19-year-old who took 1200 mg of Ivermectin Survives

A 19-year-old Black African girl took 400 tablets of 3 mg ivermectin. The Journal of Medical Case Reports published her case in April 2023.

Ivermectin is used to prevent the complications of river blindness in Africa. It is caused by a worm called Onchocerca volvulus.

The disease is called river blindness because the blackfly that transmits the infection lives and breeds near fast-flowing streams and rivers, mostly near remote rural villages.

The infection can result in visual impairment and sometimes blindness.

Additionally, onchocerciasis can cause skin disease, including intense itching, rashes, or nodules under the skin.

Worldwide onchocerciasis is second only to trachoma as an infectious cause of blindness.

Source: Centers for Disease Control and Prevention

To prevent river blindness, citizens of many African countries take ivermectin once a year at a dose of 150 µg/kg of body weight.

Case Report

A 19-year-old Black female student residing in Cameroon in Central Africa had an argument with her father.

The next day, she was admitted to the hospital with a mildly altered state of consciousness after taking 400 ivermectin tablets (3 mg). The total dose is 1,200 mg.

Upon presenting to the hospital, she was conscious but felt weak, sick to her stomach, and had a headache, a spinning sensation, and visual problems.

Her vital signs (heart rate, blood pressure, temperature, and breathing rate) were normal.

On physical exam, her pupils were dilated but reactive, and she had clumsy motor movement (kinetic ataxia) and increased reflexes.

Her EKG showed no irregularities, and her blood tests for her kidneys, liver, and electrolytes were normal except for slightly low potassium due to her vomiting.

She was monitored and managed with saline-based hyper-hydration, antiulcer (omeprazole 40 mg daily) for gastritis, and paracetamol (acetaminophen) 1 gram in case of headache.

Her vertigo and weakness improved from day two to day four, but her vision remained poor. She was discharged on day four despite slight asthenia and visual impairment.

Note: It is mandatory for any patient who is thinking of committing suicide or has suicidal ideation to be seen by a psychiatrist. In case of a suicidal attempt, the patient is managed first in the medical or surgical unit and then transferred to the psychiatry department.

Pro tip: Don’t ever joke that you are thinking of hurting yourself while in a medical facility.

Back to the report, one month later, she was psychiatrically stable but presented with persistent visual disturbance.

Six months after discharge, she passed the baccalaureate examination and was admitted to the university. (I love happy endings)

She has been diagnosed with and is currently using eyeglasses for nearsightedness and farsightedness, likely present a while before the intoxication event.

In their conclusion, the authors said,

This is the first report of a poisoning with ivermectin at ~100 times the recommended dose (for river blindness prophylaxis).

This case report confirms the safety and tolerability of ivermectin, even at exceptionally high dose.

Comment:

The recommended dose for ivermectin of the Front Line COVID-19 Critical Care Alliance (FLCCC) for the early treatment of COVID-19 is 0.3 – 0.6 mg/kg for five days or until recovered.

For a typical 100 kg person (220 lbs), the ivermectin dose would be 30 to 60 mg.

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Ivermectin Related:

FLCCC Protocols

Reference:

Donfo-Azafack, C., Nana-Djeunga, H.C., Wafeu-Sadeu, G. et al. Successful management of poisoning with ivermectin (Mectizan) in the Obala health district (Centre Region, Cameroon): a case report. J Med Case Reports 17, 141 (2023). https://doi.org/10.1186/s13256-023-03891-4

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