By Karen Kier
Pharmacist on behalf of the ONU HealthWise team
ONU HealthWise Pharmacy

Dr. Dolittle was a fictional character created by Hugh Lofting in the 1920s. Mr. Lofting wrote imaginative stories about a physician who talked to animals. Lofting started writing about Dr. Dolittle in letters to his children while fighting in World War I. His first book was written in 1920 and was titled The Story of Dr. Dolittle. In 1922, he wrote The Voyages of Dr. Dolittle, which was awarded the Newbery Medal in 1923 for distinguished contribution to American literature for children. The fascination with Dr. Dolittle has continued for over a hundred years. Some may remember Rex Harrison in the 1967 film of Dr. Dolittle or others may have seen Eddie Murphy as the main character in 1998. For those even younger, you may have seen the 2020 live action adaptation starring Robert Downey, Jr.  No matter who you remember as Dr. Dolittle, the animals are trying to talk to us!  Do you know what their message is? The animals are telling us to not take their medications. Stop buying veterinary grade pharmaceuticals that can be purchased over the counter at many farming stores. The animals are warning us of dangers ahead.

The animals are not the only ones warning us of danger but the FDA, the CDC, as well as medical and health professionals are sounding the alarm. On August 23, 2021, WebMD warned that veterinary ivermectin meant for horses and cattle can be dangerous and cause deaths.  The FDA went to Twitter and posted “You are not a horse. You are not a cow. Seriously, y’all.  Stop it”. The FDA has received reports of people hospitalized after taking ivermectin produced for horses. Overdoses of ivermectin can lead to nausea, vomiting, diarrhea, low blood pressure, dizziness, balance issues with falls, seizures, coma, and death. No ivermectin products have been FDA approved to treat COVID-19 in humans. The State of Ohio Board of Pharmacy released a CDC Health Alert to pharmacists on August 26, 2021 warning of the rapid increase in ivermectin prescriptions with reports of severe illnesses associated with inappropriate use. The memo warned of the increase in calls to the national poison control centers due to overdoses from ivermectin.

Ivermectin is available as a veterinary product, as well as a human product. Ivermectin is primarily used in animals for its ability to prevent and treat parasites.  Animal grade formulations are made differently. Certainly the active ingredient, ivermectin, is the same but the difference is the inactive ingredients that bind the drug together. In addition, the animal medications come in higher concentrations. Dosage forms are manufactured specific for humans and the active and inactive ingredients have been studied in humans for their ability to work and to be safe.

Ivermectin has been studied in adults for managing COVID-19 symptoms. The studies have been controlled clinical trials.  The Journal of the American Medical Association published one of these studies in April 2021 and the researchers found no benefit in the resolution of COVID-19 symptoms in mild disease with the use of ivermectin.  A group of authors from the United Kingdom evaluated 15 clinical studies looking at ivermectin as a means to reduce the risk of death associated with COVID-19.  The combined data had substantial variability, which makes it hard to apply to all people but they did find moderate evidence that there may be a reduced risk of death with human tablets of ivermectin.  However, they found no evidence that ivermectin could help resolve symptoms or prevent someone from needing mechanical ventilation. The risk of taking ivermectin does not outweigh the benefits. 

So what does work and shows some benefit? The FDA has reauthorized the national distribution of the combination of bamlanivimab and etesevimab, which had been paused in June due to the inability of the drugs to work against the beta and gamma COVID-19 variants.  The reauthorization is due to the retained activity of the combination against the delta variant.  The combination is not being distributed to all states right now but rather is going to states with low rates of variants that do not respond to the drugs. In other words, it is going to states where the primary variant is the delta mutation. Ohio is one of 22 states authorized for this combination. Other nearby states who are listed include Indiana, Illinois, Michigan, and Wisconsin. 

The FDA has given emergency use authorization (EUA) to 2 other medications to treat mild to moderate COVID-19 infections in individuals with a high risk of progression to hospitalization.  The drugs can be used in 12 years and up weighing at least 88 pounds. Sotrovimab is a one-time dose given as an intravenous infusion. The other is a combination of casirivimab and imdevimab (known as Regen-COV), which is given by injection either by intravenous infusion or injected into skin tissue (subcutaneous). Regen-COV can be given as post-exposure prophylaxis as well. These medications have far more evidence of benefit in mild to moderate COVID-19 symptoms than ivermectin. So listen to the animals!

Feel free to call the ONU HealthWise Pharmacy or talk to your health care professional. ONU HealthWise is offering walk-ins for COVID-19 vaccines. We still want to take calls and provide the best information possible.  Call the pharmacy to get more information on getting vaccinated.