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Li, MD, FACR — By Daniel Yetman on September 20, 2022Share on PinterestRichard Bailey/Getty ImagesIvermectin is a prescription medication doctors use to treat several types of parasitic infections. At one point, researchers were also examining ivermectin’s potential for treating or preventing COVID-19.
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Inaccurate rumors about ivermectin spread on social media — as did rumors about another antiparasitic medication, hydroxychloroquine. Hydroxychloroquine is used to treat rheumatoid arthritis (RA) and other rheumatic conditions.
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Ivermectin is not used in this way. Neither medication is currently recommended for the treatment or prevention of COVID-19.
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If you have RA, you should be able to take ivermectin to treat a parasitic infection like river blindness (onchocerciasis) or intestinal strongyloidiasis. But it’s important that you talk with a doctor before starting any new medication. Keep reading to learn more about ivermectin, including what it’s used for, whether it’s an effective treatment for COVID-19, and whether it’s safe for people with RA.
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What is ivermectin
Ivermectin is an antiparasitic medication. It’s not used to treat RA or COVID-19. In 2015, researchers William Campbell and Satoshi Ōmura won the Nobel Prize in physiology/medicine for their discovery of an antiparasitic drug called avermectin.
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The discovery was a major feat for public health because it dramatically reduced rates of parasitic infections, like river blindness, which has been a longtime issue in many developing tropical nations. Ivermectin is a derivative of avermectin.
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It’s approved by the Food and Drug Administration (FDA) to treat the parasitic worms that cause river blindness (onchocerciasis) and intestinal strongyloidiasis. Ivermectin is also FDA-approved in topical form to treat some external parasites, like head lice, and certain skin conditions, like rosacea.
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It’s also used to treat and prevent parasitic infections in animals.
Ivermectin vs hydroxychloroquine
Hydroxychloroquine is another drug people have used off-label to try to prevent or treat COVID-19.
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Like ivermectin, hydroxychloroquine is primarily used to treat and prevent parasitic infections. It’s FDA-approved to treat and prevent malaria, a parasitic infection transmitted by mosquitoes.
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Unlike ivermectin, hydroxychloroquine is regularly used to treat RA. Hydroxychloroquine is considered a disease-modifying anti-rheumatic drug (DMARD) when used to treat arthritis.
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Its anti-inflammatory properties help reduce pain and swelling. It can also help prevent joint damage and long-term disability.
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The FDA had previously granted an emergency use authorization (EUA) for hydroxychloroquine to treat severe cases of COVID-19 in people who were hospitalized for the condition. However, that status was revoked after research found that hydroxychloroquine was unlikely to be as effective at treating COVD-19 as was initially believed. The National Institutes of Health’s COVID-19 Treatment Guidelines now advise people not to use hydroxychloroquine for the treatment of COVID-19.
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A 2020 study from England found no evidence that people with RA who were taking hydroxychloroquine before the pandemic had better outcomes when they got COVID-19 than people not taking hydroxychloroquine.
Is ivermectin safe for people with RA
Ivermectin seems to be safe for most people with RA when used as prescribed. But it’s very important to talk with a doctor before starting ivermectin to make sure it’s safe for you.
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In a 2015 study, the Brazilian Society of Rheumatology examined treatments for intestinal parasitic infections in people with rheumatic autoimmune diseases like RA, lupus, and spondylarthritis. According to the study, ivermectin is the treatment of choice for several intestinal parasitic infections affecting people with rheumatic autoimmune diseases. Ivermectin should not be used to treat COVID-19 unless prescribed for this purpose as part of a clinical trial.
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Dangers of using ivermectin to prevent COVID-19
In August 2021, 21 people called Oregon Poison Center after taking ivermectin. About half of these people took ivermectin to prevent COVID-19, and the other half used it to treat COVID-19 symptoms. Out of these 21 people, 17 had purchased formulas meant for animals.
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Six of the people were hospitalized from toxicity. Four more received treatment in an intensive care unit.
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One of them developed seizures. If you’ve taken ivermectin and experience signs of toxicity, it’s important to seek immediate medical attention.
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Signs and symptoms of ivermectin toxicity
nauseavomitingabdominal paindiarrheaheadacheblurred visiondizzinessrapid heartbeatlow blood pressurehallucinationsaltered mental stateconfusionloss of coordination or balanceseizurescentral nervous system depressionDoes ivermectin work for COVID-19
According to the Centers for Disease Control and Prevention (CDC), clinical trials have shown that ivermectin is not effective at treating or preventing COVID-19. Some early studies with human participants found evidence that ivermectin may be an effective treatment, but these studies had flaws in their methodologies that made them prone to bias. Most studies since have found no benefit.
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For example, a 2021 study from Colombia found that taking ivermectin for 5 days did not significantly improve symptom duration in people with mild COVID-19 compared with a placebo. A 2021 study from Argentina found that ivermectin had no significant effect on preventing hospitalizations for people with COVID-19. Likewise, two 2022 studies published in highly regarded journals found no benefit.
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In the first study, published in JAMA Internal Medicine, researchers found no evidence that ivermectin prevented disease progression in high risk people with mild to moderate COVID-19. A larger study from Brazil, published in the New England Journal of Medicine, found ivermectin didn’t lower rates of hospital admission due to COVID-19 progression.
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How to prevent COVID-19 when you have RA
People with RA seem to have an elevated risk of developing COVID-19. In a 2021 study, researchers found that people with RA had a higher risk of developing all of the following: severe COVID-19COVID-19-related deathhospitalization for COVID-19serious complications of COVID-19, such as sepsis, blood clots, and strokes You can lower your chances of developing COVID-19 by:staying up to date with your COVID-19 vaccinations and other vaccinationswearing a well-fitted mask in public, especially in crowded indoor areas with poor ventilationavoiding poorly ventilated areas and crowds as much as possiblewashing your hands frequently with soap and water for at least 20 seconds, or with hand sanitizer when soap isn’t availableavoiding contact with people who are illstaying 6 feet (2 meters) away from othersVaccine and booster guidelines
Making sure your vaccinations are up to date is particularly important when you have an autoimmune disease like RA. It’s the stance of the American College of Rheumatology that all people without known allergies to ingredients in COVID-19 vaccines should get vaccinated.
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According to their vaccine and booster guidelines:Unvaccinated people should receive either the Pfizer-BioNTech or Moderna COVID-19 vaccine, not the Johnson & Johnson vaccine.A third vaccine dose is recommended at least 28 days after receiving the two primary doses.People who received the Pfizer-BioNTech and Moderna vaccines should get a booster 5 months after their third dose. People who received the Johnson & Johnson vaccine and a booster shot should receive another booster 2 months after the second shot.Some people may develop symptom flare-ups after vaccination, but the benefits of COVID-19 vaccination outweigh the potential risks.It may be helpful to alter the timing of certain medications while undergoing vaccination, but you don’t make any changes without first consulting a doctor.
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Takeaway
Ivermectin is a medication FDA-approved to treat some parasitic infections. Researchers have examined its potential for preventing and treating COVID-19 but found it’s not beneficial.
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Ivermectin does not treat RA, but hydroxychloroquine, another medication being studied for COVID-19, does. However, if you have RA and a parasitic infection, your doctor may prescribe ivermectin.
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People with RA seem to have an elevated risk of developing COVID-19. It’s particularly important for people with RA to stay up to date with their COVID-19 vaccinations and take steps to avoid infections.
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Last medically reviewed on September 20, 2022
How we vetted this article
SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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You can learn more about how we ensure our content is accurate and current by reading our editorial policy.ACR COVID-19 vaccine clinical guidance. (2022).
arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/acr-covid-19-vaccine-clinical-guidanceBraz AS, et al. (2015).
arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/acr-covid-19-vaccine-clinical-guidanceBraz AS, et al. (2015).
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Recommendations from the Brazilian Society of Rheumatology on the diagnosis and treatment of intestinal parasitic infections in patients with autoimmune rheumatic disorders.
sciencedirect.com/science/article/pii/S2255502115000127Chloroquine or hydroxychloroquine and/or azithromycin. (2021).
covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/chloroquine-or-hydroxychloroquine-and-or-azithromycin/Coronavirus (COVID-19) Update: FDA revokes emergency use authorization for chloroquine and hydroxychloroquine. (2020).
fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-chloroquine-andFAQ: COVID-19 and ivermectin intended for animals.
sciencedirect.com/science/article/pii/S2255502115000127Chloroquine or hydroxychloroquine and/or azithromycin. (2021).
covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/chloroquine-or-hydroxychloroquine-and-or-azithromycin/Coronavirus (COVID-19) Update: FDA revokes emergency use authorization for chloroquine and hydroxychloroquine. (2020).
fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-chloroquine-andFAQ: COVID-19 and ivermectin intended for animals.
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(2021).
fda.gov/animal-veterinary/product-safety-information/faq-covid-19-and-ivermectin-intended-animalsFDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems. (2020).
fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-orFrancesconi P, et al.
fda.gov/animal-veterinary/product-safety-information/faq-covid-19-and-ivermectin-intended-animalsFDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems. (2020).
fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-orFrancesconi P, et al.
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(2021). COVID-19 epidemiology in rheumatic diseases in Tuscany: A case-control study.
ncbi.nlm.nih.gov/pmc/articles/PMC7825932/How to protect yourself and others. (2022).
cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.htmlHydroxychloroquine (Plaquenil).
ncbi.nlm.nih.gov/pmc/articles/PMC7825932/How to protect yourself and others. (2022).
cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.htmlHydroxychloroquine (Plaquenil).
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(2020).
rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Hydroxychloroquine-PlaquenilIvermectin. (2022).
covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/Lim SCL, et al. (2022).
rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Hydroxychloroquine-PlaquenilIvermectin. (2022).
covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/Lim SCL, et al. (2022).
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Efficacy of ivermectin treatment on disease progression among adults with mild to moderate COVID-19 and comorbidities.
jamanetwork.com/journals/jamainternalmedicine/fullarticle/2789362López-Medina E, et al. (2021). Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19.
ncbi.nlm.nih.gov/pmc/articles/PMC7934083/Raiker R, et al.
jamanetwork.com/journals/jamainternalmedicine/fullarticle/2789362López-Medina E, et al. (2021). Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19.
ncbi.nlm.nih.gov/pmc/articles/PMC7934083/Raiker R, et al.
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(2021). Outcomes of COVID-19 in patients with rheumatoid arthritis: A multicenter research network study in the United States.
ncbi.nlm.nih.gov/pmc/articles/PMC8376523/Rapid increase in ivermectin prescriptions and reports of severe illness associated with use of products containing ivermectin to prevent or treat COVID-19. (2021).
emergency.cdc.gov/han/2021/han00449.aspReis G, et al.
ncbi.nlm.nih.gov/pmc/articles/PMC8376523/Rapid increase in ivermectin prescriptions and reports of severe illness associated with use of products containing ivermectin to prevent or treat COVID-19. (2021).
emergency.cdc.gov/han/2021/han00449.aspReis G, et al.
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(2022). Effect of early treatment with ivermectin among patients with COVID-19.
nejm.org/doi/full/10.1056/NEJMoa2115869Rentsch CT, et al. (2021).
nejm.org/doi/full/10.1056/NEJMoa2115869Rentsch CT, et al. (2021).
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Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: A population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform.
thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30378-7/fulltextTemple C, et al. (2021).
thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30378-7/fulltextTemple C, et al. (2021).
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Toxic effects from ivermectin use associated with prevention and treatment of COVID-19.
nejm.org/doi/full/10.1056/NEJMc2114907Vallejos J, et al. (2021).
nejm.org/doi/full/10.1056/NEJMc2114907Vallejos J, et al. (2021).
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Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized double-blind placebo-controlled trial.
ncbi.nlm.nih.gov/pmc/articles/PMC8250562/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 20, 2022 By Daniel Yetman Edited By Corie Osborn Medically Reviewed By Margaret R.
ncbi.nlm.nih.gov/pmc/articles/PMC8250562/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 20, 2022 By Daniel Yetman Edited By Corie Osborn Medically Reviewed By Margaret R.
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Li, MD, FACR
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Share this articleMedically reviewed by Margaret R. Li, MD, FACR — By Daniel Yetman on September 20, 2022
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