Ivermectin-related calls to the Poisons Information Helpline of the Western Cape (PIHWC) increased 12-fold from 2015 to 2021 – mostly during the height of the pandemic and despite health authorities not recommending the drug for use against COVID-19.
A recent South African Medical Journal research article by researchers from Stellenbosch University and UCT, titled “Ivermectin exposures reported to the Poisons Information Helpline in South Africa during the COVID-19 pandemic”, compared cases of Ivermectin exposure reported to the PIHWC before and after publication of the drug’s effectiveness against COVID-19.
Calls reported from 1 June 2015 to 30 June 2020 (period one) were compared with calls received from 1 July 2020 to 31 July 2021 (period two), reports the Cape Times.
In June 2020, after Ivermectin was reported to apparently be effective against COVID-19, it sparked public interest globally.
This was despite health authorities, both locally and internationally, not recommending the drug for use against against the virus, citing “significant methodological limitations of most trials without clear evidence of benefit”.
This led to “increased off-label and unmonitored use”, the authors explain, increasing the likelihood of “toxic Ivermectin exposures”.
“Calls increased from an average of 0.3 calls per month during period one to 3.5 calls per month during period two. A total of 54.3% during period two were specifically reported as COVID-19 related.
“Two paediatric cases involved accidental ingestion as a result of Ivermectin being accessible in their respective households secondary to its use for prevention or treatment of COVID-19.”
More than half of the Ivermectin exposures during period two were secondary to veterinary preparations.
Researchers cautioned: “The consequences of such unregulated dispensing are that patients may experience unintended Ivermectin toxicity.
“It is therefore important that while further evidence is gathered, more stringent processes are implemented to curb the irrational use of Ivermectin,” the authors said.
Study details
Ivermectin exposures reported to the Poisons Information Helpline in South Africa during the COVID-19 pandemic
V Pillay-Fuentes Lorente, G Voigt, CE du Plessis, K Balme, CJ Marks, EH Decloedt, C Stephen, H Reuter, R van Rensburg.
Published in South African Medical Journal on 2 August 2022
Abstract
Background
Ivermectin is an antiparasitic drug that has shown in vitro activity against COVID 19. Clinical studies supporting ivermectin for COVID 19 prevention and treatment are conflicting, with important limitations. Public support for ivermectin is significant, with extensive off-label use despite the conflicting views on its efficacy. Ivermectin tablets and injectable formulations are not registered in South Africa for human use by the South African Health Products Regulatory Authority. The National Department of Health does not currently recommend the use of Ivermectin for COVID 19.
Objectives
To describe cases of Ivermectin exposure reported to the Poisons Information Helpline of the Western Cape (PIHWC) before and after publication of the drug’s in vitro activity against SARS-CoV-2.
Methods
In a retrospective review, Ivermectin-related calls reported to the PIHWC from 1 June 2015 to 30 June 2020 (period 1) were compared with calls received from 1 July 2020 to 31 July 2021 (period 2), dichotomised according to the first publication indicating
Ivermectin activity against SARS-CoV-2.
Results
Seventy-one cases were screened, and 65 were included for analysis; 19 cases were reported during period 1 and 46 during period 2. During period 2, 25 Ivermectin cases (54.3%) were related to COVID 19 use. Of these, 24 cases (52.2%) involved veterinary preparations, 3 (6.5%) human preparations and 19 (41.3%) unknown preparations. Fourteen cases (73.7%) during period 1 and 30 (65.2%) during period 2 were reported to be symptomatic. The most common organ systems involved were the central nervous (n=26 cases; 40.0%), gastrointestinal (n=18; 27.7%), ocular (n=9; 13.8%) and dermatological (n=5; 7.7%) systems.
Conclusion
Ivermectin-related exposure calls increased during study period 2, probably as a result of Ivermectin being used as preventive and definitive therapy for COVID 19 in the absence of robust evidence on efficacy, dosing recommendations or appropriate formulations.
Cape Times PressReader article – Research reveals steady rise in WC Ivermectin calls (Open access)
See more from MedicalBrief archives:
Largest yet Ivermectin trial fails to show benefit in COVID outpatients
Increased human use of veterinary Ivermectin reflected in Oregon Poison Centre calls
Ivermectin: Further claims of ‘serious errors or potential fraud’ in studies
Australian regulator bans off-label Ivermectin use as prescriptions climb