Joint message from CPSA and ACP regarding inappropriate prescribing and dispensing of ivermectin to treat or prevent COVID-19
September 22, 2021
The College of Physicians and Surgeons of Alberta (CPSA) and the Alberta College of Pharmacy (ACP) have both received reports about the prescribing and dispensing of ivermectin to treat or prevent COVID-19.
In their advisory issued on August 31, 2021, Health Canada stated that ivermectin is not authorized to prevent or treat COVID-19. Included in the advisory is the following statement:
In this light, Health Canada is advising Canadians not to use either the veterinary or human drug versions of ivermectin to prevent or treat COVID-19. There is no evidence that ivermectin in either formulation is safe or effective when used for those purposes. The human version of ivermectin is authorized for sale in Canada only for the treatment of parasitic worm infections in people.
Vaccination remains the recommended best option to prevent COVID-19, its spread, and the negative outcomes associated with it. This is important to individuals, families, our communities, and our health system.
CPSA and ACP are very concerned about a small number of physicians and pharmacists who are spreading misinformation related to the appropriateness of ivermectin to prevent or treat COVID-19. There is no evidence that prescribing and dispensing ivermectin is beneficial but there is certainly significant risk of patient harm when ivermectin is used in the prevention and treatment of COVID-19. CPSA and ACP do not believe these behaviours align with a physician’s or pharmacist’s professional responsibility to their patients.
During the pandemic, it’s natural for patients to seek treatments they feel might be helpful. However, it is important for all health practitioners to remember the importance of evidence-based care when prescribing.
CPSA’s expectations for off-label and unapproved use of an otherwise approved drug can be found in the Practising Outside of Established Conventional Medicine standard of practice, which states that:
- a regulated member must offer a conventional medical approach before offering any therapy outside of conventional medicine; and
- a regulated member who offers a therapy that is outside of conventional medicine must practice in a manner that is informed by current best-available medical evidence and upholds their professional, ethical, and legal obligations.
ACP expects all pharmacy professionals to practise within the Standards of Practice for Pharmacists and Pharmacy Technicians, specifically the following standards:
- standard 6.2, which before dispensing requires the pharmacist to consider if the indication “is approved by Health Canada, considered best practice or accepted clinical practice in peer reviewed literature or is part of an approved research protocol;” and
- standard 11.10, which states: “A pharmacist who prescribes a medication must not prescribe a drug or blood product unless the intended use is an indication approved by Health Canada, is considered a best practice or accepted clinical practice in peer-reviewed clinical literature, or is part of an approved research protocol.”
In considering these standards and how they relate to the use of ivermectin for the prevention and treatment of COVID-19, CPSA and ACP direct all physicians and pharmacy professionals to adhere to the Health Canada advisory about ivermectin. Ivermectin must not be prescribed or dispensed, in any form, for the prevention or treatment of COVID-19.
CPSA and ACP recognize and appreciate your extraordinary efforts during the pandemic. Your effort to enhance immunization uptake is critical to the health and wellbeing of your communities.