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Comment by jbotz | Hacker News Reader

Ivermectin has been shown to be highly effective against hookworms [1][2] and so far no parasites seem to have developed any resistance to it. Curious that it's not on the list of drugs approved for treatment of hookworm in dogs in the US.

[1] https://pubmed.ncbi.nlm.nih.gov/2723924/ [2] https://pubmed.ncbi.nlm.nih.gov/6897345/

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A few things.

First, it's very strange that an antiparasitic like ivermectin has become known among mainstream laypersons.

Second, those articles are from the 80s, one is nearly 40 years old.

Third, various antiparasitic medications on the market for dogs contain ivermectin (e.g. Heartgard, Iverhart, and Tri-Heart) - these uses include the prevention or control of hookworm infections.

Finally, when the original article mentions "three types of drugs" to combat parasitic infections, they are referring to the benzimidazole, avermectin/milbemycin (or macrocyclic lactones), and tetrahydropyrimidine classes of drugs - where ivermectin belongs to the avermectin/milbemycin (macrocyclic lactones) class of drugs. With that said, ivermectin-containing compounds are actually a notable part of the research.

It's just where people grew up.

If you had horses, sheep, or goats, you know what ivermectin is.

While this might be true...

Surely you're aware that, given certain national conversations, ivermectin specifically is known by far more than just those that grew up around livestock now?

Oh sure -- I just meant that it's a pretty common tool for people who have or had farm animals.

Not sure what you mean. When Ivermectin was first being discussed, way before it became a national topic, I regularly heard people saying "oh, you mean my dog's heartworm medication? How could that help?"

It has been a well known drug for a long time.

In 2017 I had a coworker that told me he used a pea size amount of horse dewormer for his dog. Said his vet turned him onto it. Just don't use it with collies and other similar breeds.

> First, it's very strange that an antiparasitic like ivermectin has become known among mainstream laypersons.

I don’t find it any more strange that that Remdesivir or mRNA vaccines or even “Coronavirus” is known among the general population. COVID-19 had a huge effect on people and anything related to its treatment or prevention(regardless of the evidence) will have a lot of people know about it.

I meant that it's odd from the perspective of how unlikely this conversation, about ivermectin (or any of the things you listed), would've been even just two years ago.

EDIT: But, also somewhat odd how apparently disproportionately widespread the conversation about specifically ivermectin has become.

The weirdest one I read online is that Ivermectin might change human sexual behaviour. Since parasites can and do spread through anal sex. Speculated that the parasites can change behaviour of the human host, to engage in more anal sex. Similarly to the way its been observed in mice.

"However, the protozoan can only reproduce within the bodies of cats, and in mice, the mind-controlling parasite has evidently evolved to make mice unafraid of felines and even, according to some research, sexually attracted to the odor of cat urine"

> it's very strange that an antiparasitic like ivermectin has become known among mainstream laypersons

Who are you calling a "mainstream layperson"? ;-) Well, I'm not a medical professional, but I raise livestock, and ivermectin has been my go-to anti-parasitic since long before Covid.

First, it's very strange that an antiparasitic like ivermectin has become known among mainstream laypersons.

Not that strange among laymen dog owners when the package of HeartGard heartworm medicine says "Ivermectin" prominently on the label. People that heard about it as a COVID cure know Ivermectin as horse dewormer, many dog owners know it as a monthly heartworm preventative.

https://entirelypetspharmacy.com/heartgard-for-dogs-51-100lb...

This shouldn't be downvoted, ivermectin is highly effective against nematodes (including hookworm and heartworm) and has a good safety profile, no matter the current conversation. People have used it off-label on dogs for years. If you live in the Southern US you really need to treat your dog and outside cat for fleas and heartworm, and it's not unknown that people who can't afford afford the prescription stuff from vet get a canister of cattle dewormer from the feed store.

That said, our vet told me that there are now case reports from the Mississippi Delta about cases of heartworm in dogs regularly treated with milbemycin, a close relative to ivermectin.

Most dogs are going to be on ivermectin to prevent heart worm.

I'm not sure about most, but mine is on Trifexis (spinosad + milbemycin oxime). It protects her against fleas, heartworms, hookworms, roundworms, and whipworms. I haven't seen a single flea on her the entire time I've had her, she just tested negative for heartworm at her last vet visit, and she tolerates it well.

Heartgard is pretty common. It has ivermectin (and pyrantel) and controls heartworm, hookworm, and roundworm.

I'm baffled as to why a lot of vets in the industry moved away from it to more expensive things, but I guess a lot of it depends on the pet's environment.

Thanks for the references, I came to ask that. I have a bunch of Ivermectin left over from my bout with Covid. I need to figure out what a good dosage is for my dog in case he gets infected with hookworms.

I can't tell if you're trolling, but better use the people version for people and the animal version for animals - don't cross the streams.

Out of pure curiosity, what's different (apart from dosage) between human and animal formulations of drugs?

Animals and humans can have drastically different stomach pHs.

IANAD, but I imagine there are differing levels of quality control and differing "inactive ingredients" that may behave/metabolize differently. My doggo can't eat my grapes or onions, so I'm not going to eat his kibble or Heartguard. :)

It is all in the inactive ingredients not the drug.

Most drugs are not just simply the drug.. There are all kinds of inactive things mixed in for various reasons.

If you have a prescription and you go to CVS to fill your dog's medication you are getting the exact same thing

If you go to Rural King and by a Tube of Horse Paste, you are not...

You can get material safety data sheets for all the vet drugs that list all the adjuvants.

Depends on the drug; sometimes there are chemical differences, sometimes there aren't. Presumably there are also differences with respect to quality control and regulations, at least in some countries. But in general if the drug has a single active ingredient then it should be pretty much interchangeable. In a couple of cases veterinarians have specifically advised me to buy certain antibiotics (for a sick dog) from the "people pharmacy" because it was actually cheaper than the veterinary version sold at feed stores.

In the case of ivermectin tablets, usually available in 3mg, 6mg and 12mg versions both for dogs and for humans, there is unlikely to be any difference, and where I live the price is pretty much the same too.

Pretty sure the only doses that will cure you of covid are the ones that also kill you

Didn't kill me

The current rumored dosage for covid is 0.4-0.6mg/kg, which is 2-3x the typical dosage used for treating parasites (in humans and animals). The LD50 in humans is unknown, but is estimated to be >10mg/kg. That's a remarkable safety margin.

Overdosing is not a concern of mine. Efficacy is my primary concern.

I suspect my humor went over your head, my point was that there's no peer reviewed scientific papers about its efficacy against covid, the only way it's going to practically stop your covid infection is by taking enough to kill you

A "rumored dosage" is not the same as an actual therapeutic dosage.

What dosage was used to cure or reduce symptoms of COVID based in well controlled clinical trials?

The packages likely have mass/volume or similar measurements that can be scaled. I do this for children's vs babies medicines sometimes as the markup for new parents is intense.

However there maybe other ingredients that wouldn't be good for dogs or the division of the medication might not be straight forward depending on it's form.

In order to cut a medication like this, you need a sub-gram scale (crack scale, see Amazon for that term specifically). People using those stupid syringe marking are asking for trouble.

> I need to figure out what a good dosage is for my dog in case he gets infected with hookworms.

No you don't. Your vet does.

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