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Updated: Oct 26, 2025

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Ivermectin for preventing and treating COVID-19.

Maria Popp1, Miriam Stegemann2, Maria-Inti Metzendorf3

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Current evidence on ivermectin for COVID-19 treatment and prevention is uncertain. More high-quality randomized controlled trials are needed to determine its efficacy and safety for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

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Area of Science:

  • * Infectious Diseases
  • * Pharmacology
  • * Clinical Trials

Background:

  • * Ivermectin, an antiparasitic, shows in vitro inhibition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication.
  • * Conflicting evidence exists regarding ivermectin's efficacy and safety for COVID-19 treatment and prevention.

Purpose of the Study:

  • * To assess the efficacy and safety of ivermectin versus control interventions for COVID-19 treatment.
  • * To evaluate ivermectin's effectiveness in preventing SARS-CoV-2 infection (postexposure prophylaxis).

Main Methods:

  • * Systematic review and meta-analysis of randomized controlled trials (RCTs) up to May 26, 2021.
  • * Included studies compared ivermectin to placebo, standard care, or no treatment.
  • * Assessed risk of bias using Cochrane risk of bias 2 tool; used GRADE for certainty of evidence.

Main Results:

  • * 14 studies with 1678 participants were included; about one-third had a high risk of bias.
  • * Evidence for ivermectin's effect on mortality, clinical worsening, and viral clearance in inpatients and outpatients is of very low to low certainty.
  • * One study on prevention showed very low-certainty evidence regarding mortality.

Conclusions:

  • * Current evidence is insufficient to determine ivermectin's efficacy and safety for treating or preventing COVID-19.
  • * Completed studies are small and often of low quality.
  • * Further well-designed RCTs are necessary to provide reliable answers on ivermectin's role in managing SARS-CoV-2 infections.