The use of ivermectin for COVID-19 has been controversial. Ivermectin is a medication widely used in low- and middle-income countries to treat parasitic worm infections in adults and children. It’s been used for decades for this purpose by over 3.7 billion people, and is considered safe and effective. It has an increasing list of indications due to its antiviral and anti-inflammatory properties, and is included on the WHO’s Model List of Essential Medicines.

Alternatives to Ivermectin

The availability of ivermectin varies in different countries. If ivermectin is not available in your country, you should still proceed with early treatment e.g. FLCCC I-MASK+ protocol. The I-MASK+ protocol consists of many drugs and nutrients. If ivermectin is not available or disallowed in your country, you should still discuss with your doctor on the best available options for early treatment. Remember to start early in order to reduce the viral load. The viral will multiply on the surfaces of the throat and the back of your nose. That is where you should focus as per the I-MASK+ protocol. The FLCCC I-MASK+ protocol recommends 'mouthwashes and nasal cleansing' as part of the prevention and treatment protocols.

In the event that you simply cannot get ivermectin, there are viable alternatives. The aim of this article is to empower you with a better understanding of the options available and to discuss the options with your medical doctor.

Anti-Virals & Anti-Septics

Gargle mouthwash: 2 x daily – gargle (do not swallow) antiseptic mouthwash with cetylpyridinium chloride (e.g. Scope mouthwash™, Crest mouthwash, Colgate mouthwash) or povidone/iodine 1 % solution as alternative (e.g. Betadine® Antiseptic Sore Throat Gargle™).

Iodine Nasal Spray: Use 1 % povidone iodine commercial product as per instructions 2–3 x daily. If 1 %-product not available, must first dilute the more widely available 10 %-solution and apply 4–5 drops to each nose every 4 hours. (No more than 5 days in pregnancy.)

Nitazoxanide: 500 mg 2 x daily for 5 days after meals. Combine with ivermectin (preferred) or substitute if ivermectin is not available. (Nitazoxanide is often unavailable or high-priced in the USA.)

Betadine nasal spray (Iota Carrageenan) applied 3 times a day.

Xlear Nasal Spray with Xylitol: use twice a day.

Azithromycin 250 mg twice a day.

Quercetin and Zinc. Quercetin acting as a zinc ionophore (zinc transporter) in order for zinc to exert it's anti-viral activity within the cells.

Immune Fortifying / Supportive Therapy

Vitamin D3: 1000–3000 IU/day.

Vitamin C: 500 - 1,000 mg BID (twice daily)

Quercetin: 250 mg daily.

Zinc: 30 - 40 mg/day (elemental zinc). Zinc lozenges are preferred.

Melatonin: 6 mg before bedtime (causes drowsiness).

Curcumin: 500 mg twice a day

Dual anti-androgen Therapy

Spironolactone 100 mg 2 x daily for ten days

Dutasteride 2 mg on day 1, followed by 1 mg daily for 10 days. If dutasteride is not available, use finasteride 10 mg daily for 10 days.

Anti-Thrombotic (Anti Blood Clot)

Aspirin: 325 mg/day unless contraindicated.

Fluvoxamine (SSRI)

Fluvoxamine: 50 mg twice daily for 10 days.

Consider fluoxetine (Prozac) 30mg daily for 10 days as an alternative (it is often better tolerated).

Avoid if patient is already on an SSRI.

Monoclonal antibody therapy

Casirivimab/imdevimab: 600 mg each in a single subcutaneous injection for patients with one or more risk factors as follows: Age > 65y; obesity; pregnancy; chronic lung, heart, or kidney disease; diabetes; immunosuppressed; developmental disability; chronic tracheostomy; or tube feeding.