Missouri Department of Health & Senior Services Health A lert: Health Alert August 24, 2021 Self-medication with FROM: ROBERT KNODELL, DHSS ACTING DIRECTOR Ivermectin for the Treatment and SUBJECT: Self-medication with Ivermectin for the Treatment and Prevention of COVID-19 Prevention of COVID-19 The Missouri DHSS has received reports that some people in Missouri were using Ivermectin to prevent a COVID-19 infection. Inappropriate use of this medication, August 24, 2021 especially consuming veterinary formulations, may cause significant harm. The This document will be updated as new DHSS is urging Missourians not to use Ivermectin for self-medication against information becomes available. The COVID-19. All health care providers who encounter illnesses due to Ivermectin current version can always be viewed ingestion should report cases to the Missouri Poison Control Center at 1-800-222- at http://www.health.mo.gov. 1222. The Missouri Department of Health & Senior Services (DHSS) is now using Ivermectin is a Food and Drug Administration (FDA)-approved antiparasitic drug four types of documents to provide that is used to treat several neglected tropical diseases and scabies. Ivermectin is important information to medical and public health professionals, and to not approved by the FDA for the treatment of any viral infection, including other interested persons: COVID-19. Health Alerts convey information of the highest level of importance The National Institute for Health (NIH) has recently concluded that there is which warrants immediate action or insufficient evidence to recommend either for or against the use of Ivermectin for attention from Missouri health providers, emergency responders, the treatment of COVID-19. Several clinical trials that are evaluating the use of public health agencies, and/or the Ivermectin for the treatment of COVID-19 are currently underway or in public. development. The World Health Organization (WHO) also recommends that this Health Advisories provide drug only be used within clinical trials. important information for a specific incident or situation, including that impacting neighboring states; may not Nevertheless, the Missouri DHSS has received reports that some people were using require immediate action. Ivermectin to prevent a COVID-19 infection. Across the country, in Mississippi, Health Guidances contain two-thirds of recent calls placed to the state’s poison control center were related to comprehensive information pertaining “ingestion of livestock or animal formulations of Ivermectin purchased at livestock to a particular disease or condition, supply centers”. and include recommendations, guidelines, etc. endorsed by DHSS. The FDA has urged people to stop taking veterinary formulations of this drug to Health Updates provide new or updated information on an incident or treat or prevent Covid-19 after receiving multiple reports of patients who have been situation; can also provide informa- hospitalized after “self-medicating with ivermectin intended for horses”. According tion to update a previously sent the FDA, animal drugs are often highly concentrated because they are used for large Health Alert, Health Advisory, or Health Guidance; unlikely to require animals like horses and cows, and such high doses can be highly toxic in humans. immediate action. Patients who overdose with ivermectin can experience nausea, vomiting, diarrhea, __________________________________ low blood pressure, allergic reactions, dizziness, and problems with balance, seizures, coma and even death. Additionally, the effect of many inactive ingredients Office of the Director found in animal products is not known because those ingredients aren’t evaluated 912 Wildwood for use in people. P.O. Box 570 Jefferson City, MO 65102 Telephone: 800-392-0272 Fax: 573-751-6041 I Website: http://www.health.mo.gov v e r m e c 2 The Missouri Poison Center has concerns about the recent intentional misuse of the ivermectin as a preventative or treatment of COVID-19. The center has managed at least 22 cases in 2021 as compared to 2 cases in 2020 where an individual intentionally has ingested a prescription product or a veterinary formulation not intended for humans use. Adverse effects that have been noted from an overdose of ivermectin include, nausea, vomiting, and diarrhea. Patients have also experienced hypotension, dizziness, decreased consciousness, confusion, agitation, and hallucinations. The Poison Center does not recommend taking ivermectin that is not prescribed to them by a healthcare provider. 3-Year Comparison " • 2821 2828 18 • :0:9 8 • • 1 • Ivermectin products made for animals are not safe for human consumption. Missourians are urged to contact one of specially trained pharmacists or nurses at 1-800-222-1222 for advice if they have been using ivermectin or an ivermectin containing product and are experiencing symptoms. Missouri Department of Health and Senior Services DHSS Health Alert August 24, 2021