Drug interactions of ivermectin with a focus on COVID-19 treatment

Treatment of COVID-19 largely depends on previously used drugs as there is no cure available coupled with shortage of effective vaccine with doubts about its long-term protection due to rapid viral mutations. Ivermectin, a derivative of avermectin, introduced as an antiparasitic agent, is effective against onchocerciasis, strongyloidiasis, ascariasis, filariasis, scabies, malaria, and has a good safety profile. Ivermectin is being promoted for the treatment of COVID-19, although US Food and Drug Administration has not approved its use for any viral infection. With increasing evidences indicating the efficacy of ivermectin in COVID-19 and post-COVID-19 syndrome, there is a need to focus on the drug interactions with the dose used for indication as most of the documented interactions are with the dose used for parasitic infections. As majority of the COVID-19 patients have comorbidities and on multiple drugs, it is necessary to understand the drug interactions of ivermectin.