Fact Check: Ivermectin Precursor Did Win Nobel Prize (October 2021)
The claim: Ivermectin won Nobel Prize for its role in treating human disease
Debate over potential COVID-19 treatments has been a constantly evolving saga over the last year, with drugs like hydroxychloroquine and recently ivermectin touted by many despite a lack of convincing scientific evidence.
Demand for ivermectin reached a fever pitch as prescriptions for the anti-parasitic agent shot up by 2,400% by the middle of August compared to the weekly average prior to the pandemic, according to the Centers for the Disease Control and Prevention. Ivermectin poisoning calls have also increased by 163%, according to data collected by the American Association of Poison Control Centers.
Despite this, some social media users continue to support the drug, citing a high-profile award in an attempt to legitimize its controversial use against the virus.
"If you just got finessed into calling the medicine that won the 2015 Nobel Prize for its role in treating human disease 'horse de-wormer', then you need to sit the next couple of plays out," reads a graphic shared in a Sept. 6 Facebook post.
The graphic has been shared widely on the social media platform, and it was recently echoed by popular podcaster and UFC commentator Joe Rogan – who reportedly used ivermectin when being treated for COVID-19. He raised the issue during an episode of the "Joe Rogan Experience," a clip of which was shared in a Sept. 8 Instagram post.
The posts have collected thousands of interactions across Facebook and Instagram within the last few weeks, according to CrowdTangle, a social media insights tool.
While a precursor of ivermectin, known as avermectin, did win its two discoverers the 2015 Nobel Prize in Physiology and Medicine, it was related to treatment of parasites. It wasn't related to anything like a coronavirus.
USA TODAY has reached out to the Facebook and Instagram users, and Joe Rogan, for comment.
From golf course to veterinary drug
Avermectin's origin story calls to mind the famous case of penicillin's discovery, when it was fortuitously extracted from a mold left growing in a lab. Avermectin was extracted from a soil-dwelling bacteria growing outside a Japanese golf course southwest of Tokyo.
The bacteria, later christened Streptomyces avermectinius, was cultured in the 1970s by biochemist Satoshi Omura, who had been collecting soil samples all over Japan while hunting for new medicinal compounds.
The sample would later be sent to Merck Research Laboratories, which struck a royalties agreement with Omura's Kitasato Institute. The pharmaceutical giant, at the time, was particularly interested in creating therapeutics for veterinary use.
In the late 1970s, a Merck researcher, parasitologist William Campbell, found that when mice infected with intestinal roundworms were given the bacteria from Omura's soil sample, the parasites were effectively wiped out.
The key ingredient stifling the parasites, Campbell's team discovered, was a chemical they named avermectin, which turned out to be a mixture of eight closely related compounds. The most effective of these compounds, Avermectin B1 (made of a pair of molecules), was further tweaked and modified to overpower its parasitic targets yet be safe enough for the animals treated. In 1981, after clinical trials in animals, Merck commercialized the Avermectin B1 derivative, ivermectin, for veterinary use.
Potential for human use
By the 1980s, ivermectin was the top-selling veterinary drug in the world. This is also when potential human applications emerged.
Onchocerciasis is a parasitic disease transmitted to humans through the bites of infected blackflies. The parasite, commonly found in tropical climates of Africa and South America, infests by migrating into its host's eye, causing inflammation, bleeding and other symptoms resulting in blindness.
Campbell's team at Merck had discovered ivermectin was effective against a close relative of that parasite in horses but doesn't cause disease. This discovery encouraged Merck to test ivermectin in treating river blindness, which, in 1981, led to the first clinical trial of human volunteers in Senegal.
The success of these, and many other, human trials over the next several years, led to ivermectin being distributed in 1988 to countries affected by river blindness and another parasitic disease called lymphatic filariasis, which is caused by microscopic worms that invade the human lymph system.
The FDA approved ivermectin for human use as an antiparasitic drug in 1996 for treatment of river blindness and strongyloidiasis, another parasitic infection that mostly infects animals but humans as well.
In 2015, Campbell and Omura were awarded the Nobel Prize in Physiology or Medicine for the drug's application in roundworms. The Nobel announcement praised the duo – and another recipient awarded for a malaria treatment – for developing "therapies that have revolutionized the treatment of some of the most devastating parasitic diseases."
FLCCC (Front Line COVID-19 Critical Care) I-MASK+ Protocol
All the component medicines are FDA-approved (except ivermectin), inexpensive, readily available and have been used for decades with well-established safety profiles.
PREVENTION Protocol (for Delta variant)
- Gargle mouthwash: 2 x daily – gargle (do not swallow) antiseptic mouthwash with cetylpyridinium chloride (e.g. Scope mouthwash™, Crest mouthwash, Colgate mouthwash) or povidone/iodine 1 % solution as alternative (e.g. Betadine® Antiseptic Sore Throat Gargle™).
- Chronic Prevention: 0.2 mg/kg per dose (take with or after a meal) — twice a week for as long as disease risk is elevated in your community
- Post COVID-19 Exposure Prevention: 0.4 mg/kg per dose (take with or after a meal) — one dose today, repeat after 48 hours
- Vitamin D3: 1000–3000 IU/day. (Amazon) (iHerb)
- Vitamin C: 500 - 1,000 mg BID (twice daily) (Amazon) (iHerb)
- Quercetin: 250 mg daily. (Amazon) (iHerb)
- Zinc: 30 - 40 mg/day (elemental zinc). Zinc lozenges are preferred. (Amazon) (iHerb)
- Melatonin: 6 mg before bedtime (causes drowsiness). (Amazon)
- High risk Individuals: > 60 years with co-morbidities (hypertension, diabetes, chronic lung disease, chronic kidney disease), obesity, long term care facilities, etc.
- Post COVID-19 exposure: To use if a household member is COVID-19 positive, or you have prolonged exposure to a COVID-19 positive patient without wearing a mask.
- Precautionary Note: Ivermectin has a number of potentially serious drug-drug interactions. Please check for potential drug interaction at Ivermectin Drug Interactions - Drugs.com. The most important drug interactions occur with cyclosporin, tacrolimus, anti-retroviral drugs, and certain anti-fungal drugs.
- Due to the possible drug interaction between quercetin and ivermectin (may increase ivermectin levels), these drugs should not be taken simultaneously (i.e. should be staggered morning and night).
- Ivermectin is also lipophilic and therefore, bioavailability is maximised on a full stomach; or best to be taken with meal.
- Vitamin D3 RDA (Recommended Daily Allowance) is 800–1000 IU/day. The safe upper-dose daily limit is likely < 4000 IU/day. Vitamin D deficiency has been associated with an increased risk of acquiring COVID-19 and from dying from the disease. Vitamin D supplementation may therefore prove to be an effective and cheap intervention to lessen the impact of this disease, particularly in vulnerable populations, i.e. the elderly and obese.
- When Is the Best Time to Take Vitamin D? Morning or Night? It is possible that increasing vitamin D levels during the day may act, in part, as a signal that suppresses melatonin generation (source). Therefore, it's better to take vitamin D (with meal) during the day and melatonin to be taken just before bedtime.
- It is likely that vitamin C and quercetin have synergistic prophylactic benefit. Quercetin should be used with caution in patients with hypothyroidism and TSH levels should be monitored.
- Please consult with a qualified doctor and only use human ivermectin. Ivermectin for animals contain excipients (binding and storage compounds such as polyethylene glycol (PEG)) that are known to cause liver failure in high doses.
EARLY TREATMENT PROTOCOL
1. First line agents (use any or all medicines; listed in order of priority/importance)
- Ivermectin: 0.4–0.6 mg/kg per dose (take with or after meals) — one dose daily, take for 5 days or until recovered. (Find a Doctor). Use upper dose range if: 1) in regions with more aggressive variants; 2) treatment started on or after day 5 of symptoms or in pulmonary phase; or 3) multiple comorbidities/risk factors.
- and/or 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)
- Antiviral mouthwash: Gargle 3 x daily (do not swallow; must contain chlorhexidine, povidone-iodine, or cetylpyridinium chloride). (e.g. Scope mouthwash™, Crest mouthwash, Colgate mouthwash, 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.)
- Aspirin: 325 mg/day unless contraindicated. (Amazon)
- Vitamin D3: 5,000 IU daily. Preferred forms if available: Calcitriol (Rocaltrol) 0.5 mcg on day 1, then 0.25 mcg daily for 7 days – or Calcifediol 0.5 mg on day 1, then 0.2 mg on days 3 + 7, then 0.2 mg weekly until recovered.
- Melatonin: 10 mg before bedtime (causes drowsiness). (Amazon)
- Vitamin C: 500 - 1,000 mg BID (twice daily) (Amazon) (iHerb)
- Quercetin: 250 mg twice a day. (Amazon) (iHerb)
- Zinc: 100 mg/day. Zinc lozenges are preferred. (Amazon) (iHerb)
2. Second line agents (listed in order of priority /importance)
- Spironolactone 100 mg 2 x daily for ten days
- 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.
Consider fluoxetine (Prozac) 30mg daily for 10 days as an alternative (it is often better tolerated).
Avoid if patient is already on an SSRI.
- Optional: Betadine nasal spray applied 3 times a day (Ref) (Amazon)
- Optional: Xlear Nasal Spray with Xylitol: use twice a day (Ref) (Amazon)
- Optional: Azithromycin 250 mg twice a day. (Ref) (Find a Doctor).
- Optional: Bromhexine 8 mg three times a day (Ref) (Lazada Malaysia*)
- Face Masks - Must wear cloth, surgical, or N95 mask (without valve) in all indoor spaces with non-household persons. Must wear a N95 mask (without valve) during prolonged exposure to non-household persons in any confined, poorly ventilated area.
- Social Distancing - Until the end of the COVID-19 crisis, we recommend keeping a minimum distance of approx. 2 m / 6 feet in public from people who are not from your own household.
- Wash Hands - We recommend, after a stay during and after outings from home (shopping, sub - way etc.), a thorough hand cleaning (20–30 sec. with soap), or also to use a hand disinfectant in between.