Ivermectin is an anti-parasitic drug with anti-viral properties that may help treat COVID-19. It has been shown to reduce SARS-CoV-2 virus replication in cell cultures. Ivermectin's mechanism of action involves inhibiting importin α/β-mediated nuclear transport of viral proteins. When combined with hydroxychloroquine, ivermectin and HCQ may have synergistic effects by blocking viral entry and replication. While ivermectin shows promise based on in vitro studies, its clinical efficacy for treating COVID-19 is still unpredictable as clinical trials are still needed given SARS-CoV-2 is a novel virus.

1. ROLE OF IVERMECTIN
IN
COVID 19
DR LIPIKA MOHARANA

2. Ivermectin-About the molecule
• Anti-parasitic with Anti-viral properties
• Highly lipophilic with high volume of distribution(Vd) & low plasma
clearance.
• Accumulates mostly in liver & fatty tissue
• Half life in humans is 12-36 hours, may be found in blood for upto 3
days
• FDA Category C for pregnancy
• No major drug interaction with common drugs
• High cytotoxicity(neurotoxicity) & low water solubility

3. Ivermectin, a new candidate
therapeutic against SARS-CoV-
2/COVID-19
•Khan Sharun et al Annals of
Clinical Microbiology and
Antimicrobials volume 19,
Article number: 23 (2020)

4. MECHANISM OF ACTION
As SARS-CoV-2 is an RNA virus, the antiviral activity of ivermectin may be
mediated through the inhibition of importin α/β-mediated nuclear transport of
viral proteins.

6. HCQ & IVERMECTIN SYNERGISM
• Consequential & synergistic action
• HCQ as a first level barrier by inhibiting the entry of virus into the
host cell
• Ivermectin reduces viral replication , if it enters the host cell
Hydroxychloroquine and ivermectin: A synergistic combination for COVID-19 chemoprophylaxis and treatment?
Angela Patrì, MD∗ and Gabriella Fabbrocini, MD
J Am Acad Dermatol. 2020 Jun; 82(6): e221.
Published online 2020 Apr 10. doi: 10.1016/j.jaad.2020.04.017

8. - Ivermectin is an inhibitor of the COVID-19 causative virus
(SARS-CoV-2) in vitro.
- A single treatment able to effect ~5000-fold reduction in virus at
48 h in cell culture.
- Ivermectin is FDA-approved for parasitic infections, and
therefore has a potential for repurposing.
- Ivermectin is widely available, due to its inclusion on the
WHO model list of essential medicines.
The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2invitroLeon Calya, Julian D. Drucea, Mike G.
Cattona, David A. Jansb, Kylie M. Wagstaffb,∗aVictorian Infectious Diseases Reference Laboratory, Royal Melbourne
Hospital, At the Peter Doherty Institute for Infection and Immunity, Victoria, 3000, AustraliabBiomedicine Discovery Institute,
Monash University, Clayton, Vic, 3800, Australia

9. Assessment of Evidence for COVID-19-Related Treatments: Updated 6/8/2020

10. • The clinical efficacy and utility of ivermectin
in SARS-CoV-2-infected patients is
unpredictable at this stage, as we are
dealing with a completely novel virus.
• Although no clinical trials have reported it’s
efficacy & safety in the context of covid 19
yet,it may be expected to see in future,
delivering information about it’s potential
therapeutic action in the clinical setting.

11. THANKS