I will cut and paste part of the document here, but for some reason the citations won’t populate. If you click the link, it will take you to the source, which is fully annotated so you can one-click on any of the studies or trials.
Summary of the Evidence for Ivermectin in COVID-19
Ivermectin is an anti-parasite medicine whose discovery won the Nobel Prize in 2015 for its
impacts in ridding large parts of the globe of parasitic diseases via the distribution of over 3.7
billion doses within public health campaigns since 1987.
Since 2012, numerous in-vitro and in-vivo studies began to report highly potent anti-viral effects
of ivermectin against a diverse array of viruses including SARS-CoV-2. Further, increasing antiinflammatory and immuno-modulating effects are being identified.
Our comprehensive narrative review of the “totality of the evidence” supporting ivermectin was
published in The American Journal of Therapeutics in April, 2021 where we reviewed data on
efficacy from a diverse array of scientific sources beyond just the randomized controlled trial
evidence as illustrated in the diagram below.
Currently, as of September 19, 2021, the totality of the evidence is as follows.
• IN-VITRO (BASIC SCIENCE): ivermectin has been shown to inhibit the replication of many
viruses, including West-Nile, Zika, Dengue, Influenza, and most recently SARS-CoV-2
• IN-VIVO: ivermectin diminishes viral load and protects against organ damage in animal
models of SARS-CoV-2 infection and has multiple, potent anti-inflammatory and immunemodulating properties [1, 2, 3]
IN-SILICO: numerous computer modeling studies have found ivermectin to have one of the
highest binding affinities to the SARS-CoV-2 spike protein
• PHARMACOLOGIC: unparalleled safety profile over decades, prior WHO guidelines report side
effects that are “primarily minor and transient” and experts have found severe adverse events
to be “unequivocally and exceedingly rare.” Further, the IC-50 against SARS-CoV2 in lung and
adipose tissue easily achieved with standard dosing (Caly/Wagstaff personal communication)
• CLINICAL OBSERVATIONS/EXPERIENCE: numerous cases series, most notably one published
from the Dominican Republic in June 2020 where over 3,000 consecutive patients presented
to the ER, were treated with ivermectin, and only 16 were hospitalized and only 1 died. Also,
innumerable doctors from multiple countries around the world report observing consistent
clinical responses in treated patients with few treatment failures.
• OBSERVATIONAL CONTROLLED TRIALS (OCT): As of August 8, 2021, the results from 31 OCT’s
including over 6,800 patients find that treatment with ivermectin reduces time to recovery,
rates of hospitalization, and mortality, the latter finding best reported in the sophisticated
propensity-matched study of Rajter et al. published in the major medical journal Chest.
• META-ANALYSES OF RANDOMIZED CONTROLLED TRIALS (RCT): 27 RCT’s including over 3,400
patients have been completed. Meta-analyses find that ivermectin reduces time to viral
clearance, hastens recovery, and reduces mortality.
• OBSERVATIONAL AND RANDOMIZED TRIALS IN THE PREVENTION OF COVID-19: A series of
13 RCT’s and OCT’s consistently find that single or repeated ivermectin use strongly reduces
the risk of contracting COVID-19, with an average level of protection of 86% with higher levels
of protection found amongst the trials with more frequent dosing [1,2,3,4,5,6,7(Table 2),
• EPIDEMIOLOGIC: ivermectin distribution campaigns in Peru led to far lower COVID-19 casefatality rates in those regions with widespread use. Further, large “test and treat” programs
conducted by increasing numbers of Health Ministries report up to 75% reductions in the
need for hospitalization (Mexico City) and massive reductions in mortality (Misiones,
Argentina and La Pampas, Argentina). Finally and most importantly, the Indian state of Uttar
Pradesh (pop. 241 million) has effectively eradicated COVID via systematic and widespread
use of ivermectin in both prevention and early treatment.
The reports most relevant to public health officials are from the national and regional health
ministries that employed either distribution or “test and treat” programs with ivermectin:
• Mexico City – The IMSSS Health Agency compared over 50,000 patients treated early with
ivermectin to over 70,000 not treated and found up to a 75% reduction in need for
• Peru – A nationwide mass-distribution program called “Mega-Operación Tayta” (MOT),
initiated at various times across 25 states of Peru in May 2020, led to a 74% drop in regional
excess deaths within a month, with each drop beginning 11 days after each MOT region’s
varied start times
• La Pampas, Argentina – Health Ministry compared over 2,000 patients they treated early with
ivermectin to over 12,000 without treatment and found a 40% reduction in hospitalization
and 35% less ICU or death in older patients
• La Misiones, Argentina – Health Ministry just analyzed the first 800 of 4,000 ivermectin
treated patients and compared to the rest of the population over the same time period, they
found a 75% reduction in need for hospital and an 88% reduction in death.
• Uttar Pradesh, India – Used a strategy of close surveillance combined with both ivermectin
treatment of all positive cases and preventive treatment of all family contacts. On September
10, 2021, only 11 cases with no deaths were recorded in a population of 241 million.
As of August 31, of the previous 187,638 tests performed, only 21 were positive, an essentially
zero positive rate or .01%.
Finally, in both “long-haul” COVID and post-vaccine syndromes, ivermectin is proving to be highly
effective at eliminating symptoms based on the rapidly accumulating clinical experiences of the
FLCCC and a number of allied experts that co-developed the I-RECOVER protocol, centered
around the use of ivermectin in these syndromes.
Based on the totality of the existing evidence above, the FLCCC strongly recommends ivermectin
be used in both the prevention and treatment of all phases of COVID-19 in both vaccinated and
The totality of evidence for ivermectin is large enough that removal of any single data set, trial or
study has minimal impacts. The integrity of one study in Egypt (Elgazzar et al) out of the then 28
RCT results available, was recently called into question. While we share the concerns about this
study, the removal of its data from the most comprehensive meta-analyses did not change the
conclusion that ivermectin is highly effective in both prevention and treatment.