I have been working with #ivermectin for more than 10 years.

We need to talk about ivermectin and #COVID19

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#SARS_COV_2 is a positive single-stranded RNA virus

Ivermectin inhibits in vitro the replication of several positive single-stranded RNA viruses such as:
- Dengue
- Zika
- Chikungunya
- Yellow Fever
The maximum plasma concentration reached with that dose is around 40 ng/ml.

That is 50-fold less that the concentration proven to cut viral replication in half.

There is however hope. Prove antiviral activity opens the door to carefully conducted and controlled trials.
Now, if you are considering using ivermectin on a compassionate basis you must know this:

Ivermectin can cross react with GABA-gated chlorine channels in the CNS and cause neurotoxicity. This is normally prevented by the blood bran barrier (BBB), particularly by the P-gp.
If you do not have a fully functional BBB ivermectin may not be the safe drug it usually is.

Now, hyperimflammatory states, such as the one caused by #COVID19 make the BBB leaky.

I would be careful to use ivermectin in severely ill patients with proven efficacy.
Additionally, please be careful with drug-drug interactions.

Many #COVID19 patients are receiving Lopinavir/Ritonavir.
The new direct effects on the virus reported by Caly and colleagues are very god news!

I understand the urgency. There is reason for hope!

But this required careful planning.

Some trials have already been proposed in the last few weeks.

Watch this space.
*very goOd
*this requireS
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