Preventing & Diagnosing Overdose

Preventing ivermectin overdose

At the moment, there is a rise in ivermectin overdose cases because of very limited scientific evidence suggesting that it could treat or prevent COVID-19 infection [1]. You can read more about ivermectin & COVID-19 here.

One of the main reasons people are overdosing on ivermectin is because of misinformation [2]. As such, one of the key resources we have to prevent ivermectin overdose is clear scientific communication based on gold-standard evidence [2].

Another reason that people are overdosing on ivermectin at the moment is that they are taking veterinary strength ivermectin frequently, as some doctors won't prescribe ivermectin for COVID-19 treatment [3, 4]. So, when someone takes ivermectin that's usually given to large animals like horses or cows, they are more likely to take more ivermectin than a human can tolerate, and overdose. As such, the sale of ivermectin may be more tightly regulated in the future.

Diagnosing ivermectin overdose

The diagnosis of ivermectin overdose is based on a lot of evidence. Doctors will consider the following when assessing if a patient has overdosed on ivermectin:

Patient History

If the patient is conscious, or has family with them, one of the first things a doctor will do is get a medical history from the patient [5, 6]. This includes what the patient's primary complaint is and a history of how long it's been going on for [5, 6]. Along with the patients past medical and social history, doctors will also ask if they've been taking any prescribed, over the counter, or recreational drugs [5, 6]. If someone states they've taken ivermectin, the doctor might suspect an overdose.

Signs & Symptoms

If patients present with a lot of signs and symptoms associated with ivermectin overdose, a doctor may suspect an overdose, especially if the person is known to have taken ivermectin [5, 6].

Physical Exams

This is where the doctor may take a closer look at a patient, and listen to their heartbeat, breathing, and check their reflexes [5, 6]. For example, ivermectin overdose is associated with a fast heart rate and low blood pressure, so doctors might check somebody's pulse and blood pressure [7, 8, 9]. They may also use a Glasgow Coma Scale to assess the patient's level of consciousness and, by listening to the patient and how they speak or act, will be able to assess their level of confusion [10].

Laboratory Tests and Scans

These tests and scans can confirm ivermectin overdose, measure the severity of overdose, and guide decisions about potential treatments. Ivermectin may be found in the blood or poo, so doctors might send samples of these to a lab so they can test the concentration of ivermectin in these samples [11]. Below are some tests doctors might to do assess whether a patient has overdosed on ivermectin, and what they might expect to find:

Blood Tests

This particular blood test, called a full blood count, assesses the amount and quality of cells in the blood itself - like red and white blood cells [5, 6].

Some patients who have overdosed on ivermectin have decreased amounts of red and white blood cells [12].

Liver Function

As ivermectin is metabolised by the liver, the liver might have to work extra hard during an overdose [13, 14].

This can lead to a decrease in liver function, so liver markers might be lower than expected [13, 14].

Urea & Electrolytes

Whilst urea tests may be normal, as ivermectin has very limited involvement with the kidneys, electrolyte levels might not be normal [13, 14].

Electrolytes are small chemicals or ions dissolved in your blood stream.

Ivermectin overdose can lead to decreased levels of sodium and potassium; this may be associated with symptoms of vomitting or diarrhoea [12].

Scans & Imaging

Magnetic Resonance Imaging (MRI) and computed tomography (CT) scans might be done to assess the level of damage to the brain [12].

However, some patients who have overdosed on ivermectin may have a normal CT or MRI scan, so this cannot be used to rule out overdose [12].

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