Maine’s Board of Pharmacy said this week that there’s been an increase in the number of prescriptions for ivermectin and it issued a reminder that the drug is not approved for use to prevent or treat COVID-19.

An IverCare brand package containing a syringe of ivermectin – a drug used to kill worms and other parasites – intended for use in horses only. Health experts and medical groups are pushing to stamp out the growing use of the parasite drug to treat COVID-19. Associated Press/Ted S. Warren

For humans, ivermectin has been approved to treat “infections caused by some parasitic worms, head lice and skin conditions like rosacea,” the board said in a notice to pharmacists, but it hasn’t been approved for treating the disease caused by the coronavirus.

But that hasn’t stopped people who are seeking a COVID-19 treatment from trying to use the drug, which also is used to deworm horses and cattle. Side effects of taking the drug include headaches, muscle aches, dizziness, nausea, diarrhea and skin rashes.

Ivermectin has been touted by people who believe COVID-19 vaccines haven’t been thoroughly vetted and represent an over-reaction, along with face masks. Earlier in the pandemic, similar claims were made about other drugs such as hydroxychloroquine, which was promoted online and in social media as being effective in fighting COVID even though the claims were refuted by health officials, who said the vaccine is the best way to ward off the virus and to lessen its effect if someone gets the illness.

Tom Edge, the retail pharmacy manager for Pen Bay Medical Center in Rockport, said he’s refused to fill six prescriptions for ivermectin in the last month.

Typically, ivermectin is rarely used on humans, Edge said, and he filled only three legitimate prescriptions for the drug in the past year. The most recent prescriptions he’s received came from out-of-state doctors, he said, “which is always a little bit of a red flag anyway.”

When he looked up one prescriber online, Edge found a list of doctors that people can call and, for a fee, get a consultation over the phone and then a prescription for ivermectin.

HEALTH ALERT FROM U.S. CDC

A health alert issued by the U.S. Centers for Disease Control and Prevention in late August said that ivermectin dispensing from retail pharmacies in the U.S. jumped from an average of 3,600 a week pre-pandemic to a 39,000 a week in January. And since then, ivermectin dispensing has continued to shoot up, reaching more than 88,000 prescriptions a week in mid-August, the agency said.

The prescriptions for ivermectin that Edge refused to fill called for using the drug for a longer period than is normally prescribed, he said. For treatment, the dose was double the typical amount and also for a longer period, he said.

“We can’t fill a prescription based on what someone has on a website,” he said. “We can refuse any prescription that we feel is not being used for a legitimate purpose.”

When he contacted the doctors who wrote the prescriptions and was told it was intended to ward off or treat COVID, Edge told them he would not fill the prescription.

“At that point, it’s a quick conversation,” he said.

Edge said the notice by the pharmacy board gives him and other pharmacists “a little something to fall back on” if a customer complains about the refusal to fill the prescription.

Even in the form meant for human use, Edge said, ivermectin side effects can include central nervous system issues, diarrhea, nausea, decreased white blood cell counts “and a lot of kind of nasty things.”

Janelle Tirrell, a veterinarian in Palermo, said ivermectin is a very effective de-wormer for her patients at Third Coast Equine, but “I would not recommend it to any humans. It would just never occur to me.”

Tirrell said she was surprised to see that it had become popular among some as an alternative to COVID vaccines because the ivermectin paste that she supplies to her horses would be “literally eating away the intestines” of people who take it.

“It’s even grosser than I’m describing,” Tirrell said.

In an average year, the Northern New England Poison Center said it would record eight cases in Maine of people coming into contact with ivermectin. Typically, it said, those cases involve children who inadvertently gained access to the drug, people who accidentally took two doses of their prescribed ivermectin, or people who got it in their eyes or mouth when trying to administer it to an animal.

INCREASED CALLS TO POISON CENTER

So far this year, there have already been eight cases of human exposure to ivermectin in Maine, the center said, and four appeared to involve people taking ivermectin to prevent or treat COVID. One of those cases was in March and three were in September, the center said.

Nationally, the center said, about one in 10 people who take ivermectin inappropriately have severe side effects from the drug.

In its report last month, the CDC said calls about human exposure to ivermectin to poison control centers across the country were five times higher in July than they were pre-pandemic.

In some cases, the CDC said, people took ivermectin that was intended for veterinary use on large animals, such as horses, sheep and cattle.

Those doses “can be highly concentrated and result in overdoses when used by humans,” the CDC said, and the veterinary products may also contain ingredients that haven’t been evaluated in humans.

“People who take inappropriately high doses of ivermectin above FDA-recommended dosing may experience toxic effects,” the report said, and suffer the symptoms that Edge cited, along with decreased consciousness, confusion, hallucinations, seizures, comas and even death.

The report said an adult drank an injectable formulation of ivermectin intended for use in cattle and had to be hospitalized for nine days before recovering.

Edge, the Pen Bay pharmacy director, said he hasn’t conferred with colleagues around the state about ivermectin prescriptions, but “it would not surprise me in the least if people are seeing more of this.”

He said the state board’s statement this week is a good reminder that they should be sure that all prescriptions are for a legitimate drug with proven effectiveness in treating illnesses.

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