AMA, APhA, ASHP statement on ending use of ivermectin to treat COVID-19
The American
Medical Association (AMA), American Pharmacists Association (APhA), and
American Society of Health-System Pharmacists (ASHP) strongly oppose the
ordering, prescribing, or dispensing of ivermectin to prevent or treat COVID-19
outside of a clinical trial.
New York Times
Ivermectin
is approved by the U.S. Food and Drug Administration (FDA) for human use to
treat infections caused by internal and external parasites. It is not approved
to prevent or treat COVID-19. Ivermectin is also available to treat certain
veterinary conditions; medications formulated or intended for use in animals
should not be used by humans.
We
are alarmed by reports that outpatient prescribing for and dispensing of
ivermectin have increased 24-fold since before the pandemic and increased
exponentially over the past few months. As such, we are calling for an
immediate end to the prescribing, dispensing, and use of ivermectin for the
prevention and treatment of COVID-19 outside of a clinical trial.
In
addition, we are urging physicians, pharmacists, and other prescribers—trusted
health care professionals in their communities—to warn patients against the use
of ivermectin outside of FDA-approved indications and guidance, whether
intended for use in humans or animals, as well as purchasing ivermectin from
online stores. Veterinary forms of this medication are highly concentrated for
large animals and pose a significant toxicity risk for humans.
The U.S. Centers for Disease Control and Prevention (CDC) and the FDA have issued advisories indicating that ivermectin is not authorized or approved for the prevention or treatment of COVID-19.
The National Institutes of Health, World Health Organization, and Merck (the
manufacturer of the drug) all state there is insufficient evidence to support
the use of ivermectin to treat COVID-19. The Infectious Diseases Society of
America Guidelines on the Treatment and
Management of Patients with COVID-19 also recommend against the
use of ivermectin outside of a clinical trial.
Use
of ivermectin for the prevention and treatment of COVID-19 has been
demonstrated to be harmful to patients. Calls to poison control centers due to
ivermectin ingestion have increased five-fold from their pre-pandemic baseline.
A
recent CDC Health Alert Network
Advisory (PDF) recommends that health care professionals should
counsel patients against use of ivermectin as a treatment for COVID-19,
including emphasizing the potentially toxic effects of this drug, including “nausea, vomiting, and diarrhea. Overdoses
are associated with hypotension and neurologic effects such as decreased
consciousness, confusion, hallucinations, seizures, coma, and death.”
For
more information, we encourage patients and health care providers to consult
the FDA’s Consumer Update on
Why You Should Not Use Ivermectin to Treat or Prevent COVID-19 and the CDC
Health Alert Network Advisory on the Rapid Increase in Ivermectin Prescriptions
and Reports of Severe Illness Associated with Products Containing Ivermectin to
Prevent or Treat COVID-19.
Patients
are encouraged to talk to their physicians, pharmacists, and other prescribers
about currently available therapies authorized or approved for the treatment or
prevention of COVID-19.
The
most effective ways to limit the spread of COVID-19 are to get vaccinated, wear
a face mask, stay at least six feet from others in public places, wash hands
frequently, and avoid large crowds of people. Our organizations strongly
urge eligible unvaccinated individuals to get vaccinated.