Ivermectin and COVID-19: Keeping Rigor in Times of Urgency
Resumen: Ivermectin is a widely used drug for the treatment and control of severalneglectedtropical diseases.1 Thedrughas anexcellent safety profile, with more than 2.5 billion doses distributed in the last 30 years, and its potential to reducemalaria transmission by killingmosquitoes is under evaluation in several trials around the world.2 Ivermectin inhibits the in vitro replicationof somepositive, single-stranded RNA viruses, namely, dengue virus (DNV),3–5 Zika virus,4,6 yellow fever virus,7,8 and others.4,7,9 Caly et al.10 recently reported that ivermectin is a potent inhibitor of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in vitro.Given the coronavirus disease- 19 (COVID-19) pandemic, this has understandably resonated widely in the global press.11
Caly et al.10 report a 5,000-fold reduction inSARS-CoV-2RNA levels, compared with those in controls, after infected Vero/ hSLAM cells were incubated for 48 hours with 5 µM ivermectin. The ivermectin IC50 for the viruswas calculated at approximately 2.5 µM. These concentrations are the equivalent of 4,370 and 2,190 ng/mL, respectively, notably 50- to 100-fold the peak concentration (Cmax) achieved in plasma after the single dose of 200 µg/kg (14mg in a 70-kg adult) commonly used for the control of onchocerchiasis.12 Pharmacokinetic studies in healthy volunteers have suggested that single doses up to 120 mg of ivermectin can be safe and well tolerated.13 However, even with this dose, which is 10-fold greater than those approved by the US...

Idioma: Inglés
DOI: 10.4269/ajtmh.20-0271
Año: 2020
Publicado en: AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE 102, 6 (2020), 1156-1157
ISSN: 0002-9637

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Tipo y forma: (Published version)

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