INFORMED CONSENT FOR OFF-LABEL TREATMENT
Treatment generally starts with the cheapest drugs with the least side effects. At the top is ivermectin, then fluvoxamine and later we may add low dose steroids or maraviroc depending on response. If you already have recommendations based on the Incelldx blood panel (covidlonghaulers.com) we can use those for the initial regimen. Once your symptoms resolve we can stop some meds quickly and taper others like fluvoxamine over a few weeks depending on how long you have been on them.
You can learn more about ivermectin for COVID-19 here: covid19criticalcare.com
Ivermectin is a generally safe medication and has been used in millions of people around the world for over 30 years.
IVM SAFETY NOTES
According to the FDA it is allowed as an off-label drug. The main use of ivermectin in the US is for scabies and this is also an off-label indication.
IVM Interactions and safe usage notes:
Cardiovascular: Tachycardia (4%), peripheral edema (3%), facial edema (1%), orthostatic hypotension (1%)
Central nervous system: Dizziness (3%)
Gastrointestinal: Diarrhea (2%), nausea (2%)
Dermatologic: Skin rash (11%)
Gastrointestinal: Vomiting (children and adolescents: 12%; may be more common with oral solution)
Infection: Infection (55%)
Respiratory: Bronchitis (7% to 13%), cough (14%), upper respiratory tract infection (23% to 32%)
Miscellaneous: Fever (13%)
Cardiovascular: Acute myocardial infarction (< 2%), cardiac failure (< 2%), cerebrovascular accident (< 2%), coronary artery disease (< 2%), coronary occlusion (< 2%), endocarditis (< 2%), hypertension (3%), ischemic heart disease (< 2%), portal vein thrombosis (< 2%), septic shock (< 2%), unstable angina pectoris (< 2%)
Dermatologic: Acne vulgaris (3%), alopecia (2%), condyloma acuminatum (2%), erythema of skin (2%), folliculitis (4%), nail disease (6%; nail and nail bed disorder [excluding infection and infestation]), pruritus (4%), sweat gland disease (apocrine and eccrine gland disorders: 5%), tinea (4%)
Endocrine & metabolic:Lipodystrophy (3% to 4%)
Gastrointestinal: Abdominal distension (≤10%), abdominal pain (children and adolescents: 4%; may be more common with oral solution), bloating (≤10%), carcinoma in situ of esophagus (< 2%), change in appetite (8%), Clostridioides difficile colitis (< 2%), constipation (6%; may be more common with oral solution), decreased gastrointestinal motility (9%), diarrhea (children and adolescents: 4%; may be more common with oral solution), flatulence (≤10%), increased serum amylase (4%), nausea (children and adolescents: 4%; may be more common with oral solution)
Genitourinary: Ejaculatory disorder (≤3%), erectile dysfunction (≤3%), urinary tract abnormality (bladder/urethral/urinary signs and symptoms: ≤5%)
Hematologic & oncologic: Anemia (8%), basal cell carcinoma of skin (< 2%), benign skin neoplasm (3%), bone marrow depression (< 2%), carcinoma (nasopharyngeal: < 2%), cutaneous squamous cell carcinoma in situ (< 2%), hypoplastic anemia (< 2%), liver metastases (< 2%), malignant lymphoma (including diffuse large B-cell and anaplastic large cell lymphomas T- and null-cell types: < 2%), malignant neoplasm (anal: < ;2%), malignant neoplasm of the bile duct (cholangiocarcinoma: < 2%), malignant neoplasm of tongue (< 2%; malignant stage unspecified), neoplasm (< 2%; includes abdominal and unspecified malignant endocrine neoplasm), neutropenia (4% to 6%), squamous cell carcinoma (< 2%), squamous cell carcinoma of skin (< 2%)
Hepatic: Cholestatic jaundice (5 x ULN: 4%), increased serum aspartate aminotransferase (>5 x ULN: 4% to 5%), increased serum bilirubin (>2.5 x ULN: 6%), jaundice (< 2%)
Infection: Bacterial infection (6%; including treponema), herpes virus infection (7% to 8%), herpes zoster infection (≤5%), influenza (2%), meningococcal infection (3%), varicella zoster infection (≤5%), viral infection (3%)
Nervous system: Abnormal sensory symptoms (3% to 4%; includes body temperature perception disorder), anxiety (4%), depression (4%), dizziness (≤9%), dysesthesia (≤5%), epilepsy (< 2%), facial nerve paralysis (< 2%), impaired consciousness (4%), insomnia (8%), loss of consciousness (< 2%), malaise (≤4%), memory impairment (3%), meningitis (< 2%, including viral), orthostatic dizziness (≤9%), paresthesia (≤5%), peripheral neuropathy (4%), pain (≤4%), seizure (< 2%)
Neuromuscular & skeletal: Arthropathy (6% to 7%), myalgia (3%), myositis (infective: < 2%), increased creatine phosphokinase in blood specimen (4%), osteonecrosis (< 2%), rhabdomyolysis (< 2%), tremor (< 2%; excluding congenital)
Ophthalmic: Conjunctivitis (2%), eye infection (≤2%), hemianopia (< 2%), ophthalmic inflammation (≤2%), visual field defect (< 2%)
Otic: Ear disease (3%), otitis media (2%)
Respiratory: Irregular breathing (4%), lower respiratory tract infection (≤3%), nasal congestion (≤4%), paranasal sinus disease (3%), pneumonia (< 2%), pulmonary infection (≤3%), rhinitis (≤4%), sinusitis (7%), upper respiratory system symptoms (6% to 9%)
Frequency not defined:
Hepatic: Hepatitis, hepatotoxicity
Hypersensitivity: Hypersensitivity reaction
Immunologic: Immune reconstitution syndrome
Dermatologic: Stevens-Johnson syndrome, toxic epidermal necrolysis
Immunologic: Drug rash with eosinophilia and systemic symptoms
FLUVOXAMINE (FLV) 50mg for COVID-19
Based on data compiled by various physicians around the world we believe HCQ is effective at preventing and treating COVID19 in early stages and can be safely used off-label in humans for this indication. One of the most convincing sources of proof of its efficacy is the largest natural observational drug trial ever conducted totaling about 2.5 billion people: https://hcqtrial.com/ The most comprehensive meta analysis of worldwide studies confirms the results: hcqmeta.com
LOW DOSE STEROIDS
Dr. Mobeen Syed’s protocol for preventing long COVID, which he has also used to treat long COVID, it is cheap, easy and low risk:
Others like Dr. Bruce Patterson are combining this with ivermectin and other treatments. Sometimes continuing for 2-4 weeks instead of 6 days.
The COLCORONA trial showed colchicine is effective at preventing progression to severe COVID-19. There has also been extensive experience using this for long COVID in India by Dr. Darrell Dimello, with effects usually within days to weeks.
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