Dr. Joshua Ranum serves rural areas in North Dakota and South Dakota through West River Health Services. Working in “farm and ranch country,” the issue of ivermectin in humans for treatment or prevention of COVID-19 has come up, he says.

Ranum said a number of people have indicated to him that their cows didn’t get the full dose of the parasitic medication because “some went down the hatch.”

Ivermectin is an anti-parasitic drug that can be used in a variety of mammals. In humans, it is used for parasitic worms, scabies, lice, and some skin irritations like rosacea. It has a variety of livestock formulations, including pour-on, injectables, drenches and pastes.

Ranum was one of several medical speakers on a COVID-19 town hall put on by the North Dakota Department of Health on Tuesday, Sept. 7, who addressed ivermectin use in the treatment of COVID-19. Kirby Kruger, North Dakota Department of Health medical service section chief, stressed that despite reports circulating in social media or elsewhere that ivermectin might be a good treatment for COVID-19, the data has not shown that to be true at this time.

“At the end of the day, there just isn’t a lot of data to indicate that … ivermectin is an important and reliable and effective treatment for COVID-19 — treatment or prevention,” he said.

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And even if the human formulations were to be shown to be effective treatments, that would not make it OK to use the livestock versions of the drugs, Kruger stressed. Veterinary formulations may have different ingredients not made for humans and are for the body mass of livestock, which, especially in the case of cattle and horses, are far larger than humans.

“Never use medication intended for animals on yourself. Ivermectin preparations that are prepared for animals are much different than what are being prepared for people,” he said.

“Theoretically, since you’re not a 1,200 pound horse, there’s some problems with overdosing,” said Dr. Kim Brummond, a veterinarian at West Dakota Veterinary Clinic in Dickinson, North Dakota, and the president of the North Dakota Veterinary Medical Association.

Brummond said COVID-19 isn’t the only ailment that she’s had people ask her about using ivermectin for over the years; people have believed it’ll kill anything, up to and including cancer, she said. When people ask about it, her answer is easy.

“It’s a flat-out no,” she said. “And I talk about that you need to consult with your MD.”

While she and other veterinarians are not qualified to talk about the effects of using a livestock medication on humans, Brummond said she can tell stories of dogs dying after an owner tried to use cow pour-on it and of cats sick from horse dewormer.

“If you cross species, it could cause death,” she said.

The Food and Drug Administration has stressed in a letter to veterinarians and animal health retailers the dangers of veterinary formulations of ivermectin in humans:

“As noted in many recent news stories and in a Health Alert from the U.S. Centers for Disease Control and Prevention, poison control centers across the United States are seeing a sharp spike in reports of people suffering adverse health effects after taking animal ivermectin,” the letter said. “People are purchasing various highly concentrated animal ivermectin drug formulations such as ‘pour-on,’ injectable, paste, and ‘drench’ that are intended for horses, cattle, and sheep, and taking these drugs has made some people very sick.”

So far, Poison Control has indicated North Dakota hasn’t had a lot of recent issues with ivermectin as of late. Kruger said there was one report of someone with an inadvertent exposure to ivermectin formulated for animals and one report of someone taking a human formulation of the drug without a prescription.

North Dakota State Veterinarian Dr. Ethan Andress, like Brummond, said he could not talk about the effects of ivermectin on humans. However, he said anyone who gets an ivermectin product on them should clean it off, remove clothing with the drug on them and consult their doctor.

Andress said he did not have any information about problems with veterinary ivermectin supplies in the state. Brummond said she had not seen any supply chain problems with ivermectin for livestock and believed it was more of an issue of human ivermectin shortages.

Kruger said there are reports of a 24-fold increase in the prescribing of human formulations of ivermectin nationwide. That corresponds with a five-fold increase in Poison Control calls related to ivermectin, including ingesting without a prescription, using topical ivermectin internally, ingesting veterinary formulations of ivermectin and overdosing.

Ranum said dealing with his human patients on the issue requires building mutual understanding and rationale. Ranum was on the Sept. 7 call to stress the importance of early use of monoclonal antibody treatments for high-risk patients with COVID-19 or even some who have been exposed to the disease but have not yet tested positive. Those treatments have been well-tolerated, effective at reducing viral load and generally accepted among patients, he said. Kruger also mentioned the use of antiviral medications, steroids and other treatments. And both stressed that vaccines are the best prevention for COVID-19.

The bottom line on ivermectin for COVID-19?

“There’s more efficacious things out there that we know work and are well tolerated,” Ranum said.