• The South African Health Products Regulatory Authority will this week relax its approach to ivermectin – but will not allow general use.
  • Animal versions of the drug are now widely out of stock, as Covid-fearing South Africans take to dosing themselves with it, against medical advice.
  • Regulators will require exceptional circumstances, and controlled use, with medical oversight.
  • One private group says it is standing ready to roll out large quantities of a fit-for-human-consumption version of the drug, at R35 a tablet. 
  • For more stories go to www.BusinessInsider.co.za.

Guidelines for "compassionate" use of the drug ivermectin will be released this week, the South African Health Products Regulatory Authority (Saphra) announced on Wednesday – but it will still not be available over the counter.

In a highly-anticipated move, the regulator said it would soften its approach to the drug, which is not registered for human use in South Africa. But it did not okay it for general sale, as advocates and potential distributers had hoped.

Under compassionate-use rules, medical practitioners will have to apply on a case-by-case basis to give ivermectin to patients under their care. That is expected to be for symptomatic treatment of Covid-19, rather than as a prophylaxis against the disease, which is reportedly how some South Africans are using it - against medical advice.  

Read on Health24 | SAHPRA to allow for ivermectin use in Covid-19 in 'controlled, compassionate' programme

Ivermectin is widely sold as an anti-parasitic for animals, under brands such as Ivomec and Ivotan in South Africa. Under normal circumstances, a 50ml container of Ivotan 1% sells for around R150, while half a litre of Ivomec Super goes for around R1,800.

But those are widely sold out at co-operatives and animal supply wholesales after what some described as an incredible rush on their stock from people who did not appear to be farmers.

Various groups and individuals have promoted animal-use ivermectin, diluted with water and taken orally, as an anti-viral. Some have, against all medical and scientific advice, presented it as an alternative to Covid-19 vaccines – despite the fact that vaccines have been rigorously tested, while there is as of yet no large-scale data on the efficacy and safety for ivermectin use for the coronavirus.

But ivermectin is in general use for humans in some other countries, for the treatment of scabies, onchocerciasis, and other conditions caused by parasites. And several South African groups have prepared for the mass import of such drugs, marketed under the names Iverheal, Vermact, and Ivel, in anticipation of what they hoped would be an "unbanning" by regulators.

Off-label use against the coronavirus should be safe, these groups speculate, because ivermectin has been found safe when used against parasites.

One group told Business Insider South Africa it was "standing by" to sell 12mg ivermectin tablets at R350 for a sleeve of 10, with free collection at various sites across the country.

Those involved would not say whether they had stock at the ready, but promised quick and regular supplies through solid logistics channels.

Suppliers of injectable ivermectin for animals are, meanwhile, still scrambling to restock. In future it would sell ivermectin to only "verified" farmers, one co-operative said, in the interests of protecting the livestock of regulator customers.

It did not have any plan on how to prevent on-sale for human use by its farming customers.

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