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Evidence of efficacy for ivermectin is inconclusive. It should not be used outside of clinical trials.( May 2021, June 2021, June 2021, July 2021, July 2021) ( WHO, FDA, IDSA, ASHP, CDC, NIH)
Neither hydroxychloroquine nor chloroquine should be used, either alone or in combination with azithromycin, in inpatient or outpatient settings.( July 2020, Aug 2020, Sep 2020, May 2021) ( WHO, FDA, IDSA, ASHP, NIH)
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In the second paragraph of this section there is a small spelling inconsistency with the American English used in the article. I propose to change the bolded sceptical to its American English spelling skeptical.
Early in the
COVID-19 pandemic, laboratory research suggested ivermectin might have a role in preventing or treating
COVID-19.
[1] Online misinformation campaigns and advocacy boosted the drug's profile among the public. While scientists and physicians largely remained sceptical, some nations adopted ivermectin as part of their pandemic-control efforts. Some people, desperate to use ivermectin without a prescription, took veterinary preparations, which led to shortages of supplies of ivermectin for animal treatment. The
FDA responded to this situation by tweeting "You are not a horse" to draw attention to the issue.
[2]
Samipokanikan (
talk) 13:58, 17 May 2022 (UTC)
References
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typo: sceptical -> skeptical Ssxdd ( talk) 22:45, 17 May 2022 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Can we not have memes in the leads of medical articles, please? I removed the line The FDA responded to this situation by tweeting "You are not a horse" to draw attention to the issue
, but it
was reverted.
Endwise (
talk) 13:17, 28 July 2022 (UTC)
As it's interestingly expressed it also helps draw the reader into the article (as a lede should) it also helps draw the reader into the article (as a lede should)-- A Wikipedia lead should specifically not "tease people into reading further" (see MOS:NOTLEDE). The tweet itself is a joking PSA that went viral because it's funny, and subsequently became a meme. The lead already mentions that people were taking veterinary ivermectin products. The only thing the tweet adds is its humour value, which is not the kind of thing we should be including in a summary of the most important contents of a medical article. Endwise ( talk) 14:00, 28 July 2022 (UTC)
During the early pandemic, pro-ivermectin fervor was often placed in opposition to Anthony Fauci and Allopathic medicine in general." I would put it in Scientists targeted or Regulatory status and off-label use. is it open for our use, copyright-wise though? — Shibbolethink ( ♔ ♕) 15:38, 29 July 2022 (UTC)
You are not a horsesuggests that veterinary medications in general should not be used in humans; which is untrue. — kashmīrī TALK 17:30, 29 July 2022 (UTC)
"this tweet does look incredibly silly, even idiotic"← and enough of the sealioning. You've been around long enough to be better than that. Alexbrn ( talk) 19:00, 29 July 2022 (UTC)
it's good to take veterinary preparationsas you claim? You'd rather present evidence or retract your absurd accusations. You've been around not much shorter than me to know there are lines that should not be crossed in a discussion. — kashmīrī TALK 01:05, 30 July 2022 (UTC)
lines that should not be crossed in a discussion. Let's refrain from derailing this discussion into special pleading, ad hominem, or tone policing. — Shibbolethink ( ♔ ♕) 12:49, 30 July 2022 (UTC)
also in violation of MEDRS" - MEDRS is irrelevant here. — Shibbolethink ( ♔ ♕) 13:23, 30 July 2022 (UTC)
Yknow what's interesting? We don't have to rely on editor opinions alone to determine whether or not this tweet is worth including. We have guidelines such as WP:DUE and essays such as WP:RSUW. This tweet is noteworthy enough to be referenced in many multiple high quality RSes [2] [3] [4] [5] [6] [7] [8] [9] (also outside the US [10] [11] [12] and even scholarly publications [13] [14] [15], therefore it has DUE weight and should be included. If the NYT, NPR, WaPo, Guardian, El Pais, and scholars all think this is noteworthy, who are we to disagree?— Shibbolethink ( ♔ ♕) 13:20, 30 July 2022 (UTC)
a summary of [the article's] most important contents– and we see nothing that the "horse tweet" could be a summary of;
some editors here believe they are running a public health campaignis not assuming good faith. — The Hand That Feeds You: Bite 21:14, 31 July 2022 (UTC)
That tweet in the lead fails on so many fronts that I can't believe my eyes that some editors still keep pushing it in. Is it because ivermectin use has become a political statement in the United States, or what?Proposing that everyone else (especially those who disagree with you) is pushing a political agenda is the exact opposite of WP:AGF. — Shibbolethink ( ♔ ♕) 22:55, 31 July 2022 (UTC)
compared to, for instance, the widespread antibiotic use for minor viral infections (which is incorrect, obviously, and can lead to severe complications). Yet I don't see a separate article dedicated to the topic.... yknow there actually is an article which pretty closely covers that topic: Antibiotic misuse. If the FDA put out a joke tweet about it...and it was covered by many multiple reputable and trustworthy RSes (including scholarly ones and non-US ones)... Then I think it would pretty clearly deserve inclusion in that article. if you hear about such a tweet, let me know and I'll add it myself. — Shibbolethink ( ♔ ♕) 07:09, 1 August 2022 (UTC)
Metronidazole is not approved for use in dogs in the U.S." [17]"
Veterinarians use metronidazole as an off-label medication since it is not FDA-approved for dogs" [18]"
Metronidazole is not approved for use in dogs in the U.S." [19]@ SmolBrane, what expertise do you have again? Remember, I'm a microbiologist. — Shibbolethink ( ♔ ♕) 23:29, 4 August 2022 (UTC)
Perhaps it's a mistake to comment since this discussion seems dead, but one thing seems to have been missed in earlier discussion: My assumption has always been dosage risks is only one factor. Depending on the size of the pill (or whatever) and other factors, someone who understands what they are doing deal with dosage issues but I can't imagine many medical authorities are going to say it's okay for humans to take medication intended for other animals even if you properly account for dosage except in very extreme circumstances given the different production and regulatory environment etc. Giving human medication to other animals, in some circumstances sure but not the reverse. (I mentioned extreme circumstances earlier. I imagine when there is very good evidence of the benefits of a drug and they are important enough to outweigh the risks and there is really no human version available then I guess maybe it will happen. But this never applied to ivermectin.)
And I agree comparisons of repurposing drugs currently used with other animals in humans is just weird. Yes I'm sure it happens, although I'd note the 3 refs given by Kashimiri don't actually seem to demonstrate any drugs used in other animals that have actually been repurposed for use in humans. All 3 seem to just talk about the potential with some preliminary investigation of their possible use in humans. Most are so recent that it seems unlikely to me that any of those examples have already repurposed. Yet funnily enough they demonstrate a point that Kashmiri didn't seem to be trying to make. To actually repurpose drugs used in other animals for use in humans is a long and expensive process requiring a lot of work.
And in the end it's just a weird thing to talk about. It isn't necessary to repurpose ivermectin from its use in other animals since it's already approved for use in humans in other circumstances. In other words, the whole repurposing drugs used in other animals angle is irrelevant. Repurposing doesn't mean you randomly give drugs intended for other animals to humans simply by adjusting the dosage and hoping for the best, and it was never necessary with ivermectin anyway.
There was never any reason why humans should have been taking ivermectin intended for horses or any other animals. I know some people like to blame the FDA or others for the inability of people to access ivermectin for humans. But even if you believe that, it does not mean it was a good ides for humans to take ivermectin intended for anything but humans. I'd note that there is some irony in saying it's fine to try offlabel use of ivermectin for COVID-19 as a "speculative treatment given its extraordinary safety record", but in any way suggesting it was okay for humans to taken ivermectin intended for other animals. And if no one is suggesting that, then why is there controversy over the tweet?
The tweet seems an entirely fair point being made by the FDA since some people were trying to take ivermectin intended for horses. And even if these people properly accounted for dosage differences, which sadly not everyone did, it was still an incredibly bad idea. So if we all agree with that, whatever the fact that some drugs used in other animals may be repurposed for use in humans after a long and expensive process for use in humans, which also means they will then be produced for humans with all the safety and regulatory processes in place that we expect for production of drugs taken by humans, what's the fuss?
Nil Einne ( talk) 15:35, 19 August 2022 (UTC)
I can't imagine many medical authorities are going to say it's okay for humans to take medication intended for other animals even if you properly account for dosage except in very extreme circumstances given the different production and regulatory environmentAbsolutely 100%. There are differences in the quality standards and "allowable contaminants" in medications made for animals vs those made for humans. And it's not even that we, as a society, care less about animals. There are substances which would kill animals (e.g. chocolate for dogs) that would be totally fine as an inactive ingredient in human medications and vice versa (e.g. there are children's medications which include chocolate as flavoring). We are not dogs, they are not us. And we should not be taking their medications. The exception is medications for which a "human equivalent" exists. And that would mean dosage and form equivalency. In such cases, human pharmacies can fill pet prescriptions. And even THEN, the animal form of the drug is still better. It would also not include horse paste containing ivermectin. Horses need much larger doses of dewormer than humans do. It's a pharmacokinetics thing.
I'd note the 3 refs given by Kashimiri don't actually seem to demonstrate any drugs used in other animals that have actually been repurposed for use in humans.There's a reason for this! There's a lot more funding in human-centric medical research, so most drugs trickle down the other way, from humans to animals. We invent it for humans, it gets approved and works great, so a veterinary researcher sees if it could also work for dogs/cats. This is similar to what happens with pediatrics, where many techniques trickle down from adult medicine. There are just plain more adult humans, and we put a lot more funding into adult human medical research!
Anyway, this is now settled so I suggest we move on.- Alexbrn
the whole repurposing drugs used in other animals angle is irrelevant- Nil Einne100%, agree with both of you, I'm going to collapse this thread so we all move on. RV at will. — Shibbolethink ( ♔ ♕) 16:46, 19 August 2022 (UTC)
References
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I updated the "Research and clinical guidelines" section with some minor, but relevant detail such as names of RCTs. Give the publication of the result of a major RCT (with hundreds of authors), I also added to the introduction "Large-scale randomised controlled trials, described as 'the final nail in the coffin' for ivermectin as a treatment for covid, found it to be no different from placebo" (citing the same source as in the more detailed section).
All this was reverted with the summary "Undue". I think the changes to the introduction, and to "Research and clinical guidelines" improve the article. What do others think? Best wishes, Pol098 ( talk) 15:23, 29 October 2022 (UTC)
Collapse screed.
Bon courage (
talk) 12:25, 24 January 2023 (UTC)
|
---|
This page is misleading in several ways and don't reflect the reality regarding scientific research about ivermectin in prevention and treatment of covid-19. Lot of positive data are published in the scientific litterature. There are 3 main axes and many potential modes of action for ivermectin: https://www.nature.com/articles/s41429-021-00491-6 1/Re: antiviral effect. Most studies are underpowered, like https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30464-8/fulltext however the results are much compatible with an antiviral effect, with a reduction of 1.2 log10 copies/ml on day 7 (comparable with paxlovid (Hammond et al.) and more than molnupiravir (Jayk Bernal et al.). Krolewiecki et al. showed an antiviral effect when high plasma concentration of ivm is obtained. High plasma concentration can be obtained if IVM is prescribed in a fed state, what is generally what ivm promoters advocate for (FLCCC). In all trials qualified here as " failing to confirm the utility of ivermectin for COVID-19", the drug was prescribed on an empty stomach. All new antiviral drugs (molnupiravir, paxlovid) have been tested in trials that satisfy some conditions: a) early treatment (generally <5 days after symptom onset) b) at risk population (old or with some comorbidities, unvaccinated) in order to asses an effect on c) hard outcome (hospitalization or death). Ivermectin was not tested this way in large RCT accepted by western medical community. 2/Re: prophylaxis. Ivermectin is the only antiviral that is proven to be efficient as a prophylactic drug: https://www.medincell.com/wp-content/uploads/2023/01/PR-results-TTG-VF-EN.pdf confirming antiviral effect. Paxlovid failed in a trial sponsored by pfizer: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-shares-top-line-results-phase-23-epic-pep-study. All prophylaxis studies before the MedinCell press release were profoundly positive (Shouman et al., Kerr et al.) but not qualified as good enough quality research by agencies. WHO specifically stated that they were not interested in looking at prevention for IVM in his guideline for treatment published in March 2021, in which the meta-analysis showed an astonishing 81% reduction of mortality, but the evidence was downgraded by 2 levels due to "very serious imprecision" in contradiction with GRADE guidelines. 3/Re: mortality. The data are still positive for reducing mortality in hospitalized patients, see for example highly credential live meta-analysis: https://covid-nma.com/metacovid/ showing a 54% reduction of mortality. 4/Re: severely hypoxic patients: it has been claimed that ivermectin in combination with doxycycline, zinc and vitamine D could be highly effective to treat severely hypoxic patients (Hazan et al., Stone et al.). This hypothesis was never tested in big randomized trials.
|
Please retract this misleading page and write a narrative which reflects the truth of the controversy and is in accordance with the whole body of evidence. 2A02:1210:7A82:8F00:E53A:2892:16B6:9BCE ( talk) 12:18, 24 January 2023 (UTC)
Bon courage ( talk) 14:19, 24 January 2023 (UTC)inhibitory concentrations of ivermectin are unlikely to be achieved in humans at clinically safe doses
For example, none of your sources support your claim: "doses much higher than the maximum approved or safely achievable for use in humans would be required for an antiviral effect while treating COVID-19." This assertion is refuted by research assessing antiviral effect of ivermectin in vivo
3/They didn't apply their own new criteria: https://doyourownresearch.substack.com/p/the-cochrane-review-on-ivermectin
this is bad scientific practice. Wikipedia should not refer to bad scientific practiceThis (and most of your comments) appear to be your opinion, otherwise known as original research, which is not permitted on wikipedia. In assessing your linked sources, I do not see any which are more reliable than the current cited sources by our standards (see MEDASSESS linked above, the banner at the top of this page, and especially WP:MEDSCI). As such, I see no reason to change anything on this page. Come back with higher quality sources (no primary research, no animal papers, no substack newsletters, etc. see WP:MEDRS), or find a more lenient venue for arguing about the topic itself. Wikipedia is not a forum for debates. We care only about the quality of sources, and what they say. — Shibbolethink ( ♔ ♕) 19:29, 24 January 2023 (UTC)
The Fifth Circuit Court just criticized the FDA for discouraging doctors from using Ivermectin to treat patients with Covid-19.
Source: https://www.ca5.uscourts.gov/opinions/pub/22/22-40802-CV0.pdf
SquirrelHill1971 ( talk) 03:44, 16 September 2023 (UTC)
This is the
talk page for discussing improvements to the
Ivermectin during the COVID-19 pandemic article. This is not a forum for general discussion of the article's subject. |
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1Auto-archiving period: 100 days
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![]() | The subject of this article is controversial and content may be in dispute. When updating the article, be bold, but not reckless. Feel free to try to improve the article, but don't take it personally if your changes are reversed; instead, come here to the talk page to discuss them. Content must be written from a neutral point of view. Include citations when adding content and consider tagging or removing unsourced information. |
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WikiProject COVID-19 consensus WikiProject COVID-19 aims to add to and build consensus for pages relating to COVID-19. They have so far discussed items listed below. Please discuss proposed improvements to them at the project talk page.
To ensure you are viewing the current list, you may wish to . |
![]() | This article is written in British English, which has its own spelling conventions (colour, travelled, centre, defence, artefact, analyse) and some terms that are used in it may be different or absent from other varieties of English. According to the relevant style guide, this should not be changed without broad consensus. |
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A note on WP:MEDRS: Per this Wikipedia policy, we must rely on the highest quality secondary sources and the recommendations of professional organizations and government bodies when determining the scientific consensus about medical treatments.
Evidence of efficacy for ivermectin is inconclusive. It should not be used outside of clinical trials.( May 2021, June 2021, June 2021, July 2021, July 2021) ( WHO, FDA, IDSA, ASHP, CDC, NIH)
Neither hydroxychloroquine nor chloroquine should be used, either alone or in combination with azithromycin, in inpatient or outpatient settings.( July 2020, Aug 2020, Sep 2020, May 2021) ( WHO, FDA, IDSA, ASHP, NIH)
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In the second paragraph of this section there is a small spelling inconsistency with the American English used in the article. I propose to change the bolded sceptical to its American English spelling skeptical.
Early in the
COVID-19 pandemic, laboratory research suggested ivermectin might have a role in preventing or treating
COVID-19.
[1] Online misinformation campaigns and advocacy boosted the drug's profile among the public. While scientists and physicians largely remained sceptical, some nations adopted ivermectin as part of their pandemic-control efforts. Some people, desperate to use ivermectin without a prescription, took veterinary preparations, which led to shortages of supplies of ivermectin for animal treatment. The
FDA responded to this situation by tweeting "You are not a horse" to draw attention to the issue.
[2]
Samipokanikan (
talk) 13:58, 17 May 2022 (UTC)
References
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typo: sceptical -> skeptical Ssxdd ( talk) 22:45, 17 May 2022 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Can we not have memes in the leads of medical articles, please? I removed the line The FDA responded to this situation by tweeting "You are not a horse" to draw attention to the issue
, but it
was reverted.
Endwise (
talk) 13:17, 28 July 2022 (UTC)
As it's interestingly expressed it also helps draw the reader into the article (as a lede should) it also helps draw the reader into the article (as a lede should)-- A Wikipedia lead should specifically not "tease people into reading further" (see MOS:NOTLEDE). The tweet itself is a joking PSA that went viral because it's funny, and subsequently became a meme. The lead already mentions that people were taking veterinary ivermectin products. The only thing the tweet adds is its humour value, which is not the kind of thing we should be including in a summary of the most important contents of a medical article. Endwise ( talk) 14:00, 28 July 2022 (UTC)
During the early pandemic, pro-ivermectin fervor was often placed in opposition to Anthony Fauci and Allopathic medicine in general." I would put it in Scientists targeted or Regulatory status and off-label use. is it open for our use, copyright-wise though? — Shibbolethink ( ♔ ♕) 15:38, 29 July 2022 (UTC)
You are not a horsesuggests that veterinary medications in general should not be used in humans; which is untrue. — kashmīrī TALK 17:30, 29 July 2022 (UTC)
"this tweet does look incredibly silly, even idiotic"← and enough of the sealioning. You've been around long enough to be better than that. Alexbrn ( talk) 19:00, 29 July 2022 (UTC)
it's good to take veterinary preparationsas you claim? You'd rather present evidence or retract your absurd accusations. You've been around not much shorter than me to know there are lines that should not be crossed in a discussion. — kashmīrī TALK 01:05, 30 July 2022 (UTC)
lines that should not be crossed in a discussion. Let's refrain from derailing this discussion into special pleading, ad hominem, or tone policing. — Shibbolethink ( ♔ ♕) 12:49, 30 July 2022 (UTC)
also in violation of MEDRS" - MEDRS is irrelevant here. — Shibbolethink ( ♔ ♕) 13:23, 30 July 2022 (UTC)
Yknow what's interesting? We don't have to rely on editor opinions alone to determine whether or not this tweet is worth including. We have guidelines such as WP:DUE and essays such as WP:RSUW. This tweet is noteworthy enough to be referenced in many multiple high quality RSes [2] [3] [4] [5] [6] [7] [8] [9] (also outside the US [10] [11] [12] and even scholarly publications [13] [14] [15], therefore it has DUE weight and should be included. If the NYT, NPR, WaPo, Guardian, El Pais, and scholars all think this is noteworthy, who are we to disagree?— Shibbolethink ( ♔ ♕) 13:20, 30 July 2022 (UTC)
a summary of [the article's] most important contents– and we see nothing that the "horse tweet" could be a summary of;
some editors here believe they are running a public health campaignis not assuming good faith. — The Hand That Feeds You: Bite 21:14, 31 July 2022 (UTC)
That tweet in the lead fails on so many fronts that I can't believe my eyes that some editors still keep pushing it in. Is it because ivermectin use has become a political statement in the United States, or what?Proposing that everyone else (especially those who disagree with you) is pushing a political agenda is the exact opposite of WP:AGF. — Shibbolethink ( ♔ ♕) 22:55, 31 July 2022 (UTC)
compared to, for instance, the widespread antibiotic use for minor viral infections (which is incorrect, obviously, and can lead to severe complications). Yet I don't see a separate article dedicated to the topic.... yknow there actually is an article which pretty closely covers that topic: Antibiotic misuse. If the FDA put out a joke tweet about it...and it was covered by many multiple reputable and trustworthy RSes (including scholarly ones and non-US ones)... Then I think it would pretty clearly deserve inclusion in that article. if you hear about such a tweet, let me know and I'll add it myself. — Shibbolethink ( ♔ ♕) 07:09, 1 August 2022 (UTC)
Metronidazole is not approved for use in dogs in the U.S." [17]"
Veterinarians use metronidazole as an off-label medication since it is not FDA-approved for dogs" [18]"
Metronidazole is not approved for use in dogs in the U.S." [19]@ SmolBrane, what expertise do you have again? Remember, I'm a microbiologist. — Shibbolethink ( ♔ ♕) 23:29, 4 August 2022 (UTC)
Perhaps it's a mistake to comment since this discussion seems dead, but one thing seems to have been missed in earlier discussion: My assumption has always been dosage risks is only one factor. Depending on the size of the pill (or whatever) and other factors, someone who understands what they are doing deal with dosage issues but I can't imagine many medical authorities are going to say it's okay for humans to take medication intended for other animals even if you properly account for dosage except in very extreme circumstances given the different production and regulatory environment etc. Giving human medication to other animals, in some circumstances sure but not the reverse. (I mentioned extreme circumstances earlier. I imagine when there is very good evidence of the benefits of a drug and they are important enough to outweigh the risks and there is really no human version available then I guess maybe it will happen. But this never applied to ivermectin.)
And I agree comparisons of repurposing drugs currently used with other animals in humans is just weird. Yes I'm sure it happens, although I'd note the 3 refs given by Kashimiri don't actually seem to demonstrate any drugs used in other animals that have actually been repurposed for use in humans. All 3 seem to just talk about the potential with some preliminary investigation of their possible use in humans. Most are so recent that it seems unlikely to me that any of those examples have already repurposed. Yet funnily enough they demonstrate a point that Kashmiri didn't seem to be trying to make. To actually repurpose drugs used in other animals for use in humans is a long and expensive process requiring a lot of work.
And in the end it's just a weird thing to talk about. It isn't necessary to repurpose ivermectin from its use in other animals since it's already approved for use in humans in other circumstances. In other words, the whole repurposing drugs used in other animals angle is irrelevant. Repurposing doesn't mean you randomly give drugs intended for other animals to humans simply by adjusting the dosage and hoping for the best, and it was never necessary with ivermectin anyway.
There was never any reason why humans should have been taking ivermectin intended for horses or any other animals. I know some people like to blame the FDA or others for the inability of people to access ivermectin for humans. But even if you believe that, it does not mean it was a good ides for humans to take ivermectin intended for anything but humans. I'd note that there is some irony in saying it's fine to try offlabel use of ivermectin for COVID-19 as a "speculative treatment given its extraordinary safety record", but in any way suggesting it was okay for humans to taken ivermectin intended for other animals. And if no one is suggesting that, then why is there controversy over the tweet?
The tweet seems an entirely fair point being made by the FDA since some people were trying to take ivermectin intended for horses. And even if these people properly accounted for dosage differences, which sadly not everyone did, it was still an incredibly bad idea. So if we all agree with that, whatever the fact that some drugs used in other animals may be repurposed for use in humans after a long and expensive process for use in humans, which also means they will then be produced for humans with all the safety and regulatory processes in place that we expect for production of drugs taken by humans, what's the fuss?
Nil Einne ( talk) 15:35, 19 August 2022 (UTC)
I can't imagine many medical authorities are going to say it's okay for humans to take medication intended for other animals even if you properly account for dosage except in very extreme circumstances given the different production and regulatory environmentAbsolutely 100%. There are differences in the quality standards and "allowable contaminants" in medications made for animals vs those made for humans. And it's not even that we, as a society, care less about animals. There are substances which would kill animals (e.g. chocolate for dogs) that would be totally fine as an inactive ingredient in human medications and vice versa (e.g. there are children's medications which include chocolate as flavoring). We are not dogs, they are not us. And we should not be taking their medications. The exception is medications for which a "human equivalent" exists. And that would mean dosage and form equivalency. In such cases, human pharmacies can fill pet prescriptions. And even THEN, the animal form of the drug is still better. It would also not include horse paste containing ivermectin. Horses need much larger doses of dewormer than humans do. It's a pharmacokinetics thing.
I'd note the 3 refs given by Kashimiri don't actually seem to demonstrate any drugs used in other animals that have actually been repurposed for use in humans.There's a reason for this! There's a lot more funding in human-centric medical research, so most drugs trickle down the other way, from humans to animals. We invent it for humans, it gets approved and works great, so a veterinary researcher sees if it could also work for dogs/cats. This is similar to what happens with pediatrics, where many techniques trickle down from adult medicine. There are just plain more adult humans, and we put a lot more funding into adult human medical research!
Anyway, this is now settled so I suggest we move on.- Alexbrn
the whole repurposing drugs used in other animals angle is irrelevant- Nil Einne100%, agree with both of you, I'm going to collapse this thread so we all move on. RV at will. — Shibbolethink ( ♔ ♕) 16:46, 19 August 2022 (UTC)
References
{{
cite journal}}
: CS1 maint: PMC format (
link) CS1 maint: unflagged free DOI (
link)
{{
cite journal}}
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I updated the "Research and clinical guidelines" section with some minor, but relevant detail such as names of RCTs. Give the publication of the result of a major RCT (with hundreds of authors), I also added to the introduction "Large-scale randomised controlled trials, described as 'the final nail in the coffin' for ivermectin as a treatment for covid, found it to be no different from placebo" (citing the same source as in the more detailed section).
All this was reverted with the summary "Undue". I think the changes to the introduction, and to "Research and clinical guidelines" improve the article. What do others think? Best wishes, Pol098 ( talk) 15:23, 29 October 2022 (UTC)
Collapse screed.
Bon courage (
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This page is misleading in several ways and don't reflect the reality regarding scientific research about ivermectin in prevention and treatment of covid-19. Lot of positive data are published in the scientific litterature. There are 3 main axes and many potential modes of action for ivermectin: https://www.nature.com/articles/s41429-021-00491-6 1/Re: antiviral effect. Most studies are underpowered, like https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30464-8/fulltext however the results are much compatible with an antiviral effect, with a reduction of 1.2 log10 copies/ml on day 7 (comparable with paxlovid (Hammond et al.) and more than molnupiravir (Jayk Bernal et al.). Krolewiecki et al. showed an antiviral effect when high plasma concentration of ivm is obtained. High plasma concentration can be obtained if IVM is prescribed in a fed state, what is generally what ivm promoters advocate for (FLCCC). In all trials qualified here as " failing to confirm the utility of ivermectin for COVID-19", the drug was prescribed on an empty stomach. All new antiviral drugs (molnupiravir, paxlovid) have been tested in trials that satisfy some conditions: a) early treatment (generally <5 days after symptom onset) b) at risk population (old or with some comorbidities, unvaccinated) in order to asses an effect on c) hard outcome (hospitalization or death). Ivermectin was not tested this way in large RCT accepted by western medical community. 2/Re: prophylaxis. Ivermectin is the only antiviral that is proven to be efficient as a prophylactic drug: https://www.medincell.com/wp-content/uploads/2023/01/PR-results-TTG-VF-EN.pdf confirming antiviral effect. Paxlovid failed in a trial sponsored by pfizer: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-shares-top-line-results-phase-23-epic-pep-study. All prophylaxis studies before the MedinCell press release were profoundly positive (Shouman et al., Kerr et al.) but not qualified as good enough quality research by agencies. WHO specifically stated that they were not interested in looking at prevention for IVM in his guideline for treatment published in March 2021, in which the meta-analysis showed an astonishing 81% reduction of mortality, but the evidence was downgraded by 2 levels due to "very serious imprecision" in contradiction with GRADE guidelines. 3/Re: mortality. The data are still positive for reducing mortality in hospitalized patients, see for example highly credential live meta-analysis: https://covid-nma.com/metacovid/ showing a 54% reduction of mortality. 4/Re: severely hypoxic patients: it has been claimed that ivermectin in combination with doxycycline, zinc and vitamine D could be highly effective to treat severely hypoxic patients (Hazan et al., Stone et al.). This hypothesis was never tested in big randomized trials.
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Please retract this misleading page and write a narrative which reflects the truth of the controversy and is in accordance with the whole body of evidence. 2A02:1210:7A82:8F00:E53A:2892:16B6:9BCE ( talk) 12:18, 24 January 2023 (UTC)
Bon courage ( talk) 14:19, 24 January 2023 (UTC)inhibitory concentrations of ivermectin are unlikely to be achieved in humans at clinically safe doses
For example, none of your sources support your claim: "doses much higher than the maximum approved or safely achievable for use in humans would be required for an antiviral effect while treating COVID-19." This assertion is refuted by research assessing antiviral effect of ivermectin in vivo
3/They didn't apply their own new criteria: https://doyourownresearch.substack.com/p/the-cochrane-review-on-ivermectin
this is bad scientific practice. Wikipedia should not refer to bad scientific practiceThis (and most of your comments) appear to be your opinion, otherwise known as original research, which is not permitted on wikipedia. In assessing your linked sources, I do not see any which are more reliable than the current cited sources by our standards (see MEDASSESS linked above, the banner at the top of this page, and especially WP:MEDSCI). As such, I see no reason to change anything on this page. Come back with higher quality sources (no primary research, no animal papers, no substack newsletters, etc. see WP:MEDRS), or find a more lenient venue for arguing about the topic itself. Wikipedia is not a forum for debates. We care only about the quality of sources, and what they say. — Shibbolethink ( ♔ ♕) 19:29, 24 January 2023 (UTC)
The Fifth Circuit Court just criticized the FDA for discouraging doctors from using Ivermectin to treat patients with Covid-19.
Source: https://www.ca5.uscourts.gov/opinions/pub/22/22-40802-CV0.pdf
SquirrelHill1971 ( talk) 03:44, 16 September 2023 (UTC)