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New restrictions on prescribing ivermectin for COVID-19 https://www.tga.gov.au/media-release/new-restrictions-prescribing-ivermectin-covid-19 (10 September 2021) TGA, acting on the advice of the Advisory Committee for Medicines Scheduling placed new restrictions on the prescribing of oral ivermectin. General practitioners are now only able to prescribe ivermectin for TGA-approved conditions - scabies and certain parasitic infections Certain specialists will be permitted to prescribe ivermectin for other unapproved indications if they believe it is appropriate for a particular patient Ivermectin is not approved for use in COVID-19 in Australia currently strongly discouraged by the National COVID Clinical Evidence Taskforce, the World Health Organisation and the US Food and Drug Administration https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/ Recommendation There is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19. Firstly there are a number of significant public health risks associated with taking ivermectin in an attempt to prevent COVID-19 infection rather than getting vaccinated Individuals who believe that they are protected from infection by taking ivermectin may choose not to get tested or to seek medical care if they experience symptoms. Doing so has the potential to spread the risk of COVID-19 infection throughout the community. Secondly the doses of ivermectin that are being advocated for use in unreliable social media posts and other sources for COVID-19 are significantly higher than those approved and found safe for scabies or parasite treatment. These higher doses can be associated with serious adverse effects, including severe nausea, vomiting, dizziness, neurological effects such as dizziness, seizures and coma. https://bnf.nice.org.uk/drug/ivermectin.html https://shop.amh.net.au/products/digital https://www.tga.gov.au/sites/default/files/auspar-ivermectin-131030-pi.pdf BMJ https://bestpractice.bmj.com/topics/en-gb/3000110 Untreated paracetamol poisoning may cause varying degrees of liver injury over the 2 to 4 days following ingestion, including fulminant hepatic failure. Finally there has been a 3-4-fold increased dispensing of ivermectin prescriptions in recent months, leading to national and local shortages for those who need the medicine for scabies and parasite infections It is believed that this is due to recent prescribing and dispensing for unapproved uses, such as COVID-19. Such shortages can disproportionately impact vulnerable people, including those in Aboriginal and Torres Strait Islander communities. There is only one TGA approved oral ivermectin product, Stromectol ivermectin 3mg tablet blister pack Indicated for the treatment of river blindness (onchocerciasis), threadworm of the intestines (intestinal strongyloidiasis) and scabies. All medical practitioners can continue to prescribe oral ivermectin for the approved indications. However, prescribing of oral ivermectin for indications that are not approved is now limited to certain specialists. Onchocerciasis https://www.who.int/news-room/fact-sheets/detail/onchocerciasis More than 99% of infected people live in 31 African countries. The disease also exists in some foci in Latin America and Yemen.

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