Editing Ivermectin

== Ivermectin for long haulers ==

Ivermectin is part of the FLCCC's I-RECOVER protocol (as of Jan 19, 2021): https://covid19criticalcare.com/covid-19-protocols/i-recover-protocol/

Some patients report a noticeable reduction of symptoms while they are on the drug.  However, their symptoms come back if they discontinue ivermectin.  Others report that the drug does nothing for them.

Because ivermectin has been used in humans for decades, its safety track record is fairly well-established.

== Safety ==

Mainstream media tends to spread misinformation about ivermectin, occasionally referring to the drug as “horse dewormer”. The drug has been used in both humans and horses. The drug is FDA approved for humans (Stromectrol, Soolantra) and is on the WHO list of essential medicines.

The academic literature has some papers saying that the drug may not necessarily be safe in pregnant women. You may wish to do your own research to figure out whether or not the drug is safe for pregnancy. Chris Martenson has a deep dive into the drug’s safety [https://youtu.be/ATiX0-2PEr4 on Youtube]. He argues that the drug is safe in pregnant women because it has been used widely in pregnant mothers without issues.

As with any drug, there can be side effects. WebMd has [https://www.webmd.com/drugs/2/drug-1122/ivermectin-oral/details a list of side effects]. Tell your doctor right away if any of these rare but very serious side effects occur:

* neck/back pain
* swelling face/arms/hands/feet
* chest pain
* fast heartbeat
* confusion
* seizures
* loss of consciousness.

Seek immediate medical attention if you notice any symptoms of a serious allergic reaction.

You may be less likely to die from ivermectin than Tylenol. The WHO’s side effect reporting database can be accessed at [http://www.vigiaccess.org/ vigiAccess.org]. Deaths are reported under Adverse Drug Reactions –&gt; General disorders. Ivermectin has 21 deaths associated with it while Tylenol has 3811, Remdesivir has 557, and Covid vaccines have 10578. (These deaths ''may'' be caused by the drug but aren’t necessarily caused by the drug. There are many deaths where doctors aren’t sure about the cause of death.)

Veterinary ivermectin can contain problematic ingredients, so please research it carefully.

== How to get ivermectin ==

=== Country-specific information ===
==== United States 🇺🇸 ====
There are at least 2 telemedicine services whose doctors will prescribe ivermectin, e.g. Push Health and MyFreeDoctor.com.

Americans can use the GoodRX website to lower the cost of their prescription.

[https://www.alldaychemist.com/ AllDayChemist.com] will sell cheap Indian ivermectin to the US.  For tips on buying from online pharmacies like All Day Chemist, please see [https://solutionsbymimi.com/india-pharmacies/ Mimi's blog post on Indian pharmacies].

==== Canada 🇨🇦 ====

'''Option A''': Canadian COVID Telehealth provides uninsured services to Canadians such as an ivermectin prescription for vaccine injury, long COVID, etc.  They will also recommend a pharmacy that will not cancel your prescription.  Please check their website regarding which provinces they currently serve: https://www.covidtelehealth.ca/

'''Option B''': Indian telemedicine doctors may be able to prescribe ivermectin AND arrange for a pharmacy to drop-ship medications to the patient legally (WITH a prescription).  Paperwork is required.  Because shipment from India takes time, patients need to order drugs well in advance of needing them for COVID early treatment.  Whether customs allows prescription meds through will vary from province to province.  See [https://www.darrelldemello.in/ Dr. Darrell Demello].

'''Option C''': Many online resellers/pharmacies will not ship to Canada (e.g. Mexipharmacy, most India-based pharmacies / resellers).  Fortunately, [https://okdermo.com/ OkDermo.com] from Malaysia will as well as [https://www.emedsmart.co/ Emedsmart.co](?).  OkDermo.com does not consistently get past BC customs.  An Indian vendor [https://www.saenterprisesrx.com/ SA Enterprises] may ship to Canada but they say that they do not get the shipment past customs ~30% of the time; currently, they do not seem willing to ship to Canada.  [https://www.actizapharma.com/products/ivermectin-12mg/ Actiza Pharma] may be willing to ship to Canada and currently accepts payment via credit card (via Paypal); contact them at sales@actizapharma.com.  For more information, see the page on [[Prescription-free_online_pharmacies#SAEnterprisesRX.com|prescription-free online pharmacies]].

'''Option C (veterinary, not recommended)''': HomeLabVet.com in Ukraine will sell veterinary ivermectin.  (Note: the ivermectin is 2% rather than 1% and some type of syringe or measuring device would be needed to measure the liquid for oral consumption.  Glycerol formal sees very little use in humans.)  Despite the war there, Ukraine's air mail shipping has resumed and was still functioning as of July 2022.

'''Option D (veterinary, not recommended)''': Many of the Canadian online sellers will cancel orders to residential addresses and people who don't own horses.

==== Australia 🇦🇺 ====

Australian doctors are not allowed to prescribe ivermectin except in a very narrow set of diagnoses, since their drug regulator (the TGA) banned its off-label use. See here [https://www.tga.gov.au/news/media-releases/new-restrictions-prescribing-ivermectin-covid-19 www.tga.gov.au/news/media-releases/new-restrictions-prescribing-ivermectin-covid-19]

Australia does allow the importation of some medications for personal use. See [https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme]

However, ivermectin is listed on [https://www.legislation.gov.au/Details/F2023L00067 Schedule 4 of the Poisons Standard], meaning that legitimate importation requires a doctors prescription. As described in the above paragraph, this cannot be obtained from an Australian-based doctor. It is unclear whether a script from an overseas doctor will suffice.

Regardless, a number of Australian residents have been able to import ivermectin themselves, in small quantities for personal use.

[https://www.safegenericpharmacy.com/shipping-rates Safe Generic Pharmacy] (India) and [https://okdermo.com/ OK Dermo] (based in Malaysia) will ship to Australia.  India-based sellers listing on [https://www.indiamart.com indiamart.com] may ship to Australia.

[https://www.alldaychemist.com/imrotab-12mg.html AllDayChemist] will not ship ivermectin to Australia.

=== General information ===

Some countries like Mexico sell the drug over the counter. If you are within driving distance, this is one of the easiest options.

Another good option is to get a prescription from a doctor. The FLCCC website has <s>[https://covid19criticalcare.com/providers/ a directory of doctors]</s> that lists doctors friendly to their protocol. However, you will also need to find a pharmacy willing to fill the prescription. If you have problems, the FLCCC website has [https://covid19criticalcare.com/pharmacies/ a list of ivermectin-friendly pharmacies].

<strike>You can search the [https://www.reddit.com/r/ivermectin/search/?q=myfreedoctor&restrict_sr=1 r/ivermectin subreddit] for the name of your country for country-specific details on obtaining ivermectin.</strike>

Another option is to buy veterinary ivermectin. While it is cheap and often does not require a prescription, some websites like FarmersFarmacy will cancel your order if they see that you are using a non-rural address. There may also be ivermectin shortages due to supply/demand. Rural stores like Tractor Supply will sell horse paste if you are willing to drive hours to get ivermectin on short notice.

You can buy ivermectin from foreign countries like India, e.g. Indiamart.com, medicinevilla.com. However, one researcher found that all of the pills he sourced from India contained undisclosed active ingredients- see [http://www.samj.org.za/index.php/samj/article/view/13210/9742 this paper]. The paper states that Biomec12 from Bangladesh did not contain undisclosed active ingredients. 

Indian sellers often do not ship to certain developed countries such as Canada, Germancy, Austria, Belgium, Greece, Italy, Netherlands, Finland, Sweden, and Denmark.  One online reseller has a list of countries here: https://www.alldaychemist.com/do-not-ship  Indian (re)sellers will likely ship to these countries:
* Australia
* Indonesia
* Israel
* Japan
* Malaysia
* Peru
* Philippines
* Puerto Rico
* Singapore
* Taiwan
* Thailand
* Ukraine
* United Kingdom
* United States
* Vietnam

The FLCCC website has [https://covid19criticalcare.com/pharmacies/ a list of online pharmacies] that will sell ivermectin without a prescription. However, many of those websites don’t state the brand of generic ivermectin being sold and its country of origin. [http://medixpharma.com.mx/eng/item/2428/veridex-ivermectin-2tab-6mg A Mexican pharmacy called MedixPharma/MexiPharmacy] sells ivermectin made in Mexico.

== Veterinary ivermectin ==

Veterinary ivermectin can sometimes be much cheaper.  '''Human ivermectin may be more compelling because it is less suspect and can be much easier to obtain'''.

Veterinary ivermectin is regulated differently and is NOT the same as regular human ivermectin.  The filler ingredients are different than human ivermectin.

Do not buy anything with “Gold”, “plus”, “extra”, “super”, or “pour on” in the name- these contain ingredients that you should not be eating. For example, ivermectin is often combined with another anti-parasite drug and there is no need for you to take that other drug.

If you only want a few or several doses of veterinary ivermectin, horse paste is a good choice. Some manufacturers disclose the ingredients to their product. You can find safety sheets for a particular brand by doing a web engine search for brand name + list of excipients. Here are some brands that are relevant:

* Bimectin horse paste is available in US and Canada. Ingredients list [https://www.nesanimalhealth.co.uk/ekmps/shops/3046b1/resources/Other/bimectin-spc-131098-2-.pdf here]: ivermectin, Maize Oil, Polysorbate 80, Apple Flavour, Silica Colloidal Anhydrous.
* Eqvalan is available in the US and Canada. Ingredients list [https://www.noahcompendium.co.uk/?id=-453450&template=template_printview here]: Ivermectin, Titanium dioxide (E171), Hyprolose, Hydrogenated castor oil, Propylene glycol
* Nexmectin is available in the UK. Nexmectin [https://www.vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_1640157.PDF ingredients] are: ivermectin, Hydrogenated Castor Oil, Hydroxypropylcellulose, Titanium Dioxide (E171), Propylene Glycol.

All of these ingredients are used in human food except for ivermectin.

=== The injectable version (for eating, NOT injection) ===

Another veterinary option is the injectable form of ivermectin, which can be cheaper if you are buying large quantities of ivermectin. It is less convenient than human pills and horse paste. 

Injectable ivermectin usually contains an ingredient that sees very little use in humans: glycerol formal. It is used in a single human medicine (Apotel). You probably should not ingest glycerol formal if you are pregnant as it may be teratogenic- we have very little experience with it in humans. Like alcohol, glycerol formal [https://www.ema.europa.eu/en/documents/mrl-report/glycerol-formal-summary-report-committee-veterinary-medicinal-products_en.pdf causes birth defects in test animals in high doses].

This ivermectin will come in a bottle designed to be used with syringes, so buy a box of 3mL to 25mL syringes. Any gauge and needle length should be fine. [https://youtu.be/VRypa9gjTPE This Youtube video] demonstrates aseptic technique for getting the liquid out of the bottle. You can buy rubbing/cleaning alcohol at dollar stores like Dollarama and at pharmacies. For sharps disposal, use any plastic jug/bottle and store used syringes there. If you want, you can take used syringes to a place that disposes biohazardous waste for free (e.g. a pharmacy).

Some veterinary ivermectin comes in a bottle that is ''not'' designed for aseptic technique.  You may find it helpful to remove the inner cap so that you can insert a syringe all the way into the bottle.

==== Ingredients in injectable ivermectin ====

These brands:
* Ivomec Classic ([https://www.hpra.ie/img/uploaded/swedocuments/Licence_VPA10454-064-001_27072018161334.pdf data sheet])
* Ivomec by Merial / Boehringer Ingelheim ([https://datasheets.scbt.com/sc-359308.pdf data sheet])
* Bimeda / Bimectin Injection ([https://datasheets.scbt.com/sc-359309_mfr.pdf data sheet])
* Promectin ([https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=6155fed6-e6b9-4120-8cf9-80e9a23f0764&type=pdf&name=6155fed6-e6b9-4120-8cf9-80e9a23f0764 webpage])
* Panomec Injection ([https://www.vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_136088.PDF data sheet]) 
contain Glycerol formal, Propylene Glycol, and Ivermectin.

This brand:
* Noromectin ([https://docetp.mpa.se/LMF/Noromectin%20vet.%20solution%20for%20injection%20ENG%20SmPC_09001bee807a59e9.pdf data sheet]) 
contains Thiodipropionic acid, N-propyl gallate, Disodium edetate, Glycerol Formal, Polyethylene Glycol / Macrogol 200

The Ukrainian brand:
* Brovermektin (datasheet in [https://brovapharma.ua/brovermektin-2_10-ml Ukrainian] and [https://docs.google.com/document/d/11KQL4lRPpX8iG8pXpJuT_ek8PZyl64gqqdFDmq8Hzp4/edit?usp=sharing English]) 
contains glycerol formal, propylene glycol, polysorbate - 80.

==== Ingredients in liquid ivermectin ====

* AVL - https://www.reddit.com/r/ivermectin/comments/okzmkx/harm_reduction_veterinary_ivermectin_in_canada/

== Allergy information ==

Both human and veterinary ivermectin contain potential allergens, which are listed below.

* '''Ivermectin''' - If you turn out to be allergic to ivermectin, you should probably stop using it.
* '''Wheat, corn starch''' - occasionally found in human medications, which often do not disclose their ingredients. Horse pastes contain vegetable oils like maize oil, which is like corn. Stromectol, ivermectin made by Merck, contains contains pregelatinized '''maize''' starch and is gluten free according to [https://www.nps.org.au/medicine-finder/stromectol-blister-pack-tablets this webpage].
* '''Propylene Glycol''' - found in some horse pastes and injectable veterinary ivermectin.  Also found in salad dressing, which may help you figure out your allergies.
* '''Polyethylene Glycol and polysorbate''' - Found in some vaccines, horse pastes, and injectable ivermectin.  Also found in some cosmetics and in constipation treatments for children.
* '''Vaccines''' - Some vaccines like the mRNA COVID vaccines contain polyethlene glycol, so see the previous information on that chemical.

== Dosage calculator ==

Figure out your target dosage based on a protocol such as the [https://covid19criticalcare.com/covid-19-protocols/i-recover-protocol/ FLCCC I-RECOVER protocol for long haul]. '''A dosage calculator is available through [https://docs.google.com/spreadsheets/d/18fgfDtf_ws2vUw52jomoPSFUvVZsF1MotNXj26PZhNk/edit?usp=sharing this Google sheet]'''. Simply go to File –&gt; Make a Copy and then enter in your weight and target dosing.

Example: for horse paste and the most common dosage (0.2mg/kg), you would use your weight and follow the weight markings on the tube of horse paste.