Best Alternatives for Ivermectin 2021

The use of ivermectin for COVID-19 has been controversial. Ivermectin is a medication widely used in low- and middle-income countries to treat parasitic worm infections in adults and children. It’s been used for decades for this purpose by over 3.7 billion people, and is considered safe and effective. It has an increasing list of indications due to its antiviral and anti-inflammatory properties, and is included on the WHO’s Model List of Essential Medicines.


Alternatives to Ivermectin

The availability of ivermectin varies in different countries. If ivermectin is not available in your country, you should still proceed with early treatment e.g. FLCCC I-MASK+ protocol. The I-MASK+ protocol consists of many drugs and nutrients. If ivermectin is not available or disallowed in your country, you should still discuss with your doctor on the best available options for early treatment. Remember to start early in order to reduce the viral load. The viral will multiply on the surfaces of the throat and the back of your nose. That is where you should focus as per the I-MASK+ protocol. The FLCCC I-MASK+ protocol recommends 'mouthwashes and nasal cleansing' as part of the prevention and treatment protocols.
In the event that you simply cannot get ivermectin, there are viable alternatives. The aim of this article is to empower you with a better understanding of the options available and to discuss the options with your medical doctor.
Anti-Virals & Anti-Septics
  • Gargle mouthwash: 2 x daily – gargle (do not swallow) antiseptic mouthwash with cetylpyridinium chloride (e.g. Scope mouthwash™, Crest mouthwashColgate mouthwash) or povidone/iodine 1 % solution as alternative (e.g. Betadine® Antiseptic Sore Throat Gargle™). 
  • Iodine Nasal Spray: Use 1 % povidone iodine commercial product as per instructions 2–3 x daily. If 1 %-product not available, must first dilute the more widely available 10 %-solution and apply 4–5 drops to each nose every 4 hours. (No more than 5 days in pregnancy.)
  • Nitazoxanide: 500 mg 2 x daily for 5 days after meals. Combine with ivermectin (preferred) or substitute if ivermectin is not available. (Nitazoxanide is often unavailable or high-priced in the USA)
  • Betadine nasal spray (Iota Carrageenan) applied 3 times a day (Ref(Amazon
  • Xlear Nasal Spray with Xylitol: use twice a day (Ref) (Amazon)
  • Azithromycin 250 mg twice a day. (Ref) (Find a Doctor). 
  • Quercetin and Zinc. Quercetin acting as a zinc ionophore (zinc transporter) in order for zinc to exert it's anti-viral activity within the cells. (Ref)
Immune Fortifying / Supportive Therapy
Dual anti-androgen Therapy
  1. Spironolactone 100 mg 2 x daily for ten days
  2. Dutasteride 2 mg on day 1, followed by 1 mg daily for 10 days. If dutasteride is not available, use finasteride 10 mg daily for 10 days.
Anti-Thrombotic (Anti Blood Clot)

Aspirin: 325 mg/day unless contraindicated. (Amazon)

Fluvoxamine (SSRI)

Fluvoxamine: 50 mg twice daily for 10 days. 
Consider fluoxetine (Prozac) 30mg daily for 10 days as an alternative (it is often better tolerated).
Avoid if patient is already on an SSRI.

Monoclonal antibody therapy

Casirivimab/imdevimab: 600 mg each in a single subcutaneous injection for patients with one or more risk factors as follows: Age > 65y; obesity; pregnancy; chronic lung, heart, or kidney disease; diabetes; immunosuppressed; developmental disability; chronic tracheostomy; or tube feeding.

Related: 

Ivermectin and COVID-19 Updates:

Host Betsy Ashton welcomed several guests who have been involved in recent court cases brought by families of hospitalized patients to compel the hospitals to give their loved ones Ivermectin. The lawsuits were brought when the hospitals refused to prescribe ivermectin to their critically ill patients—though 63 studies have now shown Ivermectin’s efficacy in all stages of COVID-19 disease. FLCCC co-founding physician Dr. Fred Wagshul, who prescribed ivermectin to a patient in a Cincinnati hospital, was joined by Buffalo, New York attorney Ralph Lorigo, who has represented more than a dozen families in these court cases. Relatives of two patients (and one of the patients herself ) who survived after winning their court orders to receive ivermectin also told their emotional stories on the program.
July 2021: The American Journal of Therapeutics has just published two letters showing the results of a revised meta-analysis of studies on Ivermectin for Prevention and Treatment of COVID-19. The revised version was done without one study that is being investigated for possible fraud. The results still show “ivermectin efficacy is robust.”

July 29, 2021: Ivermectin's recent Cochrane review applies tight selection filters, e.g. eliminating 7 of the 10 RCTs with mortality end-point, and splits the rest in 2 subgroups (in/outpatients) to reach an unavoidable conclusion of inconclusiveness. The live French Ivermectin RCT meta-analysis allows to contextualize the loss of information from Cochrane's selection of 3 papers only.


June 2021: Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 by Kory et al., published on American Journal of Therapeutics.
www.onedaymd.com
A Cochrane-standard (=highest) review and meta-analysis of Ivermectin against Covid-19 by Bryant-Lawrie, now peer-reviewed and published, concludes that the evidence justify the global adoption.

Results of Ivermectin's success in treating COVID-19 outbreaks in India, Mexico, Peru, Paraquay, Argentina, Brazil and Slovakia.

June 1, 2021: The Drug that Obliterates 97% of New Delhi Cases by Justus R. Hope, MD

May 16, 2021: Do the NIH and WHO COVID treatment recommendations need to be fixed? By Steve Kirsch. Published on TrialSiteNews.
Great article on where we stand on the COVID-19 treatment front debate - COVID19Crusher

May 4, 2021: Meta-analysis of Mortality, Need for ICU admission, Use of Mechanical Ventilation and Adverse Effects with Ivermectin Use in COVID-19 Patients (N=15,002). Published on medrxiv.org.

May 03, 2021 - Joint Statement on Widespread Use of Ivermectin in India for Prevention and Early Treatment by U.K. Evidence-Based Medicine Consultancy Ltd (E-BMC Ltd) and U.S. FLCCC (Front Line Critical Care Alliance).

Apr 26, 2021: The new FLCCC outpatient protocol (I-MASK+) with the addition of fluvoxamine and nasal/oral "sanitation". Fluvoxamine 50 mg twice daily for 10–14 days. Add to ivermectin if: 1) minimal response after 2 days of ivermectin; 2) in regions with more aggressive variants; 3) treatment started on or after day 5 of symptoms or in pulmonary phase; or 4) numerous co-morbidities/risk factors. Avoid if patient is already on an SSRI (Selective Serotonin Reuptake Inhibitor).

Apr 26, 2021: The new FLCCC hospital treatment protocol (MATH+) with the notable additions of Fluvoxamine and anti-androgen therapy (Dutasteride/Finasteride).

March 2021: Dr. Satoshi Ōmura, co-author of the newly published paper, “Global trends in clinical studies of ivermectin in COVID-19” was one of the four researchers from Kitasato University in Tokyo, Japan who received the Nobel Prize in Physiology or Medicine in 2015 for their discovery of ivermectin. Global trends in clinical studies of ivermectin in COVID-19, published in the Japanese Journal of Antibiotics, March, 2021.Ivermectin for COVID-19: Real-time meta analysis

Check out the evidence tracking on Ivermectin versus COVID-19 from Ivmmeta.com (constantly updated).


Clinical Trials 

As of September 2021, there are more than 80 on-going trials globally on Ivermectin for treatment and prevention of COVID-19 on covid-nma.com.
Other Potential Treatments

For a list of COVID-19 early treatment studies, check out c19early.com (constantly updated).

Disclaimers: 
  • Always see or talk to your doctor before taking these drugs, supplements and over the counter products. 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.
  • The I-MASK+ protocol is a bridge to vaccines and a safety net for those who cannot or have not been vaccinated; or are vaccinated and have concerns regarding declining protection against emerging variants. Vaccines have shown efficacy in preventing the most severe outcomes of COVID-19 and are an important part of a multi-modal strategy that must also include early treatment. The decision to get a vaccine should be made in consultation with your health care provider. 
  • You still need to follow the advice given by CDC, WHO and your local authority in terms of local guidelines such as mask wearing, social distancing, vaccination and avoiding crowds. It's better to combine multiple strategies in order to defend yourself against this virus.

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