AMA, APhA, and ASHP Joint Statement Opposing the ordering, prescribing, or dispensing of ivermectin to prevent or treat COVID-19 outside of a clinical trial
The American Medical Association (AMA), American Pharmacists Association (APHA), and American Society of Health-System Pharmacists (ASHP) strongly oppose the ordering, prescribing, or dispensing of ivermectin to prevent or treat COVID-19 outside of a clinical trial.
Ivermectin is approved by the U.S. Food and Drug Administration (FDA) for human use to treat infections caused by internal and external parasites. It is not approved to prevent or treat COVID-19. Ivermectin is also available to treat certain veterinary conditions; medications formulated or intended for use in animals should not be used by humans. We are alarmed by reports that outpatient prescribing for and dispensing of ivermectin have increased 24-fold since before the pandemic and increased exponentially over the past few months. As such, we are calling for an immediate end to the prescribing, dispensing, and use of ivermectin for the prevention and treatment of COVID-19 outside of a clinical trial. In addition, we are urging physicians, pharmacists, and other prescribers — trusted healthcare professionals in their communities — to warn patients against the use of ivermectin outside of FDA-approved indications and guidance, whether intended for use in humans or animals, as well as purchasing ivermectin from online stores. Veterinary forms of this medication are highly concentrated for large animals and pose a significant toxicity risk for humans.
The U.S. Centers for Disease Control and Prevention (CDC) and the FDA have issued advisories indicating that ivermectin is not authorized or approved for the prevention or treatment of COVID-19. The National Institutes of Health, World Health Organization, and Merck (the manufacturer of the drug) all state there is insufficient evidence to support the use of ivermectin to treat COVID-19. The Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 also recommend against the use of ivermectin outside of a clinical trial.
Use of ivermectin for the prevention and treatment of COVID-19 has been demonstrated to be harmful to patients. Calls to poison control centers due to ivermectin ingestion have increased five-fold from their pre-pandemic baseline. A recent CDC Health Alert Network Advisory recommends that healthcare professionals should counsel patients against use of ivermectin as a treatment for COVID-19, including emphasizing the potentially toxic effects of this drug, including “nausea, vomiting, and diarrhea. Overdoses are associated with hypotension and neurologic effects such as decreased consciousness, confusion, hallucinations, seizures, coma, and death.”
For more information, we encourage patients and healthcare providers to consult the FDA’s Consumer Update on Why You Should Not Use Ivermectin to Treat or Prevent COVID-19 and the CDC Health Alert Network Advisory on the Rapid Increase in Ivermectin Prescriptions and Reports of Severe Illness Associated with Products Containing Ivermectin to Prevent or Treat COVID-19.
Patients are encouraged to talk to their physicians, pharmacists, and other prescribers about currently available therapies authorized or approved for the treatment or prevention of COVID-19. The most effective ways to limit the spread of COVID-19 are to get vaccinated, wear a face mask, stay at least six feet from others in public places, wash hands frequently, and avoid large crowds of people. Our organizations strongly urge eligible unvaccinated individuals to get vaccinated.