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Related Experiment Video

Updated: Sep 7, 2025

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Ivermectin for preventing and treating COVID-19.

Maria Popp1, Stefanie Reis1, Selina Schießer1

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Summary

This review found low- to high-certainty evidence that ivermectin offers no benefit for COVID-19 outpatients. For inpatients, evidence is very low, leaving uncertainty about ivermectin

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Trials

Background:

  • Ivermectin, an antiparasitic drug, has demonstrated in vitro inhibition of viral replication.
  • A molecular hypothesis suggests ivermectin may inhibit SARS-CoV-2 replication in early infection stages.
  • Existing evidence on ivermectin for COVID-19 prevention and treatment remains conflicting.

Purpose of the Study:

  • To evaluate the efficacy and safety of ivermectin combined with standard care versus standard care alone for COVID-19 treatment.
  • To assess ivermectin's effectiveness in preventing SARS-CoV-2 infection (postexposure prophylaxis).
  • To compare ivermectin interventions against placebo or other proven treatments in inpatient and outpatient settings.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) up to December 2021, with additional inclusion of trials with over 1000 participants up to April 2022.
  • Searches conducted across multiple databases including Cochrane COVID-19 Study Register and Web of Science.
  • Eligibility criteria focused on prospectively registered RCTs comparing ivermectin to standard of care, placebo, or proven interventions, with co-interventions being identical.

Main Results:

  • For outpatients with mild COVID-19, low- to high-certainty evidence indicates ivermectin has little or no effect on mortality, clinical improvement, adverse events, or viral clearance.
  • For inpatients with moderate-to-severe COVID-19, very low-certainty evidence leads to uncertainty regarding ivermectin's impact on mortality, clinical worsening, and serious adverse events.
  • No trials investigated ivermectin for SARS-CoV-2 infection prevention or compared it to interventions with proven efficacy.

Conclusions:

  • Current evidence suggests ivermectin provides no significant benefit for treating COVID-19 in outpatients.
  • Uncertainty remains regarding ivermectin's effects in hospitalized patients due to very low-certainty evidence.
  • No evidence supports the use of ivermectin for preventing SARS-CoV-2 infection.