Case studies regarding ivermectin overdose are often caused by people ingesting veterinary strength ivermectin [1, 2].
As such, it would be reasonable to suggest that ivermectin should be more tightly regulated, especially due to the current misinformation surrounding its use.
Ivermectin is metabolised in the liver by an enzyme called cytochrome P450-3A4 [3, 4].
Other drugs can interact with this enzyme too [3, 4]. If too many drugs are around, the enzyme gets overwhelmed and cannot process all of the drugs. This can lead to an increased chance of side effects or overdose.
However, there is currently no warning about this on ivermectin's label [3, 5].
Due to ivermectin's high profile in the media at the moment, this needs urgently addressing.
There is some evidence to suggest that ivermectin can damage DNA and kill cells [6]. Ivermectin has also been highlighted as a potential treatment against cancer [7].
As such, it is still unclear whether ivermectin can damage normal cells, or whether it can be a treatment for cancer. However, it might be considered unethical to give people a treatment that is potentially harmful.
As such, further research into ivermectin's safety is urgently required.
Ivermectin can be leave the body in its active form [10]. This means that if an insect or worm comes across poo that has ivermectin in it and ingests it, they might die [10, 11].
This can especially occur in areas with poor sanitation. Unfortunately, these areas are also where ivermectin is largely prescribed to prevent or treat parasitic infections [12].
There are already records of this affecting ecosystems and causing an imbalance between insects and predators [10].
Better sanitation and controlled ivermectin use is required.