Health warning over ‘donkey doses’ of Ivermectin in Cayman

Health chiefs are urging doctors not to prescribe high doses of the drug Ivermectin to patients concerned about COVID-19.

The drug – typically used to prevent parasites in livestock and, at smaller doses, to treat intestinal worms in humans – had been highlighted as a potential treatment for the virus.

However, it is not approved by the US Food and Drug Administration for this purpose and a number of studies did not provide evidence in support of any impact.

Nonetheless, doctors globally have been inundated with requests for the drug and Cayman does not appear to be immune.

Dr. Delroy Jefferson, medical director of the Health Services Authority, urged patients not to ask for Ivermectin and doctors to be careful about prescribing the drug.

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“I ask the community to be careful with what they are asking for with respect to prophylaxis,” he said.

“Recently we have seen a number of persons going to the physician asking for Ivermectin at very high doses to be used as a prophylactic measure.”

Dr. Delroy Jefferson, Health Services Authority

He said a patient had been given 75 tablets at a dose of 18 milligrams, which is higher than the recommended dose for humans.

“I am using this platform to beg my colleagues not to do this,” he said at the government press conference Thursday.

He said there were “specific indications” – a medical term meaning a certain treatment is potentially advisable – for Ivermectin for patients with mild to moderate COVID symptoms.

But he said this must be at the human dose and not at the “horse, cow and donkey dose”.

Speaking to the Compass after the conference, Dr. Jefferson said the greatest threat was from patients attempting to “self-medicate” with drugs like Ivermectin at doses that are far higher than recommended.

He said the drug, at the right dose, is appropriate for humans with certain conditions. But he added, “It is best not given to asymptomatic patients.”

Jefferson said the drug should only be used under the careful instruction of a physician. He warned that taking it at high doses could cause diarrhoea and vomiting, and in the most severe cases, could lead to seizures or coma.

Citing data from the US Centers for Disease Control and Prevention, The New York Times reported last week that prescriptions for Ivermectin in the US have seen a sharp rise in recent weeks, jumping to more than 88,000 per week in mid-August from a pre-pandemic baseline average of 3,600 per week.

The drug is not authorised by medical regulators as a treatment for COVID-19.

“You are not a horse,” the FDA said in a tweet, reported by the Times, with a warning explaining that ivermectin is not FDA-approved for treating or preventing COVID-19 and that taking large doses can cause serious harm.

Calls to poison control centres about Ivermectin exposure have risen dramatically, jumping fivefold over their baseline in July.

A recent review of 14 Ivermectin studies, with more than 1,600 participants, concluded that none provided evidence of the drug’s ability to prevent COVID, improve patient conditions or reduce mortality, the Times report added.

“There is great interest in repurposing well-known inexpensive drugs such as Ivermectin that are readily available as an oral tablet,” Maria Popp and Stephanie Weibel, the authors of the review, told the newspaper.

“Even if these circumstances seem ideal, the results from the available clinical studies carried out so far cannot confirm the widely advertised benefits.”

  • Additional reporting by Andrel Harris
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