Dr. Steven Gartzman, who has been a doctor since 1993, said ivermectin is rarely prescribed in an emergency setting.
But these days, Gartzman sees a patient at Victoria ER, a freestanding emergency medical center on Navarro Street in Victoria, roughly once a week who wants to take the drug as protection against COVID-19.
After a year and a half of debates over public health measures such as masks and vaccines, the safety and efficacy of ivermectin as a treatment for COVID-19 has become the latest high-profile controversy of the pandemic. Interest in the drug has increased as public figures like popular podcast host Joe Rogan and, on Saturday, former Lt. Col. Allen West, a Texas gubernatorial candidate, announced that they were taking ivermectin to treat their COVID-19 symptoms.
This has been met with dismay by physicians like Gartzman, who warn that taking the drug in the wrong form or dosage could cause serious side effects, and point out that there are other safe, effective treatments available.
“There is no reason to take ivermectin,” said Gartzman, who also works at Memorial Hermann Hospital in Houston, in an interview. “There are alternatives that are very safe and very effective.”
Nonetheless, in Victoria and the surrounding region, some doctors are prescribing ivermectin for their COVID-19 patients. The Advocate reached out to six doctors to ask them about the drug, including at least one who is reportedly prescribing ivermectin, but all of them except for Gartzman either declined to be interviewed or did not respond.
Ivermectin comes in several forms, each of which has very different uses.
The first, which was already familiar to many ranchers before the pandemic, is a livestock medicine used for deworming cows and horses. The medicine, which is sold at many farm supply and feed stores, can be administered to animals by injection or by pouring it onto the animal’s back, according to Dawn Otto, owner and manager of Otto’s Coastal Hay in Victoria.
The ingestion of this form of ivermectin by humans has drawn alarm from doctors, and Gartzman said doing so could be “harmful or deadly.”
“The animal form of ivermectin is in doses over 100 times (the human form) — extremely concentrated. It’s a very, very high dose because you’re dealing with animals that weigh significantly more than humans,” Gartzman said.
The Texas Poison Control Center has reported an increase in calls related to the ingestion of ivermectin this year, according to an August press release from the Texas Department of State Health Services.
Statewide, there were 159 calls related to ivermectin ingestion from Jan. 1 to Aug. 24, including 64 in August, compared to 48 calls in all of 2020. 55% of those calls were related to people who had taken the drug in an attempt to treat COVID-19. The press release did not specify which form of the drug had been taken in those cases.
Otto agreed that it is not wise for people to ingest the livestock version of ivermectin.
“It’s not a good idea,” she said. “I just know that it is an animal product. It states on there, not labeled for human use.”
Along with the livestock dewormer, there are at least two forms of ivermectin commonly used for treatment in humans. In 1996, the Food and Drug Administration approved ivermectin for the treatment of roundworms and river blindness, a tropical disease transmitted by blackflies, according to Merck, the drug’s manufacturer.
There is also a topical form of the drug that can be rubbed on the skin to treat rosacea and lice. In that case, the drug would typically be recommended by a dermatologist, Gartzman said.
Neither form of the drug has been approved by the FDA to treat COVID-19, but there are roughly 70 clinical trials underway to test the drug’s effectiveness, according to an op-ed published in the Wall Street Journal. That article said those trials have shown promising results.
However, Gartzman said he is not yet aware of any thorough, well-controlled and peer-reviewed studies that support ivermectin’s effectiveness against COVID-19.
State and federal agencies still advise against taking ivermectin in any form to treat COVID-19. The drug’s potential adverse effects can include rashes, nausea, diarrhea, stomach pain and facial or limb swelling, according to the Texas Department of State Health Services. In combination with other medications, such as blood thinners, the drug could lead to vomiting, low blood pressure, seizures, coma and death.
Bill Yeager, a longtime pharmacist who works at Palacios Prescription Shoppe, a drug store in Palacios, said he knows of roughly a dozen people who have taken ivermectin to prevent or treat COVID-19, and he also knows of at least one doctor who is prescribing the drug.
“If you knew you were exposed, you could get a prescription for ivermectin, take five tablets a week for five weeks, and you’re supposedly past the time you would have a reaction to the COVID,” Yeager said.
Some of the people he knows who have taken ivermectin have not contracted COVID-19 symptoms, he said.
But Yeager also said he has become concerned for his friends and neighbors who are self-medicating with ivermectin, especially the livestock version, because they risk ingesting a harmful dose. He also said he thinks some doctors might be prescribing ivermectin so they can at least exert some control over how much of the drug their patients are taking.
“I think they’d rather see them on something they can control a little bit and know the exact dose they’re getting, rather than seeing someone take a syringe and squirt it in their mouth and hope they’re not getting an overdose,” Yeager said.
While the efficacy of ivermectin as a COVID-19 treatment is still being studied, there are other safe and effective COVID-19 treatment options already available, Gartzman and Yeager both said.
That includes the COVID-19 vaccines, as well as monoclonal antibodies, a one-time treatment for people whose symptoms do not require hospitalization, and other medications like remdesivir and dexamethasone which are typically administered in a hospital setting, Gartzman said.
Another potential treatment, a drug developed by Merck called molnupiravir, which is taken as a pill, is in late-stage studies and could be authorized by the FDA soon.
Much of the information available about ivermectin on the internet is unreliable, Yeager said.
“There’s been so much pure crap that has been put on the internet,” he said. “But a lot of people believe in it.”
“I can’t emphasize strongly enough to the general public, don’t drink the Kool-Aid,” he said.