safe in pregnancy. Given the pathway used by the Omicron variant to gain cell entry, HCQ may be the preferred drug for this variant. 
  • Zinc: 75-100 mg daily. Take with HCQ. Zinc supplements come in various forms (e.g., zinc sulfate, zinc citrate and zinc gluconate). 
  • Mouthwash: three times a day. Gargle three times a day (do not swallow) with an antiseptic-antimicrobial mouthwash containing chlorhexidine, cetylpyridinium chloride (e.g., Scope™, Act™, Crest™) or povidone-iodine (e.g. Betadine® Antiseptic Sore Throat Gargle™).
  • Nasal spray with 1% povidone-iodine: 2-3 times a day. Do not use for more than 5 days in pregnancy. If 1% product is not available, dilute the more widely available 10% solution (see box) and apply 4-5 drops to each nostril every 4 hours. 
  • Aspirin: 325 mg daily (unless contraindicated). 
  • Melatonin: 5-10 mg before bedtime (causes drowsiness). Slow- or extended-release formulations preferred. 
  • Curcumin (turmeric): 500 mg twice a day. Curcumin has low solubility in water and is poorly absorbed by the body; consequently, it is traditionally taken with full fat milk and black pepper, which enhance its absorption. 
  • Kefir and/or Bifidobacterium Probiotics. 
  • Vitamin C: 500-1000 mg twice a day. 
  • Quercetin (or a mixed flavonoid supplement): 250 mg twice a day. Due to a possible interaction between quercetin and ivermectin, these drugs should not be taken simultaneously (i.e., should be staggered at different times of day – see Table 2). As supplemental quercetin has poor solubility and low oral absorption, lecithin-based and nanoparticle formulations are preferred.
  • Home pulse oximeter: Monitoring of oxygen saturation is recommended in symptomatic patients, due to asymptomatic hypoxia. Take multiple readings over the course of the day and regard any downward trend as ominous. Baseline or ambulatory desaturation under 94% should prompt consultation with primary or telehealth provider, or evaluation in an emergency room.

SECOND LINE THERAPIES (In order of priority/importance)

Add to first line therapies above if: 
1) more than 5 days of symptoms; 
2) poor response to first line agents; 
3) significant comorbidities.
  • Nigella sativa (black cumin): 80 mg/kg daily and Honey 1g/kg daily. 
  • Vitamin D3: 10,000 IU daily (two 5,000 IU capsules) for two weeks. 
  • B complex vitamins
  • Nitazoxanide (NTZ): 600 mg twice a day for 5 days. 
  • Fluvoxamine: 25-50 mg twice a day. Can substitute fluoxetine (Prozac; 20-40mg daily) if fluvoxamine not available. 
  • N-acetyl cysteine (NAC): 600-1200 mg orally twice a day. 
  • Omega-3 fatty acids: 4 g daily. Vascepa (Ethyl eicosapentaenoic acid); Lovaza (EPA/DHA); or alternative DHA/EPA. Vascepa and Lovaza tablets must be swallowed and cannot be crushed, dissolved, or chewed.
Table 1. How to calculate ivermectin dose


Ordinary Vitamin D3 Does not work in Acute Illness

According to this webinar (below) by Dr Pierre Kory and Dr. Keith Berkowitz:


Video time from 11:30 - 12:30: 

Vitamin D3 (ordinary form) does not work in acute illness. It doesn't become active for at least a week... Vitamin D3 is for prevention and you should continue to take it if your levels are below 50 ng/ml...

There is only one form of vitamin D that will have an acute impact and that is calcifediol (vitamin D3 analog). 


d.velop Vitamin D Supplements 2400 IU, 20 mcg – High Potency Vitamin D3

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Calcifediol, the form of vitamin D in d.velop, doesn’t need to be processed by the liver, it can be absorbed right into the bloodstream and throughout your body. That's why calcifediol is 3x more effective for raising vitamin D levels when compared to regular vitamin D on an equal microgram (mcg) basis.


Related: 

About FLCCC Alliance


The Front Line COVID-19 Critical Care (FLCCC) Alliance was initially formed as a working group under “emergency” conditions of the early COVID-19 pandemic in response to multiple early reports of COVID patients with an inexplicably high need for prolonged mechanical ventilation and an excessive mortality associated with the prevailing “supportive care only” recommendations disseminated by the majority of national and international health care organizations.

As a group of highly published leaders in critical care with expertise in therapies directed at severe infections, in particular “HAT” therapy first developed by Dr. Paul Marik for the treatment of bacterial sepsis, and along with published high patient survival rates from our centers, we were contacted by equally concerned and motivated colleagues from other specialties.

In October 2020, the FLCCC Alliance identified, based on a review of the recent and rapidly emerging clinical trials evidence, that ivermectin, an anti-parasitic medicine, has highly potent real-world, anti-viral, and anti-inflammatory properties against SARS-CoV-2 and COVID-19. This conclusion is based not only from multiple in-vitro and animal models, but from numerous clinical trials from centers and countries around the world showing repeated, consistent, large magnitude improvements in clinical outcomes when ivermectin is used not only as a prophylactic agent but also in mild, moderate, and even severe disease states. Further, data from large “natural experiments” that appear to have occurred when various regional health ministries and governmental authorities within South American countries initiated “ivermectin distribution” campaigns which then led to temporally associated decreases in case counts and case fatality rates.
Related: 

Disclaimer: Always see your doctor before taking these supplements and drugs. Be aware that most of the 'treatment' dosages are above the recommended dietary allowance (RDA) and therefore such dosages should not be maintained on a long term basis. 

Our aim here isn't to replace your doctors' advice. It is intended as a sharing of knowledge and information. Do take note that supplements are not 100% protective or curative against COVID-19. 

Although ivermectin and hydroxychloroquine are relatively safe drugs, they are still synthetic chemicals that can have side effects. Vitamin D, C, Zinc and Quercetin are nutrients that your body require for optimal health. Nutrients are safer alternatives especially if your risk is low e.g. age below 50 and no other chronic illness. Discuss with your doctor on the benefit vs risk for each treatment. If you are on multiple medications, be aware of supplement-drug interactions that might enhance the possibilities of adverse effects.

Nutritional supplements are meant to tip the scales in favour of you in terms of your immune system and to improve your probability of a smooth recovery, if at all you do get COVID-19. 

You still need to follow the advice given by CDC, WHO and your local authority in terms of local guidelines such as mask wearing, vaccination, social distancing and avoiding crowds. It's better to combine multiple strategies in order to defend yourself against this virus.

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