My report on Ivermectin et al

I recently watched a podcast with Pierre Kory and Bret Weinstein extolling the virtues of Ivermectin as prophylactic and treatment for COVID-19.

Here are some of the key takeaways from the almost 3-hour long podcast. These are rough notes, but I am publishing them as is rather than wait to clean them up in the interest of time, given the urgency of controlling the COVID pandemic worldwide. 

• cell called a macrophage, which is part of the immune response, amoeba-like cell that serves as a scavenger/garbage collector, that attacks the lungs
• by then the virus is no longer multiplying significantly 
• perhaps it is the debris left behind by the virus, the RNA from the dead virus that triggers the out of proportion immune response  
• moving away from house calls has taken away doctors' ability to detect patterns, e.g. a disease spreading in one part of town  
• establishment kept harping on evidence-based therapy, everything had to go through a trial, but what about experience-based therapy?
• that's what allowed docs like Kory to come up with the regiment of cortico-steroids and blood-thinners, which has now become the standard of care  
• docs were prevented from thinking creatively, forced to follow a rigid protocol - intellectual authoritarianism  
• ivermectin was originally used starting 40 years ago to manage parasitic diseases and has been a huge boon to medicine, almost on the level of penicillin 
• later, ivermectin started showing antiviral properties against zika, etc.  
• other anti-viral treatments - melatonin, zinc, vitamin d  
• "no matter how cynical you get, you're still being naive" 
• randomized trials v observation trials (looking back at who got treatment and who didn't to draw conclusions)
• meta-analyses v big trials  
• the longer we take to eradicate covid, the greater the chance that it mutates into something you can never eradicate, like the seasonal flu  
• there's no deep pocket lobbyists for ivermectin in the halls of the nih advocating for it because its patents have long expired and there's no money to be made from it  
• not so for remdesivir, which is still under patent, but whose track record for covid is nil when compared to ivermectin
• the vaccines were approved despite the risks they carry (we don't know what we don't know) without emergency authorization if there's a safe and effective treatment available, e.g. ivermectin
• so ivermectin threatens all other money-making options, e.g. remdesivir, vaccines
• off label - when you use an fda approved drug for a purpose it was not intended for or approved for - docs who do this risk punishment, e.g. losing their license, if something goes wrong  
• eua - emergency use authorization
• dosage for ivermectin for chronic prevention is once weekly 0.2-0.4 mg per kg of the person's weight? 
• ivermectin is safe does not have side-effects to a large extent  

After all of this research, I decided to contact one of the docs listed on the FLCCC website and requested a prescription. The request for a prescription cost me over $100. And then Walgreens wanted $150 to fill the prescription, which I have not yet actioned because I am fully vaccinated and unsure of the value of Ivermectin at this point. 

Subsequently, I watched Dr Mobeen Syed interview Steve Kirsch, an MIT graduate in EE&CS and serial entrepreneur (e.g. the optical mouse). Here are my raw notes from that interview.

• the interview mostly concentrates on fluvoxamine as a prophylactic for covid
• large phase 3 trial  
• once the viral disease reaches an inflammatory stage, replication has already happened, and it's too late for an anti-viral  
• that's where fluvoxamine is able to help by activating the sigma 1 receptor more effectively than all other ssri's (Selective Serotonin Reuptake Inhibitor)
• fluvoxamine is designed to pass through the blood-brain barrier and is therefore able to relieve inflammatory symptoms in the brain as well  
• ivermectin doesn't have this capability, so fluvoxamine is able address symptoms like brain fog 
• fluvoxamine is generally used for ocd and psychiatric disorders  
• but has to be administered early in the disease, a difference of 1 day can make a huge difference  
• the hydroxychloroquine study published in the lancet and used by who to justify their anti-hydroxychloroquine stance was later disproved but the public perception remained against hydroxychloroquine
• been around for 40 years without adverse side-effects like fatality  
• if i see a man drowning and have a non-us-coast-guard certified life vest, should i throw it to the drowning man or look for a certified vest?
• regulatory capture - the regulatory bodies are captured by the pharma companies  
• mobeen syed's 54 videos deleted from youtube
• robert malone's linkedin profile deleted  
• steve kirsch's sendgrid email account deleted  
• ivermectin doesn't kill even if you get the dose wrong, which is not the case for hydroxychloroquine
• alternates for fluvoxamine (in case your dr won't prescribe) include prozac (Fluoxetine) 
• dose - 50mg twice a day  
• ivermectin banned in canada  
• individual pharmacists can refuse to fill a prescription even if the store or chain/brand has no policy against filling the prescription
• in those cases just try a different store in the same chain  
• side effects - 300mg/day is the max, so at 50mg the side-effects are minimal - upset stomach 1-2%, nervousness (avoid coffee), 
• don't use steroids; use of steroids in india is a mistake because they harm your body's ability to fight the virus  

As a continuation of my ivermectin story, even though I am fully vaccinated (two shots of Pfizer), as is my entire immediate family, I thought it made sense to keep ivermectin on hand to battle covid in a scenario where there's a break-through strain (e.g. the delta variant) that infects a family member. 

I paid $100 to get an ivermectin prescription from the FLCCC-affiliated Dr Syed Haider (mentioned above). It was a prescription for 36 pills, 3 mg each. 

CVS said the retail cost was $400. My BCBS insurance brought it down to $300. I tried GoodRx (the regular free coupon, not the paid gold plan) and that didn't make a dent in the price. 

Walgreens said the retail cost was $250 and my BCBS insurance brought it down to $150. GoodRx brought it down to $60. So that's about 50 cents/mg ($60 for 36 pills times 3 mg per pill = 108 mg). 

For comparison, my friend in India pays $1 for 3 tablets, 12 mg each at a private pharmacy. That's about 3 cents/mg. And if he's able to find availability at a government pharmacy, the cost is $1.50 for 50 tablets, 12 mg each. That's 0.25 cent/mg. 200 times cheaper than the cheapest price I could find in the US. The expiry date is a year and a half from today, but I doubt I'm going to worry about that. 

At the cost of stating the obvious, notice the price gouging in the US? Why is there no agreement even on the retail price across pharmacies? How can I compare prices across pharmacies without transferring my prescription back and forth, which takes hours per transfer at a minimum? GoodRx tries to provide price comparisons across pharmacies, but I found them to be invalid (see below). 

Another point worth mentioning, neither of the two pharmacies had ivermectin in stock. Either it's too popular or not popular enough or being discouraged. Take your pick. 

In the spirit of trying to remain unbiased, I must share the following. For context, the Elgazzar study formed the backbone of many subsequent studies claiming the efficacy of ivermectin as a prophylactic and cure for covid. And I just discovered this very damning critique of the Elgazzar study that brings us all the way back to the drawing board. Glad I got those vaccination shots!